It's no secret that healthcare is complicated.
Given the convoluted nature of the industry, it's not uncommon for there to be confusion around the ins and outs of insurance, medical billing, and finding care. Unfortunately, many of these misunderstandings can cause employees to make poor decisions that lead to harmful outcomes.
In this post, we’re going to address four of the most common misconceptions that may affect both the health and wallets of your employees.
1. "As long as I find care that's within my insurance network, I don't have to worry about cost."
If only it were this simple! While most employees are aware that costs vary by insurer, it's a lesser known fact that costs can vary within your network as well, depending on various factors such as location, care setting, and facility.
Take ACL surgery, for example. This surgery is prone to large variation in cost because it tends to be expensive and includes many components (anesthesia, the facility fee for the operating room, etc.).
Our data shows that within a single insurance network in Chicago alone, the cost of ACL surgery can vary from $6,000 or less to $17,500 or more. Keep in mind that cost and quality aren't correlated, so going to a more expensive facility doesn't necessarily mean your employee will have a better experience.
2. "If I need care in the middle of the night, the emergency room (ER) is my only option."
Getting sick or injured during off hours can be a scary experience for your employees. Their primary care physician is probably unreachable, they're desperate for care, and they don't think the ailment can wait until the morning. So they Google the closest ER and head over.
This is a frequent pattern we see — especially among millennials. Our data found that 64% of flu diagnoses for millennials came from ER doctors. This is problematic is because ERs tend to be much more expensive compared to urgent care centers, which can handle many of the non-life threatening illnesses and injuries that ERs can. Urgent care centers also usually have shorter wait times, meaning your employees will likely receive care faster, too.
3. "If my doctor recommends imaging to check something out, I should just do it."
While doctors usually have their patients' best interests in mind, many have little or no training on imaging costs. They may not consider how one MRI or CT scan could impact your employee's wallet.
According to a healthcare literacy expert we chatted with, imaging is one of the most commonly overprescribed tests — especially for back pain and headaches — and it tends to be quite expensive. An ROI analysis we recently conducted on behalf of a large employer found that 38% of their overspend in 2017 could be traced back to MRIs, CT scans, ultrasounds, and X-rays.
It's important for employees to ask questions about cost and really decipher what's necessary before scheduling any appointments for imaging.
4. "I can't compare prices for medical services, so I should accept the first option I find."
Many employees feel helpless when confronted with healthcare decisions. Any research they do themselves is time-consuming, and using their insurance portal doesn't surface great results. So they find themselves settling for the first option they find, without any consideration of whether it's the best choice for their health or finances. This shouldn't be the case.
With Amino, your employees will have access to personalized cost estimates (shown alongside important quality measures) and receive recommendations for the most high-value choices so they can feel confident about the care they choose.
Now that you've identified the areas where there may be a lot of confusion for your employees, you can focus on providing them with the right resources and education to ensure they don't fall into any of these healthcare traps.