Stephanie Dwilson

Controlling Costs: Children’s Health Care

In 2013, children’s health care spending amounted to $233.5 billion, according to JAMA Pediatrics.

As an employer, you can help your staff be aware of methods to lower their expenses while still ensuring their child gets the care they need. Here’s a closer look at why these costs are so high and how parents can help keep them down.

Top 10 Most Common Pediatric Health Care Costs

JAMA’s study found that the leading expense for pediatric care was inpatient care for newborns. After that came attention deficit hyperactivity disorder (ADHD) and then dental care (including orthodontics.) Here’s a list of the top 10 conditions accounting for the most spending in 2013:

  1. Newborn care
  2. ADHD (including medications)
  3. Dental care (including general exams, X-rays and orthodontics)
  4. Asthma
  5. Oral disorders (including oral surgery, fillings, crowns and dentures)
  6. Well-child care
  7. Upper respiratory tract infections
  8. Other long-term respiratory diseases (such as allergic rhinitis and chronic sinusitis)
  9. Skin and subcutaneous diseases (cellulitis, sebaceous cyst, acne, eczema and the like)
  10. Falls and injuries

This list is likely not a huge surprise to parents. All parents dread hearing that their child needs braces, and managing any chronic condition can get costly. However, your employees can have a lot more say in their child’s treatment plan than they may know.


How Parents Can Lower Their Children’s Health Care Costs

When it comes to nonemergency care, parents should always look into getting a second opinion if something seems suspicious, as it’s possible to fall victim to overcharging or unnecessary treatments. These might include expensive optional MRIs, immediate surgery instead of trying less-invasive therapy first or expensive cosmetic add-ons during surgery. If a doctor suggests getting a child’s ears pierced during surgery, for example, pass on that “opportunity,” suggests NPR.

But how can parents tell when treatments are unnecessary? It requires a little preparation. Before getting blood work, for example, have them ask for a list of everything that’s being tested. A child might be getting an unneeded pregnancy test or extensive testing for irrelevant substances. And if pills are suggested for ADHD, find out if therapy might help, too. Sometimes behavioral modification improves ADHD faster when done before medication, as CNN reports. Not to mention that therapy brings a lowered risk of negative side effects when compared with medication.

And parents shouldn’t be afraid to do their own research before agreeing to a treatment. If they’re being pressured and it’s not an emergency, that might be a red flag. Dentists, for example, may have different thresholds when it comes to cavity treatment, with some wanting to do full treatments on minor issues that other dentists would simply watch.

How Employers Can Help Advocate for Children’s Health Care

The first thing you can do to help is educate your employees about the possibility that doctors might recommend unnecessary treatments. Make sure they know you’re telling them about these costs out of concern for their children’s well-being and not because you simply want to cut medical costs. See if there are ways you can support employees who want to shop around. For example, you could offer paid time off to get a second doctor’s or dentist’s opinion. This lets your employees know that you care and are willing to work with them to lower health costs, instead of against them.

Consider having a health insurance representative meet with employees one on one. If a prescription is denied coverage, for example, an agent may be able to suggest an appeal or an override request. And agents can also tell employees if their insurance offers a transparency tool that can let them estimate the costs of procedures beforehand, in case they want to shop around. You might even recommend telemedicine. These virtual visits with providers can cut costs and save time.

By making your workplace a wellness-focused environment, you can help your employees feel comfortable asking health insurance questions when their children are involved. And you can empower your employees to know that it’s OK to seek a second opinion and be an active advocate for their children’s health care.

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