Smarter care navigation. Lowers ER use.
Challenge
A manufacturing employer with more than 500 enrolled employees identified rising emergency room utilization for non-emergent conditions, creating unnecessary healthcare spend and inefficient care navigation for employees.
Using Springbuk analytics and reporting, Pinnacle identified:
- 43 impacted members
- More than $215,000 in avoidable ER savings opportunity
- Ongoing trends tied to non-emergent ER utilization
Like many manufacturing employers with shift-based and around-the-clock workforces, employees were often utilizing the ER for conditions that could have been treated through primary care, urgent care, or telemedicine services. The employer needed a strategy that could reduce avoidable healthcare spend while maintaining easy access to care for employees and their families.
Solution
Using actionable insights from Springbuk, Pinnacle partnered with the employer to implement a targeted care navigation and member engagement strategy focused on reducing avoidable ER utilization.
Pinnacle recommended and supported:
- Educational email and mailer campaigns promoting primary care and urgent careutilization
- Member education on when to use telemedicine vs urgent care vs ER services
- Mobile engagement alerts through Rightway
- Expanded telemedicine access through Teladoc
The strategy focused on improving healthcare literacy, increasing awareness of lower-cost care alternatives, and helping employees make more informed healthcare decisions without disrupting access to care.
Solutions Implemented
- Springbuk analytics and live reporting
- Population health insights
- Rightway member engagement tools
- Teladoc telemedicine integration
- Strategic care navigation support
- Ongoing reporting and trend analysis
Highlight Stats
- Identified more than $215,000 in avoidable ER savings opportunity
- 43 members identified with non-emergent ER utilization patterns
- Reduced avoidable ER visits by 20% within 6 months
- Teladoc telemedicine integration
- Strategic care navigation support
- Ongoing reporting and trend analysis
Results
Reduced avoidable ER utilization by 20% in 6 months
Through targeted outreach, telemedicine expansion, and enhanced care navigation strategies, the employer successfully reduced avoidable ER visits and improved utilization of lower-cost care settings.
Identified actionable savings opportunities through Springbuk analytics
Using live reporting and population health insights, Pinnacle helped uncover more than $215,000 in potential savings opportunities tied to non-emergent ER utilization patterns.
Improved employee healthcare engagement
The combination of proactive communication, digital engagement tools, and telemedicine access helped employees better understand where to seek appropriate care, improving overall healthcare decision making across the population.
