Choosing high-quality, lower-cost procedures can pay off—in cash.
Non-emergency ER visits are driving up health care costs, even when better options are right around the corner. How do we help customers get the right care they need in the right setting?
It seems obvious to say that emergency rooms are designed specifically for emergencies. But every day, ERs are full of patients with upset stomachs, sore throats or back pain. That’s an expensive choice. According to Blue Cross NC claims data, the bill for a typical ER visit is about $1,900.1 What’s more, one study revealed that only 29 percent of emergency room patients actually required ER-level care.2
It’s clear a lot of money could be going to the wrong kind of care. But the solutions are just as clear. That’s why we educate our members on the right kind of care before they need it and give them the tools to access the appropriate care once they do. For example, urgent care centers offer immediate care for issues that need prompt attention but are not life-threatening. Our Urgent Care Finder helps members find the closest locations that accept their plans. And telemedicine enables members to make a prompt appointment with a doctor 24/7.
To help members decide what type of care is appropriate, Blue Cross NC offers a 24/7 nurse hotline, Health Line Blue, potentially helping members avoid unnecessary, costly ER visits.
In August 2016, we launched another effort to reduce inappropriate ER use: an email campaign that sought to educate customers on ER use. It also explained ER alternatives and the role of primary care doctors. The result? Those who clicked to read the emails saved nearly $1 million compared to a control group. They used the ER less often, and Health Line Blue and their primary care doctor more. Even months after the campaign, those who clicked to read the emails had an 8.5 percent lower inappropriate ER use rate than the control group.3
Matching the right medical need to the right care option is critical to help lower health care costs for everyone. Plus, it frees up valuable ER resources to focus on helping those that truly need life-saving care.