When the ER Is Not the Answer

 

By Cameron Wilk, Product Portfolio Analyst

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Nobody ever wants to find themselves in the emergency room. The waiting, the discomfort, the anxiety, and certainly the cost combine to make it a difficult experience. The ER has an important role in our healthcare system, but it really should be a last resort.
 
In fact, part of why ER visits are so expensive is a reflection of their intended use -- emergencies. They are staffed and operational 24 hours a day, year-round, and stand ready for anything that comes through the door. It is in our best interest to limit the unnecessary ER visits that weigh so heavily on healthcare spending and promote the utilization of other less expensive options to access care.
 
Yet, for a variety of reasons many employees continue to look at ERs as their first resort in accessing care, jacking up their own costs as well as the employer’s.
 

 

Primary Care Physicians

 
The truth is unless most of your employees are seeing a primary care physician on a regular basis, only a limited amount of progress can be made in this effort. Primary care is a prerequisite for any attempt to control ER costs.
 
A primary care physician is like a no-wrong-door resource for an individual. He or she serves as an entry point whenever something doesn’t feel right. From treating colds or managing chronic illness to ordering tests and recommending specialists, a primary care physician helps the patient navigate his or her health options within the context of long-term diet and exercise habits, family medical history, and countless other factors that inform a complete picture of health.
 
It’s difficult to overstate the value of a primary care physician in any individual’s continuum of care. Multiple studies show that individuals with a designated primary care physician spend much less time in emergency rooms and experience better outcomes in general. 
 

Urgent Care, Retail Clinics, and TeleMedicine

 
Beyond emphasizing the importance of having a primary care physician, informing employees about emergency room alternatives is a step worth taking. It would be a mistake to assume everyone in your workforce knows the difference between a condition that calls for a visit to the ER and one that can be addressed through a visit to an urgent care or retail clinic or electronically via telemedicine.
 
For a long time, a primary cause of improper ER utilization was a lack of access to medical advice outside working hours. Today, there are a number of options. While urgent care, retail clinics and telemedicine remain underutilized, they are effective options in the right context.
 
Urgent care centers are staffed and equipped to treat time-sensitive medical issues that fall short of life threatening. Ailments including broken bones, vomiting, flu and fevers can be properly treated at an urgent care center with only a fraction of the cost that would be incurred at an ER.
 
Retail clinics, such as Walgreens and CVS, are a cost-effective alternative to ER or doctor’s office visits in many situations and much more accessible. These clinics offer little waiting for minor conditions such as sprains or infections, and are also effective sources of preventive care, such as immunizations. Many people enjoy the convenience and relative low cost of retail clinics, plus the ability to have a prescription filled while they are at the location.
 
Telemedicine services are increasing in popularity in the United States, with 24-hour remote access to basic primary care services remotely. The ease of access means patients can fit consultation services around their work and home schedules. Telemedicine services can be useful for basic consultations, expert recommendations, and minor treatments and can cost much less than other alternative delivery options.
 
Ultimately, as an employer, you want your employees to be smart consumers of healthcare and able to choose which option is most appropriate to their situation. Taking the time to highlight for employees the extent to which lower-cost alternatives are included in your coverage plans, and how to best utilize each option, is a step worth taking.
 
 
 
 

Posted: 11/15/2016 8:13:24 AM
Filed under: ER, Retail Clinics, Telehealth, Urgent Care
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