Needless emergency room visits are a scourge on health care budgets, and contribute immeasurably to employer health plan costs. Between 2012 and 2016, the average cost of an outpatient trip to the ER rose by 31 percent, to more than $1,900 per visit, according to a recent report from the Health Care Cost Institute. Routing even a fraction of these minor medical issues and ailments to more appropriate levels of care can potentially save employers millions.
Kadalyst, a leading provider of employee wellness solutions, has published a tool to help employers reduce the number of ER visits, while improving the overall standard of care employees receive. The results are improved profitability, more affordable health care plans, and less expense and waiting time for employees and their families.
A recent study from Anthem found that out of some 2.1 million members, 82 percent had an ER visit that was not medically necessary or called for. About 5 percent of these employees had actually done so three times or more. And the Massachusetts Health Policy Commission found that one out of three plan members in the state had made an ER visit for a non-emergency – usually because the condition arose outside of normal business hours or because they couldn’t get a primary care physician appointment in a reasonable time.
For some reason, these individuals were bypassing several more appropriate levels of care to go straight to the ER.
“We noticed that while the average ER visit costs nearly $2,000 even for very minor issues, the average urgent care visit cost less than $150, and telemedicine visits cost around $40. said Benjamin Prinzing, CEO of Kadalyst. “Even diverting a small percentage of these unnecessary ER trips to a more appropriate level of care can quickly save money in direct health care utilization costs,” he said.
The company developed an easy-to-read poster, designed for work areas and break areas, around the theme “It’s your plan, too.” The idea: “When employees are smart about health care utilization, they are soon rewarded in reduced health insurance premiums, which are readily passed on to employees,” said Prinzing.
The poster helps guide employees to make the most appropriate health care decisions for their level of medical emergency, while still encouraging those with potentially life-threatening conditions to call 9-1-1 or go straight to the ER.
Companies can customize the poster by writing in their own plan information.
“We also recommend our employers make a 1-800 nursing hotline available to plan members, 24/7,” said Prinzing. Many insurance companies already offer this to plan members.
The poster makes it easy for employees to see that their health plans cover a variety of options short of the ER, including retail health clinics, urgent care centers, telemedicine and free “ask-a-nurse” hotlines, any one of which can save hundreds and even thousands of dollars compared to an ER visit, while actually getting care to the patient even faster than they can get it by going to the ER.
In addition to the poster, Kadalyst developed a sample newsletter article that can quickly be included in an employee newsletter or office circular or envelope stuffer.
Benjamin, Kerwynn and Adam Prinzing founded Kadalyst shortly after Darrell, a friend and co-worker of Benjamin’s, died as a result of heart failure at the age of 39.
The “D” in Kadalyst is in memory of Darrell, who continues to inspire Kadalyst to help employers foster health and wellness among their employees and their families – saving thousands of dollars in long-term health expenditures in the process.
Kadalyst focuses on helping employers save money and improve productivity and engagement levels through the successful implementation and communication of best-in-class workplace wellness programs.