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Three keys to increased savings with expert medical opinions

By Rob Cavanaugh, President, Accolade | February 23, 2023 | 5 min read

Healthcare advocacy and navigation benefits deliver a better health experience for employees. These services provide the best care for your employees’ unique needs and decrease overall healthcare costs for the organization. Another way to reduce those expenses — while improving healthcare access, outcomes and satisfaction even more — is by adding an expert medical opinion option. 

Each year, diagnostic errors affect about 12 million U.S. adults. [1] The Institute of Medicine estimates that "unnecessary services" are the largest contributor to more than $200 billion in annual wasted healthcare costs. [2] In short, errors and needless care are costly and potentially harmful. Expert medical opinions, also commonly referred to as second opinions, can reduce these expensive and dangerous risks, while helping your employees better understand their diagnosis, treatment options and associated benefits. 

Reduce the risk of misdiagnosis 

Estimates suggest that misdiagnosis errors in emergency rooms alone lead to harm for 2.6 million people (about the population of Mississippi) each year. [3] While the goal of emergency rooms is to focus on acute and immediate situations, another relevant study speaks to how often these errors occur and are addressed overall. The New England Journal of Medicine found that second opinions resulted in a change of diagnosis in 12% of cases and a change of treatment plan in almost 30% of cases. [4] You can help your employees avoid the negative impacts of this widespread problem by equipping them with an expert medical opinion option. 

Avoid unnecessary treatments 

When your employees face a major medical decision, they may feel like their provider’s first recommendation is the best and only approach. That is not always the case. In fact, a Johns Hopkins survey found that physicians who responded believe that at least 15-30% of medical care is unneeded. [5] A study published in the Journal of the American Medical Association echoes this belief with findings that suggest approximately 30% of medical procedures may be unnecessary. [6] A second opinion can help shed light on the factors that lead to a diagnosis and examine whether the best course of treatment has been recommended.  

Lower healthcare costs 

Ensuring that employees get the right diagnosis and treatment can reduce an employer’s costs in many ways. A second opinion that changes a diagnosis can prevent treatment for the wrong condition, reducing the potential for further medical issues and increased healthcare costs. It can help your employees avoid expensive, nonessential treatments, including surgeries and costly medications, by introducing a less invasive or lower cost choice that effectively addresses their health needs. An expert medical opinion can also lead to more appropriate and potentially cost-effective treatment plans. For instance, the Centers for Disease control reported that up to 50% of all outpatient antibiotic use may be inappropriate. [7] Empowering your employees with an expert medical opinion option could correct these types of medication issues and result in substantial savings.  

Integrating a proven second opinion option 

It’s clear that HR (Human Resources) leaders are committed to helping their employees manage the complex healthcare system. That’s why many of them have elected to offer healthcare navigation and advocacy solutions. When a medical diagnosis or treatment recommendation leaves an employee confused or concerned, though, it’s valuable to have another resource. A virtual second opinion solution gives employees easy access to a resource that helps ensure they don’t feel like they're on a healthcare assembly line, makes it clear that you value their wellness and empowers them on their healthcare journey. Accolade’s Expert MD solution can: 

  • Confirm a person’s diagnosis or treatment and help them feel more confident about the next steps. 

  • Provide knowledge and alternative treatments, giving people more control over their health.  

  • Ensure peace of mind by affirming that a person is on the right healthcare path.  

  • Decrease overall medical expenses by reducing overtreatment and misdiagnosis. 

Our proven second opinion resource has already helped an organization with more than 50,000 employees drastically reduce costs in just 12 months. [8] With Accolade, the company was able to receive 75 online second opinion consultations per month, saving them more than $4.4 million. [8] Our solution is also shown to improve clinical outcomes — with 89% of consultations resulting in improved treatment plans — and elevate member satisfaction — demonstrated by a 91 Net Promoter Score across our book of business. [9] 

When you combine the benefits of advocacy with our second opinion service, employers have a unique opportunity to significantly lower costs and improve outcomes. With our advocacy service we understand where someone is on their clinical pathway and can introduce a second opinion at exactly the right time, all with very little effort from the member. That’s because we understand when someone is accessing care and the type of care they are receiving, such as physical therapy or potential surgery. These signals, along with our data and True Health Action Plan, let us integrate our second opinion service at exactly the right time. 

Accolade can lower your cost per member each year by offering your employees access to expert medical opinions via phone or video consultations — with or without advocacy. To learn more about the impact this solution can have on your organization and to request a demo contact us.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145460/

[2] https://jamanetwork.com/channels/health-forum/fullarticle/2760210

[3] https://effectivehealthcare.ahrq.gov/products/diagnostic-errors-emergency/research#field_report_title_1

[4] The New England Journal of Medicine

[5] https://hub.jhu.edu/2017/09/06/unneeded-medical-care-hopkins-survey/

[6] Journal of the American Medical Association

[7] https://www.cdc.gov/antibiotic-use/data/outpatient-prescribing/index.html

[8] Accolade Case Study Koch 2021

[9] Expert MD Book of Business Statistics 2021

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