One in five Americans will visit the Emergency Room (ER) at least once a year. Between one-third and one-half of all ER visits are for non-urgent matters.
Many conditions can be treated at Urgent Care centers. A recent review of the top 100 diagnosis codes from a self-insured employer revealed that 83 percent of them were in the top 100 diagnoses seen at a nearby urgent care center.
Unnecessary and inappropriate use of the ER causes multiple systemic issues and wastes scarce resources. The average cost for an ER visit is $1400 — compared to $125 for an urgent care visit.
Chronic conditions — which affect 45 percent of Americans — account for 75 percent of health care expenditures in the US. Diabetes, heart disease, asthma, and other chronic illnesses are also responsible for a large portion of ER visits. Asthma alone precipitated 1.8 million ER visits in 2004. The ER visits resulting from unmanaged chronic conditions are avoidable. Proactive disease management, effective patient and caregiver education and simple lifestyle changes, can reduce ER usage for this group by up to 69%.
Appropriate use of the ER could save the U.S. healthcare system more than $18 billion a year. Patients with avoidable or non-urgent conditions who use urgent care centers, primary care physicians, or a telemedicine service can contribute significantly to creating a sustainable healthcare system.
How do you divert your employees to Urgent Care or Telemedicine?
An effective ER diversion program begins and ends with employee education. If you, as an employer, are serious about reducing your health care spend you need to think about the following;
Education Campaigns: Educational messaging creates an awareness of cost consciousness, reinforcing how to use urgent care, emergency room care, telemedicine and primary care. Campaigns leverage long-standing trusted relationships in order to have the greatest impact in changing the behavior of inappropriate ER use. If you partner with a Telemedicine service make sure your employees know how to use this benefit – provide examples, maybe a wallet-sized card with the 1-800 number, a list of appropriate ailments etc. Provide an online map to the nearest Urgent Care.
Member Engagement through Incentives: It may take the use of incentives to encourage members to change their behavior about the correct use of the ER. To reinforce behavior change, a great way to keep people engaged is to provide incentives to employees who seek appropriate care, including gift cards, coupons, and vouchers for dining, entertainment, and other goods and services.
The use of good data is the key to success.
It is essential to use Data to define the Initiatives: Use data analytics to establish a baseline reading of ER, Urgent Care, Telemedicine and primary care use. This information guides initiatives revealing the hotspots for intervention. Your data analytics should measure the impact of initiatives and allow for adjustments as needed. Use claims analysis to alert employees about a previous ER visit and show them the financial advantage of that visit when compared to using Urgent Care or Telemedicine. The employee will be forever grateful – particularly if they are responsible for large ‘out of pocket’ costs.
Take the time to explain all the benefits to your employees
Employees who manage their health and seek Urgent Care treatment instead of ER services (when appropriate) can expect to enjoy several benefits:
· Save Time: The average wait time in urgent care centers is a door through door time of 45 minutes. Walk-in patients receive high-quality treatment quickly and efficiently. Very often issues can be addressed via Telemedicine in less than 10 minutes.
· Save Money: Compare the $140 price tag of an urgent care visit to the $1400 price tag of the average ER visit. Even if a member’s insurance covers these costs completely, members learn that inappropriate use of the ER drives up the cost of healthcare and inevitably the consumer will pay for it. Employers are known to cover the cost of a Telemedicine consult 100%.
· Reduce stress: Using an urgent care center when an illness or injury strike relieves the stress of handling an unscheduled crisis. When families have easy access to affordable, high-quality and convenient care when they need it, they go home happier and satisfied.
The Obeo Health Organizer module can help you reduce your ER costs – take a test drive of this module today.