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How to Help Employees Find Appropriate Health Care

Posted by Katie Holahan on Dec 11, 2018 3:10:01 PM

A coalition of employers led by AIM and the Massachusetts Taxpayers Foundation today unveiled resources to help employers speak to workers about the benefits of receiving medical care outside of hospital emergency rooms.

ER.2018The Massachusetts Employer Health Coalition plans to work with employers, employees, doctors, hospitals, and health insurers to reduce inappropriate use of emergency departments by 20 percent in two years. State officials estimate that a significant number of ED visits are potentially avoidable, a pattern that costs $300-$350 million annually for commercially insured members.

At a kickoff breakfast in Boston, Coalition officials previewed sample social media posts, newsletter articles and posters that employers might use to help employees obtain “the right care, in the right place at the right price at the right time.” Also among the resources is a document called “My Care, My Options” that allows workers to identify alternatives to emergency rooms, including their primary care physician, urgent-care center and retail clinic.

The Massachusetts Health Policy Commission says that one out of three Massachusetts residents who get health insurance through their employers reported that their last visit to an emergency room was for a non-emergency condition. The most common non-emergency conditions for which people seek treatment in the ER were neck pain, hives, sciatica, sinus infections and bronchitis.

Download the Employer Resources

Almost three-quarters of non-emergency visits to the ER are for care needed outside the normal operating house at the doctor’s office. The average visit to an emergency room costs $1,220, while the average bill for treatment at a doctor’s office is $165.

Companies such as AIM member Cummings Properties of Woburn have successfully worked with their employees for many years to create a system in which 80 percent of all medical care is delivered by high-quality community health organizations.

Bill Grant, CFO of Cummings, an AIM director and chair of the association's Health Care Committee, said the company also offers a wellness program that identifies issues such as high cholesterol that need additional attention.

But employers also acknowledge the challenge of communicating the importance of seeking care in appropriate settings.

“For us, it’s about communicating the value proposition for the individual employee…what’s in it for them,” said Lisa Collentro, Chief Administrative Officer, Chestnut Hill Realty another AIM member.

Employer coalitions in other areas of the country have already made progress curbing unnecessary use of emergency departments. Louise Probst, Executive Director of a regional health improvement collaborative serving the state of Missouri, and the St. Louis Area Business Health Coalition, told 150 people at this morning’s coalition kickoff that her organizations saw a 5 percent decrease in emergency-room visits from 2016 to 2017.

“There was a lot of shared interest” among employers, physicians, insurers, hospitals and others seeking to control the cost of health insurance, she said.

The St. Louis effort is paying measurable dividends,” Probst said:

  • Employers are talking about their emergency department usage rates and avoidable visits.
  • New worksite clinics are emerging, and roles of established clinics being reconsidered.
  • Primary care physicians are working with patients to develop alternatives to ER visits. Some medical groups have implemented condition-specific action plans for chronic diseases such as urinary tract infections or chronic obstructive pulmonary disease.
  • Two orthopedic practices have walk-in hours each evening.

The Employer Health Coalition is made up of 22 business organizations and five “strategic partners’ from the health-care industry.

Topics: Controlling Health Care Costs, Health Insurance, Health Care Costs

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