How urgent care trips are driving up employer costs

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I talk a lot about how increasing access to primary care is critical for reducing healthcare costs. When your employees can’t get in to see a primary care doctor, they make more costly trips to the ER and urgent care. They spend more time in the hospital. And self-referral to specialists goes way up.

But just how much are people using these higher-cost channels for basic needs? One Medical surveyed more than 1,500 full-time employees to find out how people typically get care for basic medical issues.

Here are three big insights from the study:

1. People who can’t get in to see their doctor are using urgent care as a back-up.

The survey validated our assertion that lack of same-day access drives up urgent care and specialist visits.

While most respondents (80%) said they have a primary care provider, 59% of this group said they can’t always get in to see their doctor on the same day. More than one-third (37%) also said their doctor doesn’t provide any care outside of regular office hours.

With few options for care outside of the office and no guarantee of same-day appointments, many people are using urgent care, the ER and specialists as their back-up plan: 61% said they had gone to urgent care when they couldn’t get an appointment or needed care outside of regular office hours, and 38% said they had gone to the ER. 18% said they had gone directly to a specialist because their PCP wasn’t available.

2. People who don’t have a primary care doctor are using urgent care, specialists and ER visits for basic care.

Of the people surveyed, 20% said they don’t have a primary care provider or group, often opting for urgent care to deal with minor issues… including ones that may not have even required an office visit. For example, 27% said they’d been to the urgent care for cold and flu-related issues; 26% for minor injuries; 9% for skin issues; and 9% for UTIs.

Specialists also are a popular go-to option for many of those without a regular primary care provider, according to the study: 43% of respondents said they had been to a specialist such as a dermatologist or allergist for basic, routine care.

And although the ER is generally thought of as a last-resort channel for care, 20% of respondents said they had been to the ER for a non-emergency issue.

3. Standalone telemedicine services aren’t bridging the care gap outside of office hours.

According to the 2015 Willis Towers Watson/NBGH “Best Practices in Healthcare Employer Survey,” just 7% of employees with telemedicine access use it. Our survey showed a similar result: just 6% of people say they have ever used a telemedicine service.

So even though most employers today are adding telemedicine to their health benefits package to improve access to care, the data shows this is doing little to bridge the access gap.

This is why smart companies are making great access to primary care part of their healthcare strategy. This can be anything from a benefit design that encourages access to primary care (i.e. through lower co-pays), or a network design that has adequate primary care coverage, or even a dedicated center for your employees.

Because while primary care is the lowest cost channel for care, it’s clear that employees who can’t get care when they need it are heading to higher-cost urgent care centers or specialists. And this is costing employers a lot of money they really don’t need to spend.

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