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How Underperforming Doctors Affect Benefits Costs and How to Fix It

How is doctor performance affecting your benefits plans costs?

Employers can expect employee healthcare costs to increase by 6.5% in 2023, totaling more than $14K per employee, according to AON’s projections. In order to better control costs, it is crucial to analyze and identify what is driving increases in your healthcare plans spending.

One significant cost driver is underperforming care providers. Without proper diagnoses or treatment, employees may incur additional costs associated with multiple office visits, prescriptions, and recurring health issues. Higher-quality care leads to better results and lowers the chances of chronic health issues.

Remember, utilizing your current claims data can answer important questions about where your employees are seeking care, and this allows you to identify potential inefficiencies in doctors’ and facilities’ performance.

With these insights, you can begin to implement simple ways to incentivize employees to use top performing providers to reduce costs and provide employees with better access to high-quality affordable care.

Increase Employee Access to Quality Providers

Employers and benefits administrators can boost employee access to quality providers with high outcome ratings. Many employers are concerned this will also raise premiums and out-of-pocket costs for their employees, but by partnering with more effective doctors, this will decrease costs for employees in the long run and prevent future issues that inflate costs.

Consider working with a healthcare concierge vendor that will research doctors and facilities for your employees and provide options for top-tier providers that won’t break the bank. Many of these vendors also assist with making appointments and reviewing bills, saving your employees considerable time and money.

You can also utilize virtual care services, which encourage employees to seek immediate care for minor issues. When employees need to seek in-person care, allowing some flexibility during work hours can help support employees in addressing healthcare concerns sooner than later.

Consider Cost-Sharing Options

While a high-deductible health plan (HDHP) may help employers in saving money, it could negatively impact the health of your employee population if employees are reluctant to seek medical attention. Employees may feel overwhelmed by high deductibles and copays—and as a result may settle for providers based on low-cost options versus quality of care, or they may even put off seeking care altogether.

Without receiving proper care and addressing problems early on, health issues may become bigger, and eventually employees may have to seek urgent care or emergency services. Ultimately, this ends up costing the employer and employee a lot more, including missed work and less productivity.

Plans with cost-sharing features allow for more affordable copays and deductibles for employees, which increases benefits utilization, allows them to manage chronic conditions, and also enhances the overall health of your employee population. All of this has long-term physical, mental and financial benefits for employees, and your business’ bottom line.

Educate Employees

It’s important to educate employees year-round on the resources available to them through their benefits packages. Provide workshops on the importance of selecting the right provider and show them the tools available to help them research and make educated decisions—such as carrier websites and doctor and facility search tools. With the proper resources and education, employees will be able to make better decisions when it comes to their doctors that result in higher-quality care.

Gain control over your benefits plans.

Our team of experts is trained to assess your benefits data and establish ways to gain control over increasing costs, improve utilization and care outcomes, and simplify the process of employee benefits plan administration.

Contact our team today to learn how Ascela can go beyond the cost of premiums and analyze your data to identify the top factors that are driving your health plan costs.

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