“Location, location, location” is an adage typically used when buying a home, but the same principle also can apply to healthcare.
After all, where employees receive care could impact your healthcare spending.
Take emergency care, for example. Both urgent care facilities and emergency rooms (ERs) have evening and weekend hours for care that needs to be addressed right away. But knowing when to go to an urgent care instead of an ER could generate significant savings: Claims data over the past year from Capital Blue Cross shows the average cost of an ER visit was 16 times higher than a visit to the urgent care.
Surgery is another example.
When choosing a facility for orthopedic surgeries and other routine procedures, some patients have the choice between an in-network ambulatory surgery center (ASC) and a hospital out-patient setting. While both options can provide quality care, ASCs typically operate with fewer overhead costs than hospitals, which translates into lower costs for patients.
In some markets, high-priced infusion therapy drugs – which treat chronic conditions like arthritis, heart disease, or cancer – are now being administered at a patient’s home for less money without sacrificing outcomes. One study found at-home infusion therapy cost an average of $1,700 to $3,500 per treatment, compared to $5,500 to $11,500 at a hospital.
Helping employees understand their best options for care – whether it is for surgery, emergency care, or medication – has the potential to reduce costs for both employers and their employees.
Empowering employee decision-making
Empowering employees to make informed decisions can be an effective approach to reining in healthcare costs. Two of the most impactful ways are health plan design and education.
Consider a company that offers a high-deductible health plan paired with a Health Savings Account (HSA). Because employees pay out of pocket until they meet their deductible and contribute additional money through an HSA, it incentivizes them to track their health spending and seek lower-cost, high-quality care.
They’ll need to be educated on the best ways to save. That’s where health literacy programs from trusted partners like Capital Blue Cross can help.
Capital offers health education presentations to employer groups that include topics such as “Choosing the Best Place for Care.”
No place like home
Dr. Jeremy Wigginton, Chief Medical Officer at Capital Blue Cross, says one trend to keep an eye on is the increase of healthcare services from home. The growing use of telehealth is one obvious example, but so is the emergence of “hospital at home” programs.
“For many health services, we should get in the habit of asking our provider ‘can we do that at home?’” said Dr. Wigginton, who cites this potential outcome:
Jane is taking an oral antibiotic for an infection, but the medication isn’t eliminating the infection. Jane’s doctor decides to prescribe an IV antibiotic. Because of the local health system’s ‘hospital from home’ program, Jane can receive the IV antibiotic at home. A nurse brings the equipment to Jane’s home and administers it. Having this service at home is less complicated and produces the same high-quality outcome at a fraction of the cost.