appropriate levels of care -...

Appropriate Levels of CareUS Health & Wellness Education Module

©2014 TeleTech Holdings, Inc. Confidential and Proprietary 2

Table of Contents


Topics

• Emergency Care

• Appropriate Levels of Care

• Cost Comparison

• Being Financially Responsible

• Quiz


Emergency Care


Emergency Care

Emergency Room: A hospital or area staffed and equipped for the

reception and treatment of persons requiring immediate medical

care.

• Immediate care is used to describe an illness or trauma that is considered life-threatening.

• Many individuals use the ER for non-urgent care because emergency rooms are required by federal law to provide care to all patients, regardless of their ability to pay. Since they can’t be turned away, patients without insurance or the necessary funds to pay out-of-pocket costs, often utilize emergency rooms as their main health care provider. Unfortunately, this places tremendous strain on emergency room personnel and their ability to care for true emergencies. Not to mention the role it plays in continually rising healthcare costs.

• The overall cost of medical premiums is heavily determined by the money spend of medical care of all participants on a given plan. Emergency room care can easily drive this cost up.

• The average cost of a visit to the emergency room in the US is $2,168. The average wait time for emergency care is 4 hours.


Inappropriate Use of Emergency Care

56% of emergency room visits are completely

avoidable.

✓ Individuals who use the ER for non-intended purposes cost themselves and the company more money.

✓ It is estimated that more than $18 billion could be saved annually if those patients whose medical problems are considered non-urgent or avoidable took advantage of a primary care provider or urgent care facility instead.

✓ Not all conditions are life-threatening and do not require emergency care.


Appropriate Levels of Care


Care Options

You have options when it comes to addressing health issues, four

of which can be handled from a non-emergency perspective.

• Telemedicine

• Primary Care Physician

• Convenience Care Centers

• Urgent Care

• Emergency Care


Telemedicine

When to Use

✓ For non-emergency medical issues and questions

✓ Your primary care physician is not available or you cannot get to them

✓ During or after normal business hours, nights, weekends, and holidays

✓ You need a prescription or emergency refill.✓ You are traveling and in need of care

Benefits

✓ Can treat both adult and pediatric conditions, including allergies, asthma, headache, cold and flu, fever, ear, sinus, skin, urinary tract, and respiratory infections, rashes, pink eye, nausea, diarrhea, and constipation

✓ Inexpensive✓ Available to everyone at TeleTech, regardless if

you’re on a company provided medical plan


Primary Care Physician (PCP)

When to Use

✓ For any condition that is not considered an emergency

✓ For a routine health exam✓ For serious medical concerns✓ For any medical treatment/diagnosis

Benefits

✓ Your PCP provides the most of your healthcare and has records of your health history

✓ If you need special care for a health problem, your PCP will make arrangements and provide guidance

✓ Your PCP understands your family history and can watch for symptoms you may not recognize


Convenience Care Centers

When to Use

✓ For simple diagnosis or common acute illnesses.✓ Allergies and sinus infections✓ Cold and flu symptoms✓ Vaccinations✓ Strep tests and diagnosis✓ Skin irritations and minor abrasions✓ Sprains and strains

Benefits

✓ Open late and on weekends✓ No appointment necessary✓ No established care required✓ Quick, convenient care


Urgent Care Clinics

When to Use

✓ For after-hours urgent care✓ Migraine headaches✓ Minor broken bones (i.e. finger)✓ Small cuts that need minor stitches✓ Minor infections

Benefits

✓ Equipped to handle many ailments✓ Cost is much less than emergency room visit✓ Open late and on weekends✓ No appointment necessary✓ No established care required


Emergency Room

When to Use

✓ For life-threatening conditions✓ Severe injuries✓ Major broken bones or burns✓ Heavy bleeding✓ Chest pain and/or difficulty breathing✓ Sudden change in vision, weakness, or trouble

talking✓ Spinal injuries

Benefits

✓ Designed to treat life-threatening situations and serious health events

✓ Can provide immediate care from an experienced trauma staff

✓ Open 24 hours a day, seven days per week


Cost Comparisons


Cost Comparisons for Non-Emergency Issues

Health ConditionEmergency Room Cost Urgent Care Telemedicine*

Allergies $345 $97 $10 ($40/$49)

Acute Bronchitis $595 $127 $10 ($40/$49)

Earache $400 $110 $10 ($40/$49)

Sore Throat $525 $94 $10 ($40/$49)

Conjunctivitis (Pinkeye) $370 $102 $10 ($40/$49)

Sinusitis $617 $112 $10 ($40/$49)

Strep Throat $531 $111 $10 ($40/$49)

Upper Respiratory Infection $486 $111 $10 ($40/$49)

Urinary Tract Infection $665 $112 $10 ($40/$49)

Telemedicine is free to Anthem members on the Primary Care Plan, $10 for non-members and Kaiser members,

and $40 (MDLive) or $49 (LiveHealth Online) for Choice HSA members.


Being Financially Responsible


Be Responsible

Know Your Options

• The cost of seeking medical treatment has increased tremendously in recent years. The best way to alleviate some of the cost burden is to make sure you are using care properly.

• If the situation is not life-threatening and not an emergency, you should not go to the emergency room.

• You would not go to a heavy metal concert to listen to classical music, so why go to the ER when it’s not an emergency?

Know the Cost

• Average cost of using Telemedicine is $10 ($40/$49 for HSA plan members)

• Average cost of PCP visit is $95-$110

• Average cost of Convenience Care Center visit is $65

• Average cost of Urgent Care is $190

• Average cost of ER visit is nearly $2,100


Employee Challenge

Congratulations! You have completed the learning portion of this education

module. Hopefully you’ve become more aware of what emergency care costs

and how its misuse not only costs you, but also the company and nation

millions of dollars annually. We challenge you to think about this when

deciding where to receive care and use this information to help you make the

appropriate decision.

Be sure to explore the MyBenefits website for additional information about

your healthcare.

In order to fully complete the module and receive points for your wellness

incentive, please complete the Appropriate Levels of Care Quiz now.

Complete Quiz Now

https://mybenefits.teletech.com/us/home/health-and-wellness-incentive-program/appropriate-levels-of-care/appropriate-levels-of-care-quiz/

appropriate levels of care -...

Documents