Last month, our local news headline read “Significant increase in patients leading to longer emergency room wait times”.
Unfortunately, many of these ER visits are for non-emergency conditions that could easily be handled in outpatient settings. When employees use the ER unnecessarily, it not only strains the healthcare system but also drives up your health plan costs.
- Lack of Access to Primary Care: Many people don’t have a primary care physician or can’t get timely appointments, so they go to the ER for non-urgent issues.
- Convenience and 24/7 Availability: ERs are open around the clock, and for some, the ER feels like the easiest option when symptoms arise after hours.
- Misunderstanding of Severity: Patients often don’t know whether their symptoms are serious. Without proper guidance, they may choose the ER “just in case.”
- Insurance Misconceptions: Some people mistakenly believe their insurance will cover ER visits regardless of the situation, leading to unnecessary visits.
- Limited Awareness of Alternatives: Urgent care centers, direct primary care, and telemedicine options exist, but many employees don’t know when or how to use these services instead of the ER.
The SymplCare team at Sympl Benefits can help employees avoid unnecessary trips to the emergency room in several ways:
- Accessibility: Employees have access to the SymplCare team through smartphone apps and text messaging for quick support. They act as a healthcare navigation team, answering questions and providing guidance.
- Proactive Support: The SymplCare team actively reaches out to employees who need support, rather than waiting for problems to arise. They constantly review claims data to identify employees who may need assistance.
- Cost Transparency: SymplCare helps employees understand costs and quality before choosing providers. They ensure everyone understands their benefits and options. Employees know the cost before their visit, understand how their benefits work, and have access to $0 cost options when available, preventing surprise bills and second-guessing.
- Comprehensive Support: The SymplCare team helps schedule appointments and ensures employees are set for their visits. They guide employees through prescription changes and pharmacy visits.
By encouraging employees to contact their healthcare navigator before heading to the ER, employers can see a significant reduction in health plan expenses.
Benefits education shouldn’t be a one-time event at open enrollment. It’s an ongoing process that should be happening throughout the year. Your employees need support to be able to make the right decision for them. And when an emergency happens, they know they have someone who can guide them through.
