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4 Ways to Guide Employees to Better Healthcare Options

August 12, 2019

“Do you accept this insurance?”

“What is my copay?”

Most employees know enough about their own health plan to ask these questions at a doctor’s office or when scheduling an appointment. They know to avoid clinics that do not accept their plan. They also understand that they may be responsible for a portion of the charges – regardless of their insurance.  

What employees may not understand? That they have a lot more control over healthcare costs than they realize. Employees who are savvy healthcare consumers can reduce their spending and improve their own satisfaction with their health plan, all while mitigating costs for their employers.

This is important for a number of reasons. First, the Kaiser Family Foundation/Health Research & Education Trust 2018 Employer Health Benefits Survey shows that the cost for employer-sponsored family health coverage has now reached $19,616 – up 5% over 2017 and 55% since 2008. That means premiums have risen twice as fast as wages and three times as fast as inflation – and it’s a big chunk out of the bottom line.

Moreover, employers are passing more and more costs along to their workers. For family coverage, employees now pay an average $5,547 toward their plan – and this doesn’t include other out-of-pocket expenses including deductibles, copayments or coinsurance. Deductibles alone have increased a staggering 212 percent in the last 10 years.

Clearly, health insurance is a considerable expense for businesses and employees alike. Beyond the financial impact, it’s also an area that leaves many people feeling powerless.

How can employees take back control of their spending, become prudent healthcare consumers and rein in unnecessary expenses? Employers can help their staff make better healthcare decisions.

1.      Help employees ask the right questions. Instead of asking, “Do you take this insurance?” employees should ask, “Are you an in-network contracted provider?” Most health providers will accept all major insurance plans, but the key is whether the provider, health system, clinic or lab is in-network. This tiny distinction can make a big difference in costs.

2.      Educate staff on seeking the right location for care. When it comes to managing costs, the place of service has the single largest impact on healthcare spending. For example, a visit to a hospital emergency department averages around $2,000 or more, but the majority of people who seek care at an ER are in the wrong place. They need a primary care provider to treat a respiratory infection, or a telehealth visit to address a urinary tract infection. When employees understand they can control their own out-of-pocket costs by seeking the right level of care, they will make better healthcare decisions. This, in turn, impacts employers’ healthcare expenses.

3.      Help employees understand the factors that drive up prescription costs. Most people know that generic is cheaper than brand-name, but there are many other variables that affect the cost of prescriptions, too. Consider that a simple antibiotic may cost $40 at a drug store pharmacy – but just $10 at a supermarket or big box store. Savvy healthcare consumers will not pay four times more money for an identical prescription.

Amid skyrocketing costs of specialty prescriptions, fewer generic options and a growing number of prescription-dependent employees, choosing the right pharmacy is more important than ever. Lovitt & Touché has resources to help employees and businesses cut unnecessary pharmacy-related costs.

4.      Give employees the tools they need to understand the cost of care. Employers can play a big role in helping their staff make informed decisions – and people are hungry for the information.

An employee who knows that telehealth is drastically less expensive (with outcomes that are just as good) will choose this option when seeking care for a routine health concern. Likewise, a tool like Good RX shows employees the best price for their prescription – and where to get it. And, apps like HealthJoy direct workers to the appropriate place of care, guiding them to a primary care doctor or telehealth service when appropriate – instead of a high-priced urgent care or emergency room visit.

The healthcare system can be complicated and confusing for businesses and employees alike. But with these simple and effective tips, employees can save considerable money on their own healthcare expenses – and save their employer money, too.

To discover more opportunities to maximize your health plan while preserving the bottom line, learn more about Lovitt & Touché’s employee benefits services.