By Mike Murphy, President, Anthem Blue Cross and Blue Shield in Nevada
The Rising Importance of Choice
Many people have experienced it: an unexpected illness or injury disrupts the day, or routine blood work gets pushed further down the to-do list.
Today, people have more choices than ever for receiving routine care, from virtual care and urgent care to retail clinics and ambulatory surgery centers. But where people receive care can significantly affect both costs and the overall experience.
For routine or non-emergency care – such as diagnostic imaging, lab work, infusions, and procedures that don’t require an overnight hospital stay – people typically have two categories of choice:
- Hospital-based outpatient settings, where people receive care without being admitted overnight; and
- Non-hospital settings such as your primary care doctor, urgent care clinic, or virtual care.
For example, virtual care may be a convenient option for flu-like symptoms, allergies, rashes, or sinus infections, while urgent care may be more appropriate for sprains, ear pain, or minor injuries.
But different care settings come with different price tags. For example, research consistently shows that hospital outpatient departments charge more due to facility fees, even when the quality of care is the same. A recent study found that infusion care received in hospital outpatient departments resulted in 42% higher costs than care provided in non-hospital settings, despite similar outcomes and patient experience. In many cases, people can receive the same high-quality care in lower-cost settings, without sacrificing outcomes or convenience.
The challenge is that these cost differences can be hard to anticipate. While the emergency room (ER) may seem like a good choice for last-minute care needs, it typically costs more and takes longer than other non-emergency care options.
That’s why helping people understand their options and identify high-quality, lower-cost alternatives is a core focus for Anthem. Through care navigation tools and support, members in Nevada can compare care locations, understand potential cost differences, and explore lower-cost, high-quality alternatives when clinically appropriate.
Why It Matters: Cost and Care Experience
When people default to higher-cost settings without understanding their options, the impact goes beyond cost alone. They may also encounter more complex, fragmented care experiences that feel harder to navigate, particularly for services that are non-urgent. Care settings outside the hospital may offer more convenient experiences, with options that can bring care closer to where people live.
One non-hospital option that may be lesser known to people is ambulatory surgery centers. These centers can perform many of the same routine outpatient procedures as hospitals, such as colonoscopies or upper gastrointestinal (GI) procedures, but at a lower cost. In fact, people can save roughly $1,000 per surgery when procedures are performed at an ambulatory surgery center.
When people have access to this information earlier, they can make decisions that best serve their health needs and budget.
How Anthem Can Help
Anthem helps members in Nevada compare healthcare costs and plan for out-of-pocket expenses before scheduling procedures through tools like Anthem’s Find Care tool and the Sydney Health mobile app. Members can compare costs, manage care in one place, and access personalized information to choose care that fits their needs and budget. Anthem’s tools and resources help members find the right care, in the right place, at the right time, resulting in lower costs, fewer surprises, and a simpler care experience. Members can compare costs, manage care in one place, and access personalized information to choose care that fits their needs and budget. Anthem’s tools and resources help members find the right care, in the right place, at the right time, resulting in lower costs, fewer surprises, and a simpler care experience.
Knowing where to go for care is not always easy, but Anthem can help simplify the decision-making process. For many common health concerns, people may have options such as virtual care, urgent care, retail clinics, or a doctor’s office that can save time, lower costs, and reduce the stress of unexpected medical bills.
Learn more at http://anthem.com/healthcareinnevada.