What is the actual cost of a team member’s doctor visit?

Trying to identify the actual cost of a team member’s doctor visit is a lot like solving those math equations that appear on Facebook. As I illustrated in my previous column, we have to break apart each component of the problem and make sure the pieces add up properly.

The health insurance we normally discuss is more appropriately considered as pre-negotiated access to healthcare at set pricing levels. This gives us a base to begin the cost calculations, but it is only a single component of a complex equation. So, what does it cost when an Employer for a team member to visit the doctor?

The simple answer is that it costs the employer the balance of the doctor’s fee not covered by the team member’s co-pay. As in the previous article, I am going to set some rates for the purpose of a fair analysis. You may feel the figures are too high or too low when considering the plan(s) to which you have been associated. Please work through the analysis and feel free to change the dollars to whatever you are currently experiencing.

When a team member decides that he or she must see a doctor, the employer has the following experience:

  • Receives notification (or maybe not) that the team member will be absent . Looks at the impact on the work schedule and on productivity;

  • Shifts other team member(s) to cover for the loss of the skill-set while team member is off;

  • Determines if overtime must be authorized to meet commitments;

  • Adjusts completion dates for projects impacted by the personnel shifts;

  • Determines if expedited shipping will be needed to meet delivery commitments.

Considering the obvious costs, the balance of the doctor’s bill may run $120 to $175 dollars for a general practitioner visit. This cost may be higher if the team member goes to an urgent care or emergency room because the physician cannot see them for several days.

Additional cost burdens

But there are other costs to be considered on the employer’s side of the ledger. Some of the additional costs associated with a team member’s doctor visit can include:

  • Overtime premium;

  • Expedited shipment to send product that was finished behind schedule;

  • Interruptions to the manufacturing line; and

  • Lost productivity, both direct and indirect.

Let’s look at direct and indirect productivity. Direct productivity is the value of the work that does not get done while your team member is away from the job. The value of the productivity is tied to the value of the products or services produced by the employer. When a team member has to take a half or full day off to see a doctor for only a few minutes, it adds significantly to the costs borne by the employer.

But there can also be indirect productivity costs. These costs are incurred when the team member who misses work has a job that significantly impacts other team members’ work effort as well. For example, in a screen printing operation, if a team member who develops the silk screens loses a day of productivity, the delay in producing new screens may affect the throughput of the facility for several weeks.

One can see that the actual costs, experienced by the employer when a team member must take off to see a doctor, can mount to multiples of the actual payment for the doctor’s visit.

Many employers are missing opportunities to reduce, or avoid altogether, the most expensive medical claims. How so? By adopting a narrow view of how to engage the majority of the employee population early in the decision-making process.

Can these costs be effectively contained and minimized? We know that video medicine can provide doctor consults for less than $50 for a GP and less than $100 for a specialist. When these consults are provided to the employee from the workplace, the loss of time from production is in the range of 12 to 15 minutes, not a half day or more. In the cases where the team member’s health concern cannot be address by a video conference, they can always follow the consult with an in-office doctor visit.

Once again, employers, through technology, can favorably impact — and control — the costs associated with team members’ health maintenance by introducing telehealth as a foundational/entry level to their healthcare plans. The number of patients using telemedicine services will increase to 7 million in 2018, up from less than 350,000 in 2013. When you provide a service that people value and want to use, you get better outcomes and greater savings.

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