Whether buying a car or purchasing groceries, consumers look to get the best deal possible. However, when purchasing health care, they often fail to do the same.
“Health care can be very expensive, and people need to understand how to be better consumers,” says Michele Hanzak, Employee Benefits account executive, team leader, Zito Insurance Agency, a Division of Risk Strategies.
Smart Business spoke with Hanzak about common mistakes when seeking health care, how employers can educate employees to be better health care consumers and how your benefits broker can help get the message out.
What are some of the biggest mistakes health care consumers make?
The first is misuse of the emergency room. The ER is often the most expensive place for care. People know it’s expensive and that they will likely wait for hours, but they don’t realize there are alternatives.
For non-emergency treatment, urgent care centers are a better option. Telehealth is another increasingly popular option, and more insurance carriers are making it part of their overall benefits package. You can see a physician via a video call, generally within 10 minutes of reaching out. There is no need to miss work. Common conditions can be addressed and there is generally no co-pay, or co-pay is similar to that of an office visit.
Finally, employees often don’t research to find the least expensive place to seek treatment or tests — for example, an MRI at a freestanding facility is less expensive than at a major hospital system. You can still receive quality care at a more reasonable price, you just need to do the research. If the doctor recommends a test, go where it’s going to be more cost-effective.
Why should employees care about the cost of health care, and how can they contain it?
How they use their plan directly impacts insurance premiums. Misuse of the emergency room, brand name drugs versus generics, or not taking advantage of less expensive facilities impact the renewal cost. To help contain costs, employees should seek care within their Preferred Provider Organization (PPO) network, as going outside of the network costs more out of pocket.
Review benefits to understand what is covered; before a procedure, confirm if it is covered so you’re not surprised if your claim is later denied. Also, take advantage of a Health Savings Account (HSA), if offered by your employer. With an HSA, employees — and sometimes employers — contribute pre-tax dollars to an account that can be used to pay for qualified medical, dental and vision care expenses. HSA funds roll over year after year, so employees won’t lose contributed funds. If they leave the employer, they take the account with them.
In addition, many carriers have cost-comparison tools, where consumers can type in the procedure, pull up providers in the network and see an approximate cost at each. And websites such as goodrx.com provide prescription comparisons, showing nearby pharmacies and the cost of the drug at each, which can be significantly different from one pharmacy to another. When employees take steps to reduce costs, it can be the difference between a single-digit increase and a double-digit increase in premiums.
How can employers deliver the message, and how can their benefits broker assist?
Conduct annual enrollment meetings with your broker present to address ways the employees can be conscientious health care consumers. The message is sometimes better received from an outside source, versus the employer simply stating, ‘We need to save on health care.’ Employees need to know the resources available so they can become active participants.
Some employers present ways the employee can help save on health care expenses, such as showing the approximate cost of a service in the ER versus urgent care. Employers can also include information with paychecks. It’s a matter of repetition to get the message out.
It may take a few years, but over time, we see a difference in usage and shifts in behavior. When we do, we tell employees their increase in premiums was reduced thanks to their change in behavior.
Employees doing their research and making wise decisions is good for their overall health and bottom lines. ●
INSIGHTS Business Insurance is brought to you by Zito Insurance Agency a Division of Risk Strategies