Routine annual physicals and preventive care

CDHP members are 30 percent more likely than traditional health insurance subscribers to get a routine annual physical and 23 percent more likely to follow their doctor’s preventive care guidelines. The point of routine annual physicals is to catch problems early, and the aim of preventive care is to minimize the risk of developing problematic health conditions in the first place. Preventive care methods include screening for diseases, immunizations, and counseling on how to prevent diseases. CDHP members are educated about the importance of preventive healthcare and catching conditions early, and understand that the earlier something is caught, the less money will be spent on treatment.

There are many pre-existing conditions for various health concerns that we can use to illustrate the power of early detection. For example, Joanne long ago developed a slightly misshapen mole on her lower back. She only goes to her doctor to address specific problems, never for a regular physical, and since she didn’t know about her mole, her doctor remained unaware of it. Years later, the cells of her mole were found to be cancerous, and doctors worried that the cancer may have spread to Joanne’s other organs via her bloodstream or lymphatic system. Joanne will have to have the mole removed, and treatment will likely require surgery, radiation therapy, and possibly even chemotherapy. Had her doctor noticed the mole earlier, he probably would have recommended that it be removed as a precaution. A simple yearly check-up could have saved Joanne not only all of the costs associated with treatment, but also the risk to her life and general state of health.

Ruby, a mother of three young children, serves as a good example of preventive care. At the beginning of each winter, Ruby takes all of her kids to get their flu shots, which decreases their chances of getting the flu. Their potential good health also ensures they won’t pass the flu along to any of their classmates at school and daycare, to each other, or to their aging grandparents.

Treatment programs

CDHP members are 20 percent more likely to follow their doctor’s treatment program for chronic diseases. This is a prime example of cutting costs in the right ways. Although CDHP members are taught to avoid spending money where it isn’t necessary, they are also taught to know when treatment is essential.

Andre, an asthma sufferer, has a prescription inhaler that he is supposed to use twice a day. Not having had an attack for a few weeks, he decides he probably doesn’t need his inhaler that often, and will use it only if he feels an attack coming on. However, asthma doesn’t always work this way, so when Andre does have an attack, the immediate use of his inhaler doesn’t stop it. He is rushed to the hospital where he has to undergo tests and spend the night, resulting in a significant hospital bill. If he’d only done what his doctor recommended and used his inhaler as prescribed, his only bill would be for his prescription.

Asking questions

CDHP members are more likely to ask about medical costs and choose a less expensive option when available and appropriate, which makes sense, because consumers spend their own money more wisely than they spend yours. Most of the time, healthcare consumers don’t ask if there is an effective alternative to the treatment being prescribed. While patients should follow their doctors’ recommended treatment plans, this does not mean they shouldn’t ask if there are less expensive alternatives. If there are not, you should do as your doctor orders, but remember: it never hurts to ask.

Tom  suffers from epilepsy. His doctor has prescribed a drug called Depakene, which Tom takes three times a day. One 250-mg bottle of Depakene lasts one month and costs him $200.38. If Tom had asked a few questions, he would have found out that 250 mg of valproic acid, which is the common generic alternative to Depakene and is essentially the same drug, can be purchased for $41.56. This is a 79 percent price difference, one that is not uncommon between generic and brand-name drugs. Choosing the generic alternative would have saved Tom $158.82 every month, or $1905.84 per year.

Alternate choices

CDHP members are encouraged to be responsible healthcare consumers. They become more aware and more conscious of the symptoms and degrees of illness that dictate a visit to the emergency room or to their family doctor, and when they can safely treat themselves. When they aren’t sure, in most cases there are health plan nurse advice lines they can call to confirm whether or not their symptoms are serious.

Alternative measures that can take some of the burden off of the healthcare system can be seen in Maria’s example.

Maria started feeling under the weather on Sunday afternoon, bothered by a runny nose and sore throat. She woke up Monday morning feeling the same, and decided to call in sick to work. After calling, she took two acetaminophen and went back to bed. Throughout the day she drank tea, ate soup, rested, and took two more acetaminophen in the afternoon. After a solid sleep on Monday night, she woke up Tuesday morning feeling much better and went to work. Had Maria been worried about her symptoms, she could have called a nurse advice line, and would have been reassured that she was taking the right steps and that her symptoms pointed to a common cold.

Maria could have decided that she wanted to be absolutely sure she wasn’t suffering from something more serious and made an appointment to see her doctor that afternoon. She wouldn’t have given her body the rest it so badly needed because she’d be too busy driving to the doctor’s and sitting in the waiting room when she could have been in bed resting.