How convenient care could increase healthcare cost growth in 2019

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Ingrid Stiver Senior Manager, Health Research Institute, PwC US September 07, 2018

Consumers have more ways to obtain care than ever—including, for example, grocery store retail clinics and video chats with clinicians via smartphone.

Access to traditional care settings also is increasing, with the number of urgent care establishments nationwide estimated to grow 32 percent from 2014 to 2019. This is great for convenience, a key healthcare experience feature valued across consumer segments, according to a 2018 HRI report on customer experience.

But this “care anywhere and everywhere” trend also is driving utilization, making it an inflator for 2019.

The background

  • Many consumers are seeking out care in settings outside of the traditional doctor’s office; of those surveyed with employer-based insurance, 60 percent said they have received care in an urgent care center, 25 percent in a retail health clinic and 11 percent by video visit.
  • To meet the demand for convenience, employers offer different types of healthcare touch points to their employees. Some, such as wellness programs, aren’t direct medical care but are “low touch” and can lead to follow-on medical care.
  • For example, the majority of employers surveyed offer health risk questionnaires and biometric screenings to their employees—both of which can identify health concerns and prompt further care.
  • Other employer offerings are “high touch” and involve direct visits with primary care providers.
  • New high-touch points of care—from retail clinics to video visits to urgent care in the home— have popped up over the past few years. In 2018, 38 percent of employers offered executive health exams to their employees—a high-touch benefit that is usually separate from the employee’s health insurance benefits and in addition to the free, annual preventive care visit covered under the health insurance benefit—up from only 24 percent in 2014.

The data

Consumers have more ways to access care than ever, but the trend may also be driving utilization
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HRI impact analysis

While the short-term result of increased access may be increased utilization, payers and employers hope that access will reduce costs in the long term by detecting and treating health concerns early and shifting care from higher-cost environments to those that cost less. Achieving appropriate utilization will require employers, payers and providers to strike a balance between access and convenience to avoid delaying care or creating unnecessary demand.

Contact us

Ingrid Stiver

Senior Manager, Health Research Institute, PwC US

Benjamin Isgur

Health Research Institute Leader, PwC US

Rick Judy

Principal, Health Industries, PwC US

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