The Overuse of Emergency Rooms by Patients: Why It Costs Everyone More in the End

The Overuse of Emergency Rooms by Patients: Why It Costs Everyone More in the End

The world of healthcare is a constantly evolving one, and several unsettling trends have emerged so far in 2016. Healthcare costs are increasing and customers are struggling to figure out why as their wallets are consistently empty. More and more large medical and pharmaceutical brands are linking together to bump out smaller competitors. These smaller medical facilities then have to pay more than the big fish to offer the same healthcare for customers. Patients are also flooding hospital emergency rooms. ER usage is much higher than usual. According to a poll completed by 2,098 medical professionals for the American College of Emergency Physicians, 47 percent of doctors believe that ER overuse rates have become only slightly worse while 28 percent believe that they’ve become much worse. Many believe that those numbers will only increase unless this problem is stopped.

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PBM carve-out is the solution to non-optimized pharmacy spend

PBM carve-out is the solution to non-optimized pharmacy spend

In our series of opinion pieces on questions that companies should be asking their carrier at all times, one of the most important one is related to non-optimized pharmacy spend and variability in drug costs. Everyone claims to be offering a transparent PBM. The question is, if it really is transparent or not? We have seen drug prices such as $498 and $166 for the same drug in the same region at retail stores depending on the PBM the employer is on. The difference is around $222 to up to $332 per drug. We are talking about savings of anywhere between 1 to 5% on overall healthcare costs.

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ANALYTICAL INSIGHTS: Closing gaps in care

ANALYTICAL INSIGHTS: Closing gaps in care

Chronic diseases like diabetes and chronic obstructive pulmonary disease drive a significant percentage of your healthcare costs. Preventative care and sound disease management make an enormous difference when it comes to your employees’ well-being as well as your costs. Unfortunately, high-risk patients are less likely than their healthy peers to seek preventative care and comply with recommendations.

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ANALYTICAL INSIGHTS: Impact of wellness programs on healthcare costs

ANALYTICAL INSIGHTS: Impact of wellness programs on healthcare costs

The Problem

Workplace wellness programs have grown significantly in popularity. A recent study showed that some 92% of employers with 200 or more workers offered them in 2009. These programs may range from simple gym subscriptions to robust programs that include healthy lunchboxes, fitness programs, on-site health clubs, work sports teams, and stress therapy sessions.

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