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November 2023  Volume 21, Number 11        
 

doctor and patient

How Smart Employers are Using Second Opinions to Avoid Unneeded Surgeries

When employees require surgery, the costs to employers can be immense—not only the direct medical bills but also lost productivity from time off work. However, a growing number of employers are realizing that many recommended surgeries may be unnecessary. By offering employees access to second opinion consultations through virtual health partners, employers can enjoy significant savings per avoided surgery while improving worker health outcomes.

The High Costs of Surgery

According to data, the average cost of common surgeries ranges from over $18,000 for a knee arthroscopy to over $110,000 for a spinal fusion. Even “minor” procedures like a tonsillectomy can cost from $3,500 to nearly $9,000.

For employers who pay a portion of employee medical bills, these costs quickly add up. A company with just 100 workers could easily spend $500,000 a year on surgeries alone.

Additionally, employees undergoing surgery require considerable time off work to recover. The average recovery time for an orthopedic procedure is 12 weeks, but it can be longer for a more complicated procedure. At a median weekly salary of $1,100, that results in $13,200 in lost wages per surgery – not counting the costs of hiring temps or paying overtime.

How Second Opinions Prevent Unneeded Surgeries

According to experts, up to 30% of medical services in the U.S. may be unnecessary. This includes procedures like spinal fusions, hysterectomies, prostate removals, and knee arthroscopies.

By providing employees access to second opinion consultations, employers give workers the chance to ensure surgery is truly the best option. Top specialists review the employee’s records and provide an expert perspective on whether alternative treatments like physical therapy or medication could be effective.

According to one major second opinion provider, over 70% of patients who consult with their specialists are given a diagnosis change or recommended alteration to their treatment plan. For musculoskeletal issues, in particular, the average savings from avoided surgery is $36,000 per patient.

The Benefits of Second Opinion Programs

Offering a second opinion program through a virtual health partner provides advantages both for employees and employers.

For employees, key benefits include:

  • Convenient access to top specialists without travel
  • Faster answers, with appointments in days instead of months
  • Improved treatment plans and medical outcomes
  • Avoiding unnecessary surgeries and associated risks
  • Reduced time off work for recovery.

For employers, benefits include:

  • Significant savings for each avoided surgery
  • Lower insurance premiums as unnecessary costs are reduced
  • Less spent on hiring temporary workers or paying overtime
  • Improved productivity as workers recover quicker
  • Boosted worker morale and retention.

Best Practices for Implementation

Implementing a second opinion program requires partnering with a respected virtual health provider. The best solutions offer access to multiple top U.S. hospitals and health systems, along with an efficient intake process to collect medical records.

Key best practices include:

  • Promoting the program in new hire packets, e-newsletters, and other employee communications
  • Training benefits administrators and HR staff on how to refer interested employees
  • Streamlining intake procedures to make the process simple for workers
  • Following up with employees after the consultation to document outcomes
  • Tracking program ROI through costs avoided.

For employers facing rising healthcare expenses, second opinion consultations represent an innovative way to reduce costs while also improving worker health. By avoiding unnecessary surgeries, companies can save thousands productive workers.

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In this issue:

This Just In ... PPACA Penalties Pack a Punch: What Employers Need to Know

Seven Open Enrollment Tips for Communicating Benefits

Virtual Physical Therapy: An Employer’s Secret Weapon Against Opioids

How Smart Employers are Using Second Opinions to Avoid Unneeded Surgeries

Employers Apply Brakes to Runaway Compensation Growth

 

 


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