Weighing the Cost of Healthcare and Value-Based Choices

As individuals increasingly share the cost of health care they receive, consumerism in healthcare is on the rise. No longer are patients willing to wait for bills to arrive in the mail to find out what their financial responsibility is for an office visit or medical procedure—they are seeking upfront pricing and greater control over their out-of-pocket costs.

Where is the information to help them get the best value when they need to see a doctor? The first step in becoming an informed healthcare consumer is planning ahead. When patients understand their benefit plan, payment responsibilities, and the healthcare options available to them at work and in their community, they are well on their way to being a savvy decision-maker and proactive manager of their health.

Understanding How to Lower the Cost of Healthcare

Medical home at work

A great starting place for any non-emergency health issue is a worksite health center, as we provide for our clients. Onsite health centers are staffed with highly trained, experienced, compassionate medical providers whose primary mission is to help employees maintain and improve their health so that they can thrive at work and in their lives.

Community-based care

If employees haven’t already established a relationship with a Primary Care Provider (PCP) or a specialist in their community, they will likely need to do so at some point. Selecting a community-based provider should not be a stressful process!

Employees should begin by considering their wants and needs and collecting information to help them answer questions such as:

• What type of provider do I need?
• Which providers are in network on my insurance plan?
• How do I define “quality care”? What are the most important qualities to me in a provider?
• If my family members will be using the same practice or providers, what are their needs?

Emergency care

Unfortunately, employees don’t always have the luxury of time and choice when they need care–emergencies happen! Planning ahead for health issues that may occur after hours or on weekends can reduce anxiety and save them both time and money.

Most people are aware of the availability of Urgent Care facilities and Emergency Departments for after-hours care. However, they may not understand the differences between these options and the impact their choice will have on cost, care and their experience. Here are a few differences:

• Emergency Departments are typically open 24 hours a day, and are intended for potentially life-threatening emergencies, such as chest pain or heart attack, severe respiratory distress from asthma, traumatic injuries, and other serious impairments. Emergency Departments are staffed and resourced to stabilize patients and provide the interventions necessary to sustain lives. Patients are not seen on a first-come, first-serve basis, but rather triaged based on the severity of their condition.
• Urgent Care Centers are typically stand-alone facilities with extended hours that are equipped to provide treatment for non-life-threatening conditions which still require immediate attention. Examples might include small lacerations, dehydration, sprains, strains and possible fractures.

Most health plans include urgent care centers in their networks and require a co-pay of anywhere from $30-100 and possibly additional charges for treatment. Co-pays for Emergency Rooms can be as much as ten times more, and generally include a facility fee that employees may also be responsible for paying, depending on their insurance plan.

A proactive approach in weighing the cost healthcare will result in more money in employees’ paychecks, better financial outcomes for their organizations, and a more efficient healthcare system for all Americans.

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