As employers are frustrated and struggling with high health care costs, they're seeking new and creative ways to offer their plan members access to affordable health care.
Data suggests that employers may be able to lower their health care spending by encouraging patients to utilize alternative health care centers. A study done in Minnesota completed in 2007 found that the median cost for treating three common illnesses (otitis media, pharyngitis, or urinary tract infection) during the 2005-2006 time period was $110 at a retail clinic, $156 at urgent care, $160 at a physician's office, and $570 in emergency departments.
A Texas-based study completed ten years after the Minnesota study found an even larger gap between emergency departments and retail health care centers. The average cost in 2015 of an urgent care visit was $168, while the average hospital ED visit was $1,842. The costs of care at retail clinics remained stable during that time period, while treatments completed in the ED continued to rise.
In 2018, a study found that between 2008 and 2015, the cost of an average retail clinic visit rose $1, while the cost of an urgent care visit declined by $3. In the same time period, the cost of an ED visit rose $723.
A PNC Healthcare white paper revealed the percentages of various groups who had visited a retail clinic in the 12 months prior to the survey:
Millenials - 34%
Gen-Xers - 28%
Baby Boomers - 17%
Older generations - 15%
When patients access an urgent care or retail clinic rather an ED or a physicians office, their health care spending is likely to decrease while getting similar results. Employers should ensure that their employees know that clinics and urgent care facilities are covered and are widely available in certain areas. Of course, there are circumstances where it's necessary to make a hospital visit or head to the emergency room. In order for employers to utilize this advantage correctly, it's important that they explain to their employees and offer examples of difference illnesses that can be taken care of at specific facilities. If applicable, employers should also mention that their health plans incentivize use of these facilities over the ED through lower copayments or other versions of cost sharing.
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