It’s easy for employees to make critical errors in judgment when choosing a doctor or seeking other types of healthcare. You can help by educating them about how to avoid four common mistakes that cost time and money.
Mistake #1: Not checking the network
Many health plans, particularly HMOs and narrow network plans, provide coverage only when beneficiaries choose in-network providers. Others, like PPO and POS plans, have a different level of cost-sharing for out-of-network providers.
Be sure your employees and others covered by your plan understand how to check whether a primary care physician, specialist, lab or hospital they select is in their network. This can be done by checking the carrier’s website or by contacting the provider directly.
Keep in mind that carriers have different networks for each plan, so employees should reference their insurance card or plan documents to identify their specific plan type before choosing care.
Mistake #2: Relying too much on online reviews
In an age where it’s routine to check online reviews for restaurants, hotels and even potential employers (see Glassdoor), there’s also a plethora of patient reviews about physicians.
The problem? Unreliable opinions.
Some patients are dissatisfied with excellent doctors — doctors who won’t provide the pain relievers they request, doctors who don’t overprescribe antibiotics or doctors who want their patients to lose weight. A recent blog in the Medpage’s Kevin MD.com reminds readers, “…the doctor’s ethical and moral duty is to prevent or treat the patient’s illness or injury whether or not that is what make the patient ‘happy’ or satisfied.”
Steer employees toward reliable online information that provides credentials, outcomes, ratings and more. Credible resources include U.S. News Doctor Finder, Health Grades, Surgeon Ratings by Checkbook.org and ProPublica’s Surgeon Scorecard.
Mistake #3: Procrastinating until a problem arises
No one enjoys going to the doctor, so the natural tendency is to wait until a pesky flu bug, a sports injury or a troubling symptom forces the issue. Encourage employees to pick a primary care provider now, before they need one. (Some health plans actually require it.) This doctor can be a general practitioner, an internist, an OB/GYN or, for children, a pediatrician.
There are several advantages. According to Consumer Reports, patients who have a strong relationship with a doctor are more satisfied with their care, and they may even be healthier. Plus, when issues do arise, the doctor will act as a project manager, arranging for tests, contacting specialists and helping avoid duplicative or contradictory treatments.
Mistake #4: Not shopping around for tests and medical services
Imagine shopping for a television or a car but not knowing the price until you get it home. That sounds absurd, but it’s how most people purchase healthcare services. Make employees aware that prices can fluctuate wildly. An appendectomy can range from $1,529 to $186,990, and hip replacements can cost anywhere from $11,100 to $125,798, according to a report published by George Washington University.
The move toward high deductible health plans is making employees more conscious of the cost of healthcare because they have more “skin in the game,” but there’s still room for improvement.
Although many of today’s health plans offer a cost estimator tool, but only about 2 percent of consumers use them, according to a special report published in Modern Healthcare. Blame a lack of awareness that transparency tools exist and ignorance about how to use them.
Communicate. Communicate. Communicate.
To maximize the ROI of your benefit investment, create a communication strategy that helps employees avoid these mistakes and make good healthcare provider choices.
This is best accomplished with an ongoing communication plan that keeps health-related topics in front of employees and their covered beneficiaries throughout the year.