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How to avoid costly ER visits

Senior adult man sits in the waiting room with his head in his hands

Lived experiences influence health and lifestyle choices. In fact, certain experiences can help predict patterns in community health and outcomes. They also play a role in the cost of care.

That’s why Arkansas Blue Cross and Blue Shield proactively uses data to gather insights on employee health needs. This then guides the education and resources available for employees to get the most from their health plan. Read on for an example of how data insights can help employees navigate the best option between preventative and emergent care.

How family experiences influence our health decisions

Data shows that one family member’s healthcare experience can influence care decisions for the rest of the family. A prime example of this is an emergency room (ER) visit. By analyzing anonymized claims data, Arkansas Blue Cross found that if a family member visits the ER once, then another family member is likely to visit the ER within the next three months.

For example, a dad goes to the ER for a medical emergency. He receives same-day treatment and gets better. The next time his son or daughter has a health issue, the ER may be the first place they think to go. Because of the dad’s positive experience, the child goes to the ER, regardless of whether it’s an emergency.

While the ER is a great way to access care for emergencies, lower-cost options are often available that can still provide timely and quality care. Opting for primary care over emergency room visits is a strategic choice that benefits both employees and organizations.

Turning insights into action

Arkansas Blue Cross’s data analytics team can identify events and trends that lead to things like unnecessary ER visits. With this data, we can gain deeper insight and intervene accordingly.

In the ER visit example, we can see the family’s medical emergency put their health top of mind. These moments are important opportunities to connect with members. We can provide education about their health and resources on care options. We can help encourage employees to establish a relationship with a primary care provider. By intervening early, we can help prevent unnecessary care and costs in the future.

Through predictive modeling[L(1]  and understanding the spillover effects to the family, we can identify factors that lead to certain behaviors and health outcomes. We can then provide the resources and programs to support members’ health. In turn, this promotes healthier outcomes, reduces overall healthcare costs, and ensures they receive timely, effective care, ultimately supporting productivity and well-being in the workplace.

Taking good care of our members

At Arkansas Blue Cross, we are always looking for innovative ways to take good care of our members and employers. Access to data helps identify trends in members’ health decisions. It also helps us understand the right moments to connect with them. These touchpoints are crucial to help members access resources to support their whole health and wellbeing – all while helping keep your workforce healthy and give you financial peace of mind.

Our website provides helpful information on how to find an in-network provider. More details on Arkansas Blue Cross health plans are available on our employer health plans page.

 

Dr. Aaron Novotny

Dr. Aaron Novotny smiling

Dr. Aaron Novotny, Ph.D., M.S. is director of health economics at Arkansas Blue Cross and Blue Shield, where he works to examine the economic impact of clinical services and population health interventions on members’ outcomes and understand how community characteristics impact members’ health trajectories and manifest as regional health disparities. In addition to his role at Arkansas Blue Cross, he is also an adjunct professor at the Fay Boozman College of Public Health at the University of Arkansas for Medical Sciences where he works with other faculty members on research projects regarding population health and dynamics while serving on dissertation committees.