It’s a weekend, and one of your employees just turned her ankle while doing yard work. It feels like a bad sprain, but she doesn’t know for sure. Where will she go for care? Will she call her doctor? Head straight to the emergency room? Try a local urgent care center? Call her mom?
The Cost of Care
When your employees need urgent or emergent medical treatment, the cost of care is probably the furthest thing from their minds. But the fact is, how much an employee (and the plan) pays for medical services can vary greatly depending upon where he or she seeks care.
A recent study by the Agency for Healthcare Research and Quality* examined the national average retail cost of care provided in emergency rooms and physician office visits. Not surprisingly, the study found that the average cost of an emergency room visit is nearly five times the cost of an office visit with a primary care doctor*. Urgent care centers offer a middle-of-the road alternative — less than a trip to the ER, but more than an average office visit. The table below illustrates just how much the cost can vary, depending upon where a participant seeks care.
|
Emergency Room |
Doctor’s Office Visit |
Potential Savings |
| Average Cost Of Care |
$560 |
$121 |
$439 |
| Median Cost Of Care |
$299 |
$63 |
$236 |
*Note to reviewers: The average cost of care in an ER is skewed by extreme results on both ends of the spectrum. In other words, the lowest cost revealed in the study for an ER visit was only $42, while the highest cost was for an ER visit that involved surgery, which totaled $1,246.
Helping Employees Choose the Best Course of Action
If an employee is not sure whether or not his situation is an emergency, he should call his doctor first to determine the best course of action. Perhaps waiting to see his doctor is the most appropriate solution: your employee will be are treated by someone who knows his medical history, and it costs the least of the options available.
All too often, people go directly to the emergency room because it offers the convenience of round-the-clock care, seven days a week. But it may not always be the best solution. For example, if your employee’s situation is not a true emergency, she may be in for a long wait before she can be treated. It is also the most expensive of the options available. If your employee can’t wait to see her doctor and it is not an emergency, an urgent care center may be a good alternative. Some conditions that are appropriately treated in an urgent care center include earaches, minor cuts where bleeding is controlled, sprains, skin rashes, as well as colds, coughs, and sore throats.
On the other hand, some medical situations are true emergencies, and a trip to the ER is not only appropriate, but necessary. These include life-threatening situations such as heart attack, coughing or vomiting blood, poisoning, or severe shortness of breath, to name just a few.
When your employee becomes ill or injured, clearly the most important thing is for him or her to seek treatment. But educating employees about their options, and the associated costs, may give them the information they need to make the best decision for their situation. A little information can go a long way toward ensuring your employees receive the best possible care in the most appropriate setting, at the most cost-effective price.
Emergency room and office visit data is extracted from Expenses for a Hospital Emergency Room Visit, 2003, Statistical Brief #111, January 2006 by S.R. Machlin. Agency for Healthcare Research and Quality.
