Population health analytics vendor Healthentic, serving nearly 11,000 employers and holding data on 38.7 million individuals, recently analyzed the degree of avoidable emergency room utilization by employees at 31 client companies, with sobering results.
Based on 2013 data, the 31 companies paid $1,326,523 for potentially avoidable visits to the ER. Ten percent of visits were for ailments that could have been treated in an outpatient setting. The top avoidable ER visits were headache, back pain, urinary tract infection, sore throat, acute upper respiratory infection, ear ache, acute bronchitis, pink eye and sciatica.
Simply knowing some of these top conditions is valuable and can help employers work towards reducing unnecessary ER use, but its not always enough, the vendor notes in a brief summary of results. Every employer should understand what their own usage looks like as rates vary widely between companies.
For instance, the rate of potentially avoidable ER visits among the 31 analyzed companies ranged from slightly less than 2 percent to nearly 18 percent. Sixteen of the companies had rates ranging from about 4 percent to 8 percent, and eight employers had rates well exceeding 10 percent.
The average ER cost and average urgent care costs for the 31 companies were: allergies ($345/$97), acute bronchitis ($595/$127), ear ache ($400/$110), sore throat ($525/$94), pink eye ($370/$102), sinusitis ($617/$112), strep throat ($531/$111), upper respiratory infection ($486/$111) and urinary tract infection ($665/$110).
The vendor advises employers to design a benefit plan that encourages alternatives to ERs and to publicize availability of nurse telephone lines, urgent care alternatives, use of a primary care provider, and disease and case management programs.
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