/ Economics / Health Care Cost Containment Beyond the Obvious

Health Care Cost Containment Beyond the Obvious

Lisa Hall

A bottle of pills spilling on top of a stack of dollar bills.

Cost Containment

When you think about health care cost-containment, you probably envision wellness programs such as weight loss plans, exercise regimens and smoking cessation programs. Poor health habits are very costly to us as individuals, and as a nation. According to a new study by the Society of Actuaries, obesity-related illnesses cost the U.S. an estimated $270 billion dollars per year. Smoking has been a strong risk factor for cancer and heart disease for many years.

As you will see from the healthy living pyramid below, lifestyle is the foundation for overall good health. First, you must exhaust all opportunities to heal with a healthy diet, adequate rest, a healthy outlet for stress, and regular exercise. If these options do not help the symptoms, the next step is to add a trial of vitamins or supplements. If still not successful, then try prescription medication, with the last resort being surgery.

Healthy living is an obvious solution for reducing health care costs. But there are other actions that you and your employees can take to use your health care resources more efficiently, thus reducing or even eliminating unnecessary health care spending. More importantly, these simple strategies can help you and your team members improve your quality of life and in some cases, even save your life:

1.    Keep up with Regular Screenings. Early detection is the next best thing to prevention. Catastrophic illness caught in an early stage offers a much better prognosis and cost savings to the patient, employer, and insurer. You may assume that your doctor will tell you when you are due for your screenings, but this is not always the case. Claire had her first mammogram at age 77 – at her request. Because she visited her primary care physician sporadically, her regular screenings fell through the cracks. Larry’s story is more compelling. He requested his first colonoscopy at age 68, despite the absence of symptoms. The gastroenterologist found a large mass which turned out to be malignant.
Fortunately, Larry’s cancer was stage I and he was cured with surgery and didn’t need chemo. But had he waited, his story may not have had a happy ending.

Bottom line is this – the responsibility for regular screenings lies with the patient. Your physician cannot possibly know when you and 3,000 other patients are due for screenings, unless he has an expensive electronic medical system. To determine which screening tests you need based on age and gender, visit women.webmd.com/tc/early-disease-detection-overview.

2.    Make the most of physician office visits. The average primary care physician must see between twenty-five and fifty patients per day to maintain a successful practice. This means you will have just to nine to nineteen minutes with your physician. Make the most of these minutes by preparing a list of questions prior to your visit and by bringing an up-to-date list of medications, surgeries, hospitalizations and chronic conditions, particularly if any of these have changed since your last visit.  You can find downloadable tools to help you organize your medical information at  www.theproactivepatient.com/page7.php.

3.   Manage your medications. Medication errors occur with far more frequency than any other medical adverse event. Physicians, nurses and pharmacists take precautions, but there are also steps that you as the patient can take. Use just one pharmacy to avoid dangerous drug interactions. You must have one central source for your medications; there is too much room for error with more than one. Most pharmacies have sophisticated computer systems that flag dangerous interactions. But as an added precaution, you should check medications before you take them to make sure you received the correct prescription. Learn as much about medications’ side effects and interactions as possible. Talk to your pharmacist, look at the package inserts, check the Web sites of the drug manufacturers, and check online for postings from patients who have experienced troubling side effects. Call in refills on your medications several days before you run out in case the pharmacy has to order more.

4.    Coordinate care between multiple physicians to avoid costly duplication of services. To ensure that you are not receiving treatments that conflict with one another, make sure your primary care physician knows about medical care you are receiving from any specialists you have found on your own or from alternative practitioners. You may find that one doctor needs to share your records and, in some cases, X-ray films with other doctors. It is your responsibility to follow up to make sure this happens; even if it means hand delivering reports and films yourself. You must also be the focal point when you have several medical practitioners working together on your case. You cannot assume that all of your doctors are communicating effectively with one another.

5.    Know your insurance plan and its limitations. Again, this is a patient responsibility, not a physician’s office responsibility. The best time to determine coverage of a test or treatment is before it is administered.  If you have questions after contacting your insurer or reviewing the manual provided by your insurer, you can contact your company benefits administrator.

6.    Know your options for emergency medical care before you have a medical emergency. Contact local urgent care clinics to determine their capabilities for treating emergencies that are not life-threatening. In many cases, urgent care clinics can provide care for a fraction of the cost at a hospital emergency department. And you may get better care with a shorter wait time.

7.    Know your rights and responsibilities during hospitalization. If you are unable to assume these rights and responsibilities, make every effort to have a friend or family member help you safeguard against infection risks, surgical errors and medication errors. You can also contact the hospital’s patient advocate or administrator if you need help resolving any issues with treatment.

These strategies are simple, no-nonsense ways to curb unnecessary health care spending, while keeping your team as healthy and happy as possible!

About the Author

Lisa Hall works full-time in human resources at AAR CORP, with a focus on training and development. She is also the author of the patient health care reference guide Taking Charge of Your Own Health (Harvest House Publishers: 2009.) To learn more about this book and Lisa’s amazing medical journey, please visit www.theproactivepatient.com.

Lisa is an avid runner and recently completed her first marathon. Her story appears in the December 2010 issue of Runner’s World magazine.

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