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The Tools That Help Employees Make the Right Health Care Choices

The Tools That Help Employees Make the Right Health Care Choices


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  • What your employees don’t know about their doctors could hurt them—and your organization’s bottom line.

    The health care tools employers typically provide their employees focus on logistics: which providers are in the network, in the area, or taking new patients. Most employees select their doctors based on anecdotal or superficial information, such as referrals from people they know, social media reviews, or even the decor of the waiting room.

    They’re in the dark about what really counts—how well a doctor performs on the measurements that matter—and that translates to unnecessary expenses, excessive downtime, lost productivity, and worse health outcomes. And the lack of transparency runs in both directions, concealing from doctors how they compare with their own peers and preventing them from optimizing their performance.

    But some employers provide their workforce greater visibility into the quality of their health care options so workers can make selections based on objective standards and hard results. Offering tools to share data-driven, actionable insights about the appropriateness, effectiveness, and cost efficiency of available providers enables employees to find high-performing doctors who fit their personal needs and preferences.

    The result is healthier employees, reduced absenteeism, and lower costs for patients and employers alike.

    Visibility into Provider Practice

    Not all health care providers are created equal. The vast majority of doctors have good intentions, but some fail to keep up with the latest scientific research, charge exorbitant fees, or even recommend unnecessary procedures and treatments, pointlessly inflating costs and increasing the risk of complications without improving care. Worse, it can be daunting, if not impossible, for individuals such as people of color, those who are LGBTQ+, and people who require translation to find care that aligns with the specific needs of their community.

    Nearly 30% of doctors say close to half of all medical care is unnecessary, and nearly a third of the $3 trillion Americans spend on health care each year is wasted on expenditures that do little to improve health.

    When employees have no insight guiding them to high-quality providers, they and their employers pay the price. Receiving subpar or overpriced care can directly harm employees’ health and saddle them with exorbitant medical bills. It also hurts businesses, which lose an estimated $225.8 billion in productivity every year to employees needing medical leave.

    Reducing Spending, Improving Outcomes

    Employees don’t have to pick physicians the way they pick restaurants. Some organizations offer tools that help their workforce access independent, objective physician ratings grounded in science and based on real patient outcomes. Individuals should evaluate the doctors they choose based on three measurements:

    1. Is care appropriate or medically necessary based on current science?
    2. Is the physician effectivefollowing the latest clinical guidelines and achieving optimal results?
    3. Is care delivered at a reasonable cost compared to that of similar providers and services?

    Many patients diagnosed with arthritis of the knees are referred for knee arthroscopy despite strong evidence that this high-cost surgical procedure lacks clear benefits. Considering knee-arthroscopy rates among orthopedic surgeons gives individuals valuable insight into the appropriateness of care they might receive with that provider.

    Similarly, the rate of hardware removal after low back surgery is a way to gauge the effectiveness of orthopedic surgeons. And an evaluation of the cost of care must account for both pricing differences and variations in the use of costly interventions.

    Advanced statistical models can compile and convert independent data like this into scores and ratings that any employee can understand. And employees also need personalized physician recommendations that factor in a provider’s specialties and cultural inclusivity. The results of this transparency are better care and lower spending for employees and enterprises alike, reducing the need for extended leave and the likelihood of developing complications or disabilities. And these tools also help doctors measure their own performance in the context of their peers so they can make any necessary changes.

    Choosing Care with Care

    One global retailer’s health care tools and practices demonstrate the benefits of such high-quality, results-based personalized care.

    In 2013, the retail giant founded its Centers of Excellence program to give employees access to top specialists, with treatment and travel covered in most cases. One associate with chronic mild neck pain had seen a doctor who had referred him for surgery at a local clinic. But after the company sent him to a top spine specialist in another state, he was diagnosed with Parkinson’s disease, requiring different treatment. The patient avoided unnecessary surgery, and the company saved $30,000.

    More than half of spine patients at the company’s Centers of Excellence avoid surgery, and those who need it spend 14% less time in the hospital. They are also 95% less likely to need readmission, and they return to work more than two weeks sooner on average than those who did not go through Centers of Excellence.

    Any employer can bring these advantages of quality care to their workforce. Polk County Public Schools in Florida is using technology that supports personalized, results-based care to help its 14,000 employees and their families easily find the doctors who deliver the best care in the right context at the most reasonable price.

    Knowledge Is Power

    Nothing matters more than health. All employees should be empowered to make high-stakes decisions about medical care based not just on whether doctors take their insurance but also, more importantly, on sound, objective data about how they perform and what they elect to do (and not do).

    Getting access to relevant health care information and insights lets employees identify the physicians who consistently deliver appropriate, effective, cost-effective care, and it lets them use that information to make smarter, more personalized health care choices than ever before. And that can lead to a healthier, happier, stronger workforce.

    Every employee is also a patient. And every patient deserves to have the right information about their health care. Your employees can’t afford to leave their health to chance—and neither can your organization.

    To learn how Embold Health’s physician measurement engine can improve employee outcomes and reduce overall spend, visit www.emboldhealth.com.

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    Greg Aftayev is a Journalist at Flaunt Weekly Covering Tech News.

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