Avoiding Unnecessary ER Visits Provides Win-Win Savings for Companies and Employees
Unnecessary ER visits for minor conditions – sore throats, urinary tract infections, colds, earaches, minor cuts and muscle strains – are costly, time consuming and result in increased healthcare costs for everyone. It is estimated that 13.7% to 27.1% of all emergency room care could take place at an urgent care or other alternative treatment center, potentially generating $4.4 billion in annual healthcare cost savings.
Saving money, being seen quickly and not having to take extra time off work are some of the benefits for employees who choose these alternatives over Emergency Room visits. How can employers encourage their employees to make better decisions?
Education is the key! Most employees “vote with their wallets.” Simply educating employees about their choices can significantly reduce unnecessary emergency room visits. In one study, 40 percent of employees surveyed had never used, or were unfamiliar with, Urgent Care. Employers can help by making sure employees know ahead of time about:
- The cost of Urgent Care vs. Emergency Room
- The in-network Convenient and Urgent Care centers located near home and work
- The business hours of Convenient and Urgent Care centers located near home and work
- The ease of obtaining a prescription from a Telehealth or Convenient Care visit
Telehealth from Teladoc and Doc On Demand
Typical Total Cost: $40-$60
Typical Cost to Insured Patient: $0-$25
Online doctor visits from companies like Teladoc and Doc on Demand are available 24-hours, 7 days a week to anyone with a smart phone. Most carriers such as Aetna, Humana and United Healthcare include these features at no extra cost to insured employer groups. These doctors can quickly call in prescriptions for many common ailments. Employers can choose to charge employees nothing or the primary care visit copayment. Employees enrolled in an HSA-type plan must pay the full cost of the visit in some cases.
Convenient Care Clinic
Typical Total Cost: $75-$100
Typical Cost to Insured Patient: $25
Convenient Care Clinics are walk-in clinics set up inside larger retail stores such as Target and Walgreens. They are staffed by nurse practitioners and physician’s assistants who diagnose and treat a range of minor illnesses and injuries that do not require emergency care – such as cold and flu symptoms, strep throat, rashes and other low-level health needs. They are highly convenient and usually can see patients very quickly, saving patients valuable wait time. Most are only open until 6 pm 6 days per week.
Urgent Care Clinic
Typical Total Cost: $100-$200
Typical Cost to Insured Patient: $60-$75
Urgent care clinics are a step above convenient care clinics and are set up to help patients with conditions that are not life-threatening but cannot wait for a primary care appointment. These include things like broken bones, burns and cuts requiring stitches. They have physicians on staff who can provide a higher level of care and more sophisticated diagnostic services such as x-rays and lab services. If emergency services are needed, they can arrange to transfer patients directly to an Emergency Room for further treatment. Most are open until 8 pm 7 days per week.
Typical Total Cost: $300-$1,200
Typical Insured Patient Cost: $250-$500
Emergency rooms specialize in life-threatening conditions and injuries that require more advanced technology and medical personnel. These facilities are fully equipped to handle any kind of illness or injury that walks through the door. This includes chest pain, head injuries, bleeding that isn’t controlled with pressure, loss of consciousness or severe breathing difficulties. They are required by law to accept all patients, regardless of their ability to pay. Because of this and other factors, ER wait times can be several hours and the average cost is much higher than a Convenient Care clinic or Urgent Care center.
It is crucial that if someone is encountering a true life threatening emergency, they call 911 or get to the emergency room immediately. However, when someone needs medical care, but it’s not life threatening, lower level care services can be smart alternatives to an emergency room visit. Making sure employees understand all their options will save them time, hassle and money and control healthcare costs for everyone. Let Arista help you design a custom communication strategy for your employees.
Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Deciding to Visit the Emergency Department for Non-Urgent Conditions: A Systematic Review of the Literature. The American journal of managed care. 2013;19(1):47-59.
Mehrotra, A., Liu, H., Adams, J., et. al. “Comparing Costs and Quality of Care at Retail Clinics with That of Other Medical Settings for 3 Common Illnesses.” Annals of Internal Medicine. September 2009.
Weinick, R. M., Burns., R. M., and Mehrotra, A. “Many Emergency Department Visits Could Be Managed At Urgent Care Centers and Retail Clinics.” Health Affairs. September 2010.