Buck Bond Group
Is a second opinion program right for your employees? 

Is a second opinion program right for your employees? 

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When an employee receives a catastrophic or complex diagnosis, making the best choice for next steps can be overwhelming. And finding unbiased, expert health care can be a challenge.  

Most patients don’t think about a second opinion until they’re faced with a serious diagnosis, looking at a potential major surgery, or struggling with a frustrating undiagnosed health issue. In these situations, a second opinion can help to ensure they receive an accurate diagnosis and the most appropriate care. 

What’s more, many conditions have several treatment options, so a second opinion often helps a patient make better choices about what’s best in their personal situation. Second opinions can also help to steer patients to high-performing providers, Centers of Excellence, and clinical trials. Talking to another medical provider can help patients and families learn more about the condition, helping them feel more confident about treatment choices. 

Employer health plan sponsors also reap the benefits 

While beneficial to employees, a second opinion program under the company health plan is also good business for employer sponsors as they can help avoid the high costs associated with misdiagnosis, inappropriate treatment, missed follow-up care, and duplicate testing. A study published in JAMA in 2019, examined the cost of waste due to failure of care coordination, over-treatment or low-value care, pricing irregularity, fraud and abuse, and administrative complexity in the U.S. healthcare system. These costs were estimated to be between $102.4 billion to $265.6 billion annually. 

The goals of a second opinion program are to: 

  • Empower patients to take charge of their own health  
  • Improve doctor/patient interaction and communication 
  • Decrease duplicative tests and procedures 
  • Improve care coordination 
  • Help the patient navigate the medical system for better health outcomes 
  • Reduce stress and anxiety due to healthcare uncertainty  
  • Increase employee productivity  
  • Offer support and information for caregivers 

However, some patients report feeling uncomfortable going through the health plan for provider and treatment recommendations. They may fear the health plan will steer them to the least costly option when a better quality, more expensive option might be appropriate. For that reason, many employers choose to contract directly with a third-party vendor for second opinion programs. These programs tend to be buy-up options.  

Features of a best-in-class second opinion program include:  

  • A dedicated care coordinator to follow the patient throughout the process 
  • Seamless collection of medical records 
  • A comprehensive medical review by a physician expert in the specialty area 
  • A clearly written medical opinion from the physician expert with answers to most frequently asked questions 
  • A one-on-one (telephone or virtual) meeting between the physician expert and the patient  
  • Referral to a high-performing in-network specialist  
  • Consultation with the patient’s treating physician if appropriate 

According to Mayo Clinic patient educators, getting a second or third opinion gives patients greater control over their treatment. Whether facing a complex health issue or difficult treatment decision, a second opinion gives patients a fresh perspective, new information about treatment options, and greater confidence in the treatment itself.  

And your employee can focus on what matters most—getting well.