Controlling Employee Benefits Cost By Knowing Where to Receive Care
The rising cost of healthcare is a major concern for employers and employees alike. Hospital spending, physician services, and prescription drugs are the three main contributors to these costs. By understanding which medical care options to choose and when, it is possible to reduce and manage these expenses.
Hospital Spending is projected to grow at an average annual rate of 5.7%, Physician and Clinical Services at 5.6%, and Retail Prescription Drugs at 5.0% (Average annual increase through 2030) [1].
Managing costs is essential given the projected growth of each of these areas through 2030. Fortunately, optimizing different care options can help organizations and their employees control healthcare spending.
How? Leverage Lower-Cost Sites of Care
Using the ER for non-life-threatening emergencies is one of the most expensive ways to receive care. Alternatives such as urgent care facilities and telemedicine can offer lower costs for certain treatments due to their lower overhead costs.
Knowing which care option is best for your needs can help you control spending. By knowing which services to have performed where, you can help keep costs down.
1. Urgent care facilities, walk-in clinics & telemedicine
Urgent care facilities, walk-in clinics, and telemedicine can help provide cost-effective, convenient access to medical care for non-life-threatening symptoms such as eye/ear infections, colds, flu, congestion, fever, allergies, bug bites, skin rashes, flu shots, sprains/strains, vomiting, diarrhea, stomach pain, painful urination, annual physicals, and vaccines. On average, an ER visit can cost $1,400, whereas a trip to an urgent care facility for the same treatment may only cost about $100-150.
Expand Telehealth for a Broader Range of Health Services
By expanding telehealth offerings, employers and employees can receive cost-effective and convenient access to a broad range of health services, including mental health, behavioral care, primary care, and emergency services, potentially saving up to $3,600 per employee in lost productivity due to off-site doctor appointments, and almost 50 percent over a traditional in-person appointment.
2. Imaging centers
Diagnostic imaging, including MRIs, x-rays, CT scans, ultrasounds, and mammograms, is often significantly more affordable at an imaging center than at a hospital – up to 75% less.
3. Infusion centers
Specialty drug treatments can be administered through injection or intravenous (IV) therapy. Visiting a specialty medication center instead of a hospital can save patients up to 50% on the cost of these drugs.
4. Ambulatory surgical centers
Ambulatory surgery centers can lower costs for certain non-complex, outpatient hospital procedures, such as routine colonoscopies, hysterectomies, and musculoskeletal procedures, by 59%.
5. Hospital ER
Life-threatening medical conditions that may require quick or complex surgery include: chest pain, difficulty breathing, stroke, fainting, burns, head trauma or concussion, eye injury, seizure, bleeding due to pregnancy, etc.
Communicate Navigation and Concierge Services
It is essential to communicate the value that health navigators or concierge services, which are often included in employer health plans, offer during the whole year when medical care is needed. Health navigators can help members make better decisions about their care, such as suggesting a free-standing imaging clinic for an MRI instead of a hospital, when seeking the most cost-effective and optimal level of care. By intervening before a service or prescription is ordered or a claim is filed, members can save money and ensure they are receiving the best care.
Reach out to us now to discover how our Benefits team can assist you in controlling increasing healthcare expenses.
[1] CMS.gov
This material has been prepared for informational purposes only. BRP Group, Inc. and its affiliates, do not provide tax, legal or accounting advice. Please consult with your own tax, legal or accounting professionals before engaging in any transaction.