As a benefits leader, you’re navigating a new landscape in health care – from generational shifts in the workforce and rising rates of chronic illness to escalating pharmacy costs and economic uncertainty. It all adds up to the most challenging health care cost environment in more than a decade. The good news: by taking smart actions and choosing a health care plan that delivers the most value, you can protect your people and your bottom line.

Cost drivers like unnecessary ER visits, missed screenings, and confusion about coverage are preventable. When you offer health care that’s proactive, benefits that are easy to understand, and a simple, stress-free way to access care, you’re protecting your people and your budget. 

But where do you start? It can be tricky to know what actions you can take to contain costs without sacrificing quality care. Here, you’ll find strategies and actionable steps you can take to keep costs predictable. 

1. Make prevention automatic

Small preventive actions taken early can stop big costs later. Missed screenings, unmanaged chronic conditions, and skipped vaccinations can all create unpredictable spending down the line. 

The solution isn't convincing employees to care more. It's choosing a health care provider that makes prevention so easy they don't have to think about it. Here's how: 

• Make it easy to book appointments: When reminders include a scheduling link to your provider, employees can book in minutes instead of adding it to a to-do list. 

• Make prevention a priority: Launch "Preventive Care Weeks" tied to the start of benefits periods. Make the campaign visible, make it easy, and give employees a clear window to act. 

• Reinforce prevention throughout the year: Use short, seasonal messages to remind employees about timely checkups, screenings, and vaccinations.

2. Make benefits easy to understand

Coverage confusion can lead to skipped preventive care, enrollment errors, and frustrated employees who question whether their benefits are worth it.  
 
The cost of confusion is real: Complex enrollment errors can cost employers an estimated $6,800 per instance to correct.1 And when benefits are hard to navigate, employees can become frustrated, leading to higher turnover, which can cost $25,000 to $50,000 per instance.2,3

You can help close those gaps with simple communications that are consistent and designed to help at the right moment. Here's how:  

• Replace dense PDFs with short, focused messages: Instead of sending the full benefit guide, send a series of short emails with easy-to-understand subject lines.

• Check for understanding after enrolment: Use quick pulse surveys to catch recurring confusion before the next cycle. If employees consistently misunderstand the same things, that tells you where to clarify. 

• Offer live Q&A sessions before major milestones: Give employees a chance to ask questions before key moments like open enrollment or changes in coverage.

3. Make the right care easy to find

When employees can quickly find the right care, they stay healthier and your costs stay steadier. But when care feels hard to access, small problems can snowball into expensive emergencies.   

The math is stark: An ER visit can cost 10 to 15 times more than urgent care for the same condition. A single ER incident for a minor illness can cost several thousand dollars more than an urgent care or virtual visit. 

The key is making access to care simple and stress-free, so employees don't hesitate when something's wrong. Here's how:   

• Regularly promote care options: Spotlight virtual care, nurse advice lines, and nearby urgent care in employee channels. Don't assume employees remember this from onboarding. When it comes to costly chronic conditions like high blood pressure, making it easy to monitor makes it easier to manage. This can reduce the risk of higher cost hospitalizations down the road.  
• Show real cost comparisons: Include actual out-of-pocket dollar amounts in newsletters and onboarding. "ER visit for back pain: $2,800. Urgent care: $150. Virtual visit: $40."

Keep your promises, and keep costs steady

Each action you take, from making prevention easy to ensuring simple, stress-free access to care, adds up to a healthier workforce and more predictable costs for you.   
 
We've created a cost-control checklist that helps you see how your current approach measures up. Use it to identify where your program is strong and where small changes can prevent unnecessary costs before they start.

Sources:

1. Ernst & Young. (2022). "Cost and risks due to payroll errors." 
https://eyquest.com/files Cost_and_Risks_Due_to_Payroll_Errors_2022_Final.pdf 
2. Agency for Healthcare Research and Quality. (2024). Costs of treat-and-release emergency department visits in the United States, 2021 (HCUP Statistical Brief #311). https://hcup-us.ahrq.gov/reports/statbriefs/sb311-ED-visit-costs-2021.pdf 
3. Health Care Cost Institute. (2023). Emergency room spending, price, and use trends 2012–2021. 
https://healthcostinstitute.org/all-hcci-reports/emergency-room-spending-price-and-use-trends-2012-2021/