Rising healthcare costs aren't only a pricing problem — they're a behavior problem. A large share of plan spend is avoidable, and the most underused tool to reduce it is better employee communication.
You can't negotiate your way out of employees using the ER for a sore throat, skipping preventive screenings, or letting chronic conditions go unmanaged. But you can communicate your way toward better decisions. Here are the communication levers that measurably lower cost.
Where avoidable costs come from
- Wrong site of care — an ER visit can cost roughly 10X an urgent care visit for the same issue.
- Late detection — catching conditions like cancer at Stage IV instead of Stage I can cost hundreds of thousands more per case.
- Unmanaged chronic conditions — gaps in care for diabetes and similar conditions drive expensive complications.
- Underused programs — telehealth, EAPs, and disease management you already pay for go unused.
You can't negotiate away an ER visit for a sore throat. But you can communicate your way to a smarter decision.
Lever 1: Care navigation
Timely, plain-language guidance on where to go for care — telehealth, urgent care, or the ER — steers employees toward the right setting in the moment they need it. Even a modest shift from ER to urgent care produces immediate, measurable savings.
Lever 2: Preventive care engagement
Reminders that keep screenings, annual physicals, and vaccinations top of mind catch problems early, when they're cheaper and easier to treat. Prevention is the highest-leverage cost play there is.
Lever 3: Chronic condition support
Consistent nudges that keep employees connected to condition-management programs and medication adherence prevent the costly complications that drive a disproportionate share of claims.
Lever 4: Driving program utilization
Most employers already offer telehealth, EAPs, and wellness programs. Communication that keeps them visible and easy to access turns sunk costs into active savings — the theme we explore in unlocking benefits through education.
The compounding effect — and the proof
No single message transforms a claims trend, but together these levers compound. And because the behavior is measurable, you can prove the impact: tie communication to utilization shifts and translate them into dollars, exactly as outlined in our guide to measuring communication ROI.
Which lever to pull first
All four levers work, but they do not pay back on the same schedule — and that difference matters more than it first appears, because a program that cannot show progress inside a budget cycle rarely gets funded for a second one.
Care navigation reads fastest. The cost difference between an emergency room visit and an urgent care or telehealth visit for the same complaint is large, well documented, and already sitting in your claims data. The behavior is directly addressable by communication, and the effect shows up within a quarter or two.
Program utilization is nearly as fast and requires no new spend at all, since you are paying per-employee-per-month for those programs regardless of whether anyone uses them. Chronic condition support takes longer but compounds, because a small number of members drive a disproportionate share of total spend. Preventive care is the slowest to read and the most valuable over a multi-year horizon.
The practical sequence, then: start with care navigation to establish credibility and a defensible number, use that result to fund the rest, and pair every slow-reading initiative with a fast-reading one so leadership always sees movement. The arithmetic for building that case is in measuring communication ROI.
Why this is a communication problem, not a plan problem
It is worth being precise about the mechanism, because plan design and communication get conflated constantly.
Plan design changes what something costs an employee. Communication changes whether they know that at the moment of decision. Those are different problems, and only one of them is solvable at 9pm on a Saturday when a parent is deciding where to take a sick child.
That moment is where avoidable cost is actually created. The employee is not weighing cost-sharing structures; they are trying to remember whether there is an alternative to the emergency room and whether it is open. If the telehealth app is already installed and the number is in their phone, they use it. If it was explained in an enrollment PDF ten months ago, they do not.
This is why raising deductibles reliably produces less behavior change than employers expect. Cost exposure only influences decisions employees understand well enough to make deliberately. Without the understanding, higher cost-sharing shifts spend onto employees without redirecting care — which produces dissatisfaction rather than savings.
The corollary is optimistic: the cheapest cost-control lever available is usually making an existing benefit findable at the moment it matters. That is a communication task, and it is the same argument that runs through all benefits education.
Making the case internally
Cost-control initiatives compete for attention with plan design changes and vendor negotiations, both of which arrive with vendor-supplied projections attached. Communication rarely does, which puts it at a disadvantage that is easy to correct.
Get your unit costs from your carrier or broker before you launch anything — the average cost of an avoidable emergency room visit versus its urgent care equivalent, the cost of a late-stage versus early-stage diagnosis, the per-employee fee for programs currently going unused. Those figures turn a communication proposal into a business case.
Then present conservatively. A number you have deliberately understated survives scrutiny; an optimistic one gets picked apart and takes your credibility with it. For the full framing HR teams use with finance leadership, see proving HR ROI.
Key takeaways
- A large share of healthcare spend is avoidable and behavior-driven.
- Care navigation steers people to lower-cost, appropriate settings.
- Preventive and chronic-care engagement catch issues before they get expensive.
- Communication activates programs you already pay for.
- Measure utilization to prove the savings in dollars.
Frequently asked questions
Can employee communication actually lower healthcare costs?
Yes. Communication that drives better care decisions — urgent care over the ER, preventive screenings, chronic-condition engagement, and right-site care — reduces avoidable claims, a major driver of plan cost.
What are avoidable healthcare costs?
Costs from care that could have been prevented or delivered more efficiently — ER visits for non-emergencies, late-stage diagnoses, and unmanaged chronic conditions.
How quickly does communication reduce costs?
Some levers, like steering care to lower-cost settings, can show savings within a plan year, while preventive and chronic-care engagement compound over time. Measuring utilization lets you track impact as it happens.
Turn communication into a cost-control strategy. See the data behind every number on our Why It Pays page.
A co-founder of Touchpoints with two decades of experience in employee benefits communication. He partners hands-on with benefits firms and employers nationwide to build strategies that deliver real outcomes.
