PreferredOne Newsroom

PreferredOne research points to need for education on care setting costs

Minneapolis, Minn. October 15, 2018 - It’s the easiest, fastest and least costly route to relief for many conditions. Yet less than 5 percent of PreferredOne’s health plan membership choose online care when seeking treatment for common ailments.

PreferredOne analysts selected eight common conditions which could be similarly and effectively treated at a number of care settings. They pulled 2017 claims for those conditions and identified where the members sought treatment, then averaged the costs by setting. The averages exclude any costs for prescriptions or follow up care.

At $45 per visit, online care is the least expensive choice to treat all eight conditions. You might guess most people would elect that option but you’d be wrong. For example, in 2017, PreferredOne paid claims for 26,182 sore throats. Of those, only 17 chose online care—the $45 option. A whopping 638 chose the $803 emergency room option, while the majority chose $182 office visits.

The same price to treat those 638 sore throats in the emergency room would treat 11,384 patients online. Put differently, each time a sore throat patient chooses online care instead of the ER, an employer saves $758.

While the focus on our research was return on investment for online care, the results can be extrapolated to reflect other care providers. The data clearly demonstrates the value of encouraging members to choose less costly care delivery settings across the spectrum of options. Assume the care setting is appropriate for the patient's medical condition, moving the dial even one notch—for example, from emergency room care to urgent care or from office visits to convenience care—can save members and employers hundreds of dollars per visit.

Online care utilization is low across the board. Maybe it’s because online care—and to some extent convenience care and urgent care—are relatively new options for patients in need of treatment. The challenge for health plans and employers is to help patients understand their options and the associated costs. While member education is critical, employers can also take steps to encourage cost efficient settings with changes to benefit plans such as no copays or no charge at all for online care or convenience care.

PreferredOne continues to lead the market with products and services that conserve employer health plan dollars while helping members achieve their best health.

PreferredOne is a wholly-owned subsidiary of Fairview Health Services. Our comprehensive local and national provider networks, high performing networks and cost and quality drivers help self-funded and fully insured employers maximize their investment in employee health benefits.