Many healthcare providers offer discounts on treatment to staff members in addition to health benefits packages, potentially incentivizing them to consider their employers as partners in their care. However, there is significant variation throughout the industry as to the amount of discounts and the circumstances in which staff may use them. To help providers develop staff discounts that best fit their needs, we‘ve summarized a variety of provisions found in providers’ staff discount policies.
Determining Staff Eligibility
Some policies evaluated by the research team simply state that they apply to “staff members” or “employees.” However, others include more detailed descriptions or even limitations on who is eligible for discounted treatment. For example, a Louisiana-based system’s policy states that discounts are available to both full- and part-time staff and their immediate family, “defined as the employee’s spouse, as well as dependents listed on the employee’s tax return and/or individuals under the employee’s/spouse’s health insurance policy.” A Utah-based facility states that their discount is available to staff “with three months of service and members of their immediate household.”
Available Discount Amounts
Though not an exhaustive review, Academy research revealed broad variation in the amount of discounts offered to staff, ranging from 5% to 50% of balances. Many policies offer a flat, universal discount (e.g., all staff receive a 20% discount), while others indicate that the amount could vary. For example, the aforementioned Louisiana provider’s policy states that eligible individuals “are allowed up to a 25% reduced fee from gross charges not to exceed the existing balance on the invoice for care received,” suggesting the actual discount received could depend on the balance owed.
The aforementioned Utah-based provider offers staff discounts on a sliding scale based on payment timeliness; if staff pay in full within 30 days of their insurer’s reimbursement, they receive a 15% discount on their outstanding balance. That discount drops to 10% if they pay within six months and to 5% if they pay within one year. Research also revealed that some providers offer higher discounts if more than one service is performed at once. For example, an Idaho-based provider’s plastic and reconstructive surgery clinic offers staff a 15% discount for a preapproved list of elective procedures or products, and the discount increases to 25% for any additional preapproved procedures performed simultaneously.
Limitations on Use
It appears common for healthcare providers to set parameters on which services are included in their staff discounts. Beyond the Idaho provider’s preapproved list described above, many healthcare organizations offer staff discounts only on hospital services, thereby excluding clinic visits. However, The Academy did identify some providers offering discounts on both hospital and clinic services, though one provider indicates its discounts are offered for “selected hospital services,” suggesting it has further exclusions. Additionally, an Illinois-based provider offers staff discounts on glasses at an owned facility; one Pennsylvania-based provider offers discounted treatment at clinics specializing in massage and physical therapy and stress reduction, among other services; and another Pennsylvania-based provider offers staff discounts at its pharmacy, though prescriptions are not eligible.
Finally, research revealed additional terms or conditions for staff discounts that healthcare providers might consider as they craft their own policies. For example, the aforementioned Louisiana-based provider requires that staff members explicitly request that the discount be applied to their physician charges, either in person or by phone. An Oregon-based organization allows staff members to use earned personal time-off hours to resolve outstanding balances—potentially helping alleviate concerns when unexpected healthcare needs arise. Additionally, the Idaho-based provider described above requires staff to pay in cash to receive the discount.
As healthcare providers consider whether to offer staff discounts on treatment and, if so, what the extent of and terms for use should be, they might consider the examples outlined above. The variation in amounts offered, covered services, and staff and/or immediate family eligibility indicate that providers exercise significant autonomy in crafting a best-fit policy.