Consumers today are overwhelmed with health care options. It can be difficult to know when to use urgent care, online care, primary care or the emergency room. Not to mention choosing between various care systems that may, or may not, be in-network for their health insurance plan.
Place of care can make a big difference in the cost and quality of care. And employers like you can play an important role in helping employees understand how to navigate their health care benefits and choose the right place to get care for their situation.
Here are answers to 5 questions we commonly hear from employers:
1. Do we need to be concerned about lower cost care (i.e. convenience care) being lower quality care?
Convenience care centers are great for low acuity services. They usually provide the best value for things like ear infections, sinus infections, etc. Most have a list of services they treat so you’re able to know if treatment is within their scope. It will generally be a nurse practitioner level of provider and they’ll direct you to more advanced place of care if needed. Another resource for members is the nurse line, which can help determine if a convenience clinic is the most appropriate place to get care.
2. What are “high-value providers”? How are they determined?
From HealthPartners’ perspective, high-value providers are providers who manage cost efficiently and provide high quality care. Our informatics analysis determines high-value providers based on quality measures and cost efficiency for specific high volume, high cost services. In some cases we’re able to vary a benefit plan design to direct people to use high-value providers. Another common term you may hear for high value providers is “Centers of Excellence” , Again, from HealthPartners’ perspective, COEs are for high cost, lower volume services such as transplants or bariatric surgery where the members’ benefits provide an incentive for them to use a Center of Excellence. Both are designed to target more affordable options for high cost services. Through education, transparency and benefit differentials, we’re designing ways to get people to the highest-value providers.
3. What is the nurse line? Is there a cost for the call?
There is no cost for the call to HealthPartners’ nurse line, CareLine. The nurse line is a great resource available to members who can call or chat with a nurse. They get advice about whether they should seek additional care. We also have a baby line for new parents. It’s a great option to save money because it gets people to the most appropriate care level. They may direct people to telemedicine, urgent care, or to the emergency room as needed.
4. What do doctors know about lower cost drugs? Is the entire burden on the employee?
Currently drug costs are rarely available to physicians at the time of prescribing but we are working on that. It can be a significant burden for the individual to ask that question and it’s usually after they’ve gotten a prescription from the provider. They’re not always comfortable going back to the provider and having a conversation around cost of care. What can happen is that they may choose not to take the medication, which is not the outcome we want. We’re working really hard to get cost information more readily accessible to doctors so they can provide prescriptions for lower cost drugs where it makes sense.
5. What’s the best way to communicate with my employees about their care options?
There is no one size fits all answer. It really depends on your employee population and what is best for them. For some groups, email may be best. For others it might be signs around the workplace. We work with one group that is a trucking business and to reach their employees on the go, they’ve created dashboard stickers to remind them of the resources available. You have to evaluate your unique population and see how they consume information. For a simple place to start, check out our free online communications toolkits available on the Employer portal.