The rising importance of听choice听
Many people have experienced it: an unexpected illness or minor injury disrupts the day, or routine bloodwork gets pushed further down the to-do list.听
Today, people have more choices than ever for receiving routine care, from telehealth and urgent care to retail clinics and ambulatory surgery centers. But where people get care can significantly affect both costs and the overall experience.听
For routine or non-emergency care (such as diagnostic imaging, lab work, infusions and procedures that听诲辞苍鈥檛 require an overnight hospital听stay), people typically have two categories of choice:听
Hospital-based outpatient settings, where people receive care without being admitted overnight.
Non-hospital settings such as your primary care doctor, urgent care clinic, ambulatory surgery center听or telehealth.听
For example, telehealth visits may be a convenient option for flu-like symptoms, allergies, rashes or sinus infections, while urgent care may be more appropriate for sprains, ear pain or minor injuries.听
But听different care settings come with different price tags.听For example, consistently shows that听hospital outpatient departments听charge听far more for many services, in part听because they include facility fees, even when the quality of care is the same. A recent found that infusion care received in hospital outpatient departments resulted in 42% higher costs than care provided in non-hospital settings, despite similar outcomes and patient experience. In many cases, people can receive the same high-quality care in lower-cost settings, without sacrificing outcomes or convenience. This is why we strongly suggest that our members consider these lower-cost options.听
One challenge is that many people 补谤别苍鈥檛 thinking about cost when they need care, especially when they need care urgently. While the emergency room may seem like听a good choice for last-minute care needs, it typically costs much more and takes longer than other non-emergency care options.听
Tha迟鈥檚 why听helping people understand their options and identifying听high-quality, lower-cost alternatives is a core focus for Anthem. Through care navigation tools and support, members in Missouri can compare care locations, understand potential cost differences and explore lower-cost, high-quality alternatives when medically appropriate.听听
Why it matters: Cost and care experience听
When people use higher-cost settings without asking about their options, the impact goes beyond cost alone. They may also encounter more complex, fragmented care experiences that feel harder to navigate, particularly for services that are non-urgent.听Care settings outside the hospital may offer more convenient , with options that can bring care closer to where people live.听听听
Ambulatory surgery centers are one non-hospital option that people might not know about.听These centers can perform many of the same routine outpatient procedures as hospitals, such as colonoscopies or upper gastrointestinal procedures, but at a lower cost.听In fact, people can save up to thousands of dollars per surgery when procedures are performed at an ambulatory .听
When people have early access to this information, they can make听decisions听that best serve their health needs and budget.听听
How Anthem can help听
For Anthem members in Missouri, these tools and resources can help people find the right care, in the right place, at the right time,听resulting in lower costs听and care that feels easier to navigate. When they use our Sydney Health app, or log into their account with Anthem, they can compare costs, manage care in one place and get personalized information to help choose care that fits their needs and budget. Providers highlighted in the app and on our website as 鈥淎nthem Diamond Providers鈥 offer outstanding care at competitive prices.听
Knowing where to go for care is not always easy, but Anthem can help simplify the decision-making process. For many common health concerns, people may have options such as telehealth, urgent care, retail clinics or a doctor鈥檚 office that can save time, lower costs and reduce the stress of unexpected medical bills.听
Learn more at .
