One of the largest (and growing) issues facing our clients today is skyrocketing out-of-pocket costs. According to the 2014 Milliman Medical Index, the average American family of four spent $3,787 in out-of-pocket costs. Estimates for this year place it over $4,000.
As an industry, we're hitting a wall. The average family budget can't take much more. This is a problem because the most-used plan design changes lately have shifted costs to employees. We need new approaches that actually change costs and outcomes, not just shift the expenses.
It's time for strategies with real results. Approaches that put cash back in an employee's hands, while also reducing employer health costs. We don't have time for ideas that sound good, but don't deliver. We need savings now.
Let's look at a case study of a Texas company that installed a pair of solutions that increased access to care while returning hard-dollar savings more than 300 percent and improving employee morale.
What is the strategy?
Telehealth and advocacy services deliver these kinds of results. Disclaimer: if delivered properly. If not, they go over like a lead balloon.
Telehealth allows patients a doctor visit by phone – all the way to getting a prescription written, if appropriate. It works for two-thirds of doctor visits that are short-term acute care issues. Advocacy services include price transparency, out-of-network bill negotiation and/or someone to help frustrated people navigate a complex health care system. Sounds like the kind of services every employer and employee would want and use.
The Delta Cos. thought so. They're an employee staffing company specializing in physician and health care workers. Calli Corley, their director of human resources, was hopeful of the concepts when they got started in January 2013: "We initially decided to install these services in order to save our employees money and a lot of headaches."
What are the results?
Calli quickly became a fan because most of her 300+ staff used the services – a lot!
Regarding telehealth, Calli says, "It seems every other week someone stops by with great feedback: 'it's easy to use,' 'it's convenient,' or 'it saved me from having to make an ER visit late at night.'"
Imagine that – a benefit that employees actually thank their employer for providing.
She appreciates the support advocacy services bring her team: "Anyone going through an illness or injury knows the frustration of finding health care providers, estimating costs, etc. What's worse is trying to understand the billing aftermath. This is a service that helps employees sort through both."
And this saves her HR team a lot of time, too. She says, "I no longer have employees bring me a stack of EOBs to look over and tell them what to pay!"
The irony is these employees work in the healthcare industry and probably understand how to navigate it better than most. The good news is these solutions are even better for neophytes.
What are the hard-dollar results?
On average, every telehealth consultation saves $325 in unnecessary costs (i.e. emergency room, urgent care center or doctor office visit) that we know would have occurred within 24 hours of the consult (we know because the employee answers this question each time they call for a visit).
Using just these hard savings, The Delta Co.'s 288 telehealth consultations in the past 12 months saved $93,600. During that year, the program cost was about $30,000.
Other savings came from employees getting directed to lower cost providers/facilities, lowered medical bills resulting from negotiations by the advocacy service, and lower readmission rates from telehealth consults versus other modes of care. These more than double the hard savings above to more than $200,000.
What does the client say?
So, what are Calli's thoughts going into year three? She says, "We get to give our employees their time and sanity back, and we save many times more than what this costs us!"
If this isn't what you hear from clients regarding the strategies you've installed, then find the right breakout sessions at the Expo for some new ideas and a new perspective. If you want more real life results with Telehealth & Advocacy, join me at 3:15 on Tuesday, May 19, in Scottsdale, Arizona.
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