Health Care Groups Try to Steer Traffic From ERs

Your 9-month-old wakes up screaming and rubbing her left ear on a Saturday morning.

You know she needs a doctor, but the pediatrician's office is closed and won't reopen until Monday.

So what do you do?

You might be surprised how many people are rooting for you to take her to a clinic or urgent care center rather than the emergency room.

Health care providers, health insurance companies and various employers are trying to persuade consumers to choose clinics or urgent care centers when appropriate to reduce medical costs.

The potential savings are staggering. The average ER charge for treating strep throat is $313 compared with $33 at urgent care centers and $30 at retail health clinics, according to Anthem Blue Cross Blue Shield.

Indianapolis-based Anthem in August launched an online campaign to direct people to clinics when the situation is serious but not a life-or-death emergency. The site links to Google Maps, which provides directions.

Anthem Blue outlines differences between emergency and urgent care situations on its website. The ER is appropriate when "immediate medical attention is needed to avoid serious health risks."

An urgent care clinic or retail health clinic is the right choice for "serious conditions that cannot reasonably be postponed for regularly scheduled care, but which are not emergencies."

Ben Eisbart hopes people pay attention.

The human resources vice president for Steel Dynamics Inc. said unnecessary emergency room use costs an employer's health plan significantly more than a clinic visit. That expense has motivated some companies to launch employee education efforts and others to address the issue during labor contract negotiations.

Eisbart spoke about a particular set of the company's unionized employees who logged 100 percent more ER use in recent years than other OmniSource Corp. workers.

That group of Michigan employees was working under a contract that allowed them to visit emergency rooms without making a co- payment or first paying a deductible for health care expenses.

"There's no encouragement to make an appointment with Doc Jones," Eisbart said of the expired health benefit. "No one is saying the emergency room should not be used. But it should be used for emergencies."

Al Sprague, president of Teamsters Local 164, represents those OmniSource employees at three Michigan locations.

Sprague agreed that clinics are gaining in popularity and are bound to save money for those who use them. But, he said, the small towns where his workers live don't have urgent care centers or other clinics. They just have a small hospital and various doctors' offices.

Workers in Local 164 are on the job from 5 a.m. to 5 p.m. six days a week. They hoist scrap metal into railroad cars outdoors in all kinds of weather, Sprague said. The hours make it harder for them to visit a doctor's office, and their job duties make them prone to more injuries, the union leader said.

Sprague disagreed with Eisbart's method of calculating ER use. Eisbart used the usage rate of the 77 Michigan workers compared with the average usage rate of the company's other 2,176 workers, a group that includes executives and others who don't have physical jobs, Sprague said.

"He wasn't comparing apples to apples" when he found that Michigan workers used the ER twice as much, Sprague said.

Steel Dynamics Inc., OmniSource's parent company, employs more than 6,000 and insures 13,000 to 14,000 lives, including workers' families, Eisbart said.

Nationally, about 17 percent of hospital ER visits could have been treated in a retail clinic or urgent care center instead, according to a study by the Rand Corp., a non-profit research firm.

Rand's report defines a retail medical clinic as an area inside a pharmacy or grocery store that is typically staffed by a nurse practitioner. Those clinics can handle minor conditions, such as sore throats and urinary tract infections.