TO:              Airborne Employees

FROM:         Gene Rhodes                                                                 DATE: August 24, 2001

                    Corporate Director, Human Resources

SUBJECT:    Rising Health Care Costs

This is the fourth in a series of memos discussing the rising cost of health care at Airborne Express. This important topic affects all of us at Airborne. In this memo I would like to focus on emergency room use–in particular at our Wilmington, Ohio hub.

Increased medical costs due to excessive emergency room use are a significant concern for Airborne Express. At ABX, emergency room use per individual is more than double the norm when compared to other companies insured with United Health Care. System-wide, ABX Air employees and family members used the emergency room more than 4,330 times last year¹ . In Wilmington, Clinton Memorial Hospital's emergency room had 2,419 visits from ABX Air employees and families.

The average amount paid by our plan for an emergency room visit was $372. This compares to the average amount of $36 for a visit to a primary care physician. Emergency room visits cost more than ten times as much as a visit to a physician's office, which is having a major impact on the cost of our plan. As you may already know, our health insurance plan is self-insured and this has a direct impact on Airborne's bottom line.

This data and other information suggest that many employees and families are using the emergency room for non-emergencies. The question is why?

Lack of Access: Many employees report that they are unable to obtain timely appointments at primary care physicians in Wilmington, particularly if they are not an established patient. Undoubtedly, many people use the emergency room as a substitute for a primary care physician.

Lack of Convenient Urgent Care: In Wilmington, the CMH After Hours clinic is open from 5pm to 11pm on weeknights and 11 a.m. to 9 p.m. on Saturdays and Sundays. These hours are limited when compared to more traditional urgent care centers.

Patient’s Convenience: Some people may find it more convenient to go to the emergency room rather than waiting for an appointment with a physician.

What is ABX doing to address this issue?

There are a number of options that ABX is exploring:

1. ABX and Clinton Memorial Hospital are discussing the possibility of extended hours at the CMH After Hours clinic in Wilmington.
2. Clinton Memorial Hospital is exploring the possibility of a physician/patient initiative designed to help individuals find a primary care physician before they need one.
3. Other employers such as Mead Paper, Goodyear, G.E., and U.S. Steel have established on-site family medical centers that are available for the exclusive use of their employees and families. These medical centers offer greatly improved access to health care providers. ABX is actively exploring this possibility.
4. The emergency room benefit in our health plan can be adjusted to better reflect the true cost of using the emergency room. Typically, many health plans have an emergency room co-payment of $75 or more. This co-payment is waived if the patient is admitted.

As a consumer of health services, the more knowledgeable you are, the better for your health and your finances. Here are a few suggestions to assist you in choosing the appropriate care.

1. Consider selecting a network primary care physician for you and your family before there is a health need. Generally, appointments are more readily attainable if you already have an established relationship with a physician. This will avoid unnecessary visits to the emergency room in non-emergency situations.
2. Consider using a network urgent care center when immediate non-emergency care is necessary.
3. Consider calling the Nurseline for health information and education at 1-888-609-5880. The Nurseline is available 24 hours every day and is staffed with experienced registered nurses. If you are unsure whether to go to your doctor’s office, an urgent care clinic, or an emergency room, Nurseline can give you information to help you choose appropriate care. Nurseline can also give you in-depth education on medical conditions, treatment options, and possible risks and outcomes.

If you experience an emergency, call 911 or go to an emergency room. If you are admitted to the hospital from the emergency room, have someone notify United Health Care Medical Management by the next business day.

It’s important for you to understand that our health plan always allows you to have access to an emergency room. You, the patient, make the decision about what type of care is appropriate. Emergency room services are covered under our plan even if it is not an emergency and you are not required to seek prior approval. But I ask you to use the emergency room responsibly and seek alternate forms of care when it’s not an emergency.

If you are sure immediate care is necessary, but it is not an emergency, why not receive care from a network urgent care center? In Wilmington you may use the CMH After Hours clinic at 2241 Rombach Ave. In other locations, check your United Health Care provider directory for an urgent care center near you.

Under our health plan you have the freedom to use the emergency room when you feel it is necessary. By making wise decisions, you can help ensure that the emergency room is used wisely and cost effectively.

Once again, I invite you to provide cost savings suggestions or ideas to your employee benefits department for consideration. You may e-mail your comments to abx.benefits@airborne.com or send written comments to ILN Benefits Dept. 2061B. Attn: Health Care Cost.

Thank you.

1. Does not include on-the-job injuries.

2. United Health Care

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