Vincent B. Boianelli, Broker

Emergency Room Usage

The Issue

During a renewal review meeting with one of our larger clients, we broached the topic of emergency room utilization. The detailed breakout of claim usage for their group indicated a larger than average cost of this service than would be typically expected.

Our Solution

With care costs at an ER running 4-5 times that of a physician’s office, it is important to educate employees that there are better alternatives for minor illnesses or injuries than the emergency room. We suggested raising the co-pay for non-emergency ER visits and a campaign to educate employees as to ER alternatives. Among the points targeted through print and electronic media were scenarios where patients might obtain superior care with shorter wait times and less out-of-pocket expense.

The Result

The strategy was effective, as the client saw a modest reduction in emergency room visits and the associated costs in the following year’s renewal. Emergency room utilization dropped by 28%, translating into an estimated $36,000 savings in their premium.