Great-West Healthcare, now part of CIGNA. Volume 22 Driver’s Seat It’s Your Health. Stay in the Driver’s Seat.® • Your Road Map to Health Care Services • Did You Know? • The Ins and Outs of Patient Care • Take Our Quiz Your Road Map To Health Care Services Choosing a health care provider or facility isn’t as simple as it used to be. Consumers now have options ranging from outpatient surgical centers, to inpatient hospital treatments, to retail or “minute clinics.” This issue of Driver’s Seat covers the basics about the various types of providers and facilities and how your choices affect your costs. GPS – Good Place to Start Your primary care physician is usually the best starting point for diagnosis. Your doctor can provide many treatments – even minor surgical procedures – in the office. Short Cut If you need to see a doctor but can’t get an appointment as quickly as you need, ask if the office has a physician’s assistant (PA) or nurse practitioner (NP) on staff. These licensed professionals can perform most of the same tasks as doctors but are often more readily available – and sometimes less expensive – to see. Emergency Vehicles Only Using emergency rooms for non-life-or-limb-threatening conditions is an expensive and time-consuming route: The typical ER visit costs about $150, versus the average doctor’s office visit charge of around $60 (before insurance discount, based on 2005 Great-West Healthcare data). And ER patients are usually treated in order of severity of injury, which could mean hours spent waiting in the emergency room just to be treated for something simple. If you feel your injury or illness is not an emergency but you do need care as soon as possible, consider going to an urgent care facility. Go to MyGreatWest.com to locate the urgent care center nearest you. Express Lane Another option for nonemergency but quick or last-minute medical care is a retail clinic or “minute clinic.” These facilities are like taking the express lane to health care – patients can be seen by a PA or NP, receive basic medical care, including any necessary prescriptions, and be out the door in about 15 minutes. The clinics do have a limited scope of practice (for example, they don’t treat chronic conditions such as diabetes). But if you need something simple such as a strep culture or treatment for seasonal allergies these clinics might be the perfect medicine. Visit MyGreatWest.com for a list of Great-West Healthcare, now part of CIGNA, participating retail clinics. Detour This One antacid tablet for nearly $14? Four acetaminophen tablets for $16? Charging hefty prices for common medicines is common among hospitals because they must offset their costs for quality control and they fear liability for medication errors. Some hospitals allow patients who undergo certain procedures to bring their own medications, if their doctor provides a written order and the hospital can verify the drugs before the procedure. Discuss this option with your doctor and the hospital as far ahead of time as possible and be sure all medications and dosages are properly documented and recorded. Did You Know? MyGreatWest.com has a Treatment Cost Estimator tool that gives you the average out-of-pocket costs for a variety of medical procedures in your geographical area MyGreatWest.com has a Hospital Quality Comparison tool that can help you evaluate the quality of area hospitals based on specific inpatient procedures 78% of the public thinks retail/ minute clinics could provide a fast, convenient way to receive basic medical services1 More than 60% of elective surgeries in the U.S. are performed as outpatient surgeries2 A poll of ER visitors published in October by the California HealthCare Foundation found that 46% of the respondents admitted their problems could have been handled by a primary care doctor3 1 The Minute Clinic Movement: Model for the Future or 60 Seconds of Fame? California Health Care Foundation, January 2007 2 Outpatient surgery, www.emedicinehealth.com/outpatient_surgery/article_em.html, (Aug.2008) 3 Bread, Milk — and a Diagnosis, Los Angeles Times, January 2007 The Ins & Outs of Patient Care Inpatient means you must be admitted to a hospital for a procedure – usually so you can be closely monitored during the procedure and during recovery. The length of your hospital stay depends on the procedure. And the longer your hospital stay, the higher your out-of-pocket costs can be. If you have an upcoming surgery or procedure, ask your doctor if it can be done on an outpatient basis. An increasing number of surgeries can be done on an outpatient basis. That means the procedure may be done without hospital admission – for example at an ambulatory surgery center, or sometimes within a hospital but without an overnight stay. In these situations, patients are monitored after their procedures but can then recover in the comfort of their home. And outpatient treatment typically costs less than inpatient treatment: Average Inpatient Cost $4,047 Average Outpatient Cost $2,093 Source: Milliman Medical Index, 2006 Take Our Quiz 1.  Communities with high emergency department use have higher numbers of uninsured and noncitizen residents. A. True B. False 2.  Reducing emergency department use for nonurgent medical care could help lower health care costs and improve patients’ experiences with the health care system. A. True B. False 3.  The average time spent waiting in an emergency room is more than three hours. A. True B. False Answers: 1. B. False4, 2. A. True5, 3. A. True6 4 What Accounts for Differences in the Use of Hospital Emergency Departments Across U.S. Communities? Peter J. Cunningham, The Center for Studying Health System Change, July 2006 5 Ibid 6 Centers for Disease Control 2003 National Hospital Ambulatory Medical Care Survey Emergency Department Survey Legal disclosures M4931 (Rev. 9/08)  Vol. 22 © Copyright 2008 CIGNA.