ROI Calculators For Improved Primary Care Access

The following calculations will help you estimate the potential return on your investment with a primary care solution that increases access to high-quality care, reduces inappropriate care and increases employee productivity.

The following calculators can be used separately or in any combination. The default numbers shown in each calculator are based on industry averages. Customizing the data to your specific organization is suggested to get the most accurate results.

Customize your Total Potential Savings using the fields below

Increase in Primary Care Visits

Number of lives insured

Cost of average primary care visit

$ .00

Average number of primary care visits by member per year

The cost of an average primary care visit is defaulted to $200, however you should speak to your consultant to refine this number to accurately reflect your usage.

Since the investment needed to achieve more primary care utilization varies across organizations, users should enter their actual investment in 2023 US dollars to measure the return on investment.

Emergency Room Avoidance through After Hour Care

Included in Total ROI Savings

Number of emergency room visits per year

Percentage of Emergency Room visits that are avoidable

Average cost of emergency room visit

$ .00

The cost of an average emergency room visit is defaulted to $2,000, however you should speak to your consultant to refine this number to accurately reflect your usage.

Avoidance of Urgent Care Visits

Included in Total ROI Savings

Average Urgent Car Visit Cost

$ .00

Average number of urgent care visits per year per member

Assumption for reduction of urgent care visit that could be seen by primary care by percentage

The cost of an average primary care visit is defaulted to $200, however you should speak to your consultant to refine this number to accurately reflect your usage.

Decrease in Inappropriate Specialist Visits

Included in Total ROI Savings

Average cost of specialist outpatient visit

$ .00

Average number of specialist visits per member per year

Assumption for reduction of inappropriate specialist visits by percentage

Total Potential Savings

Year 1

Year 2

Year 3

Projection of % Uptake

Discover the hidden link between boosting primary care and maximizing productivity. The calculator below reveals the incredible potential for financial gain. Please note that this calculator is not linked to the primary care ROI results mentioned above.

Lost Productivity Cost from Primary Care Visits Calculator

Number of primary care doctors appointments for employees at a specific site

Average Salary of employee for a specific site

$ .00

Lost Productivity Cost from Primary Care Visits

Year 1

Year 2

Year 3

This calculation assumes a medical appointment (with travel) takes around four hours and having a more accessible solution will cut that by half (two hours).

Data Sources

Bradley, C. J., Neumark, D., and Walker, L. S. (2018). The Effect of Primary Care Visits on Other Health Care Utilization: A Randomized Controlled Trial of Cash Incentives Offered to Low Income, Uninsured Adults in Virginia. Journal of Health Economics, 62, 121-133.
U.S. Bureau of Labor Statistics. (2023). Consumer Price Index. Retrieved from https://data.bls.gov/cgi-bin/surveymost?bls
Reference for detault # of primary care visits: Reference for # of visits (for ROI calculation): https://www.cdc.gov/nchs/fastats/physician-visits.htm
Ma, Q., Sylwestrzak, G., Oza, M., Garneau, L., and DeVries, A. R. (2019). Evaluation of Value-Based Insurance Design for Primary Care. The American Journal of Managed Care, 24(5), 221-227.
Allina Health. (2022). Allina Health’s Top 25 Primary Care CPT Codes and 2022 Pricing. Retrieved from https://www.allinahealth.org/-/media/allina-health/files/customer-service/billing-and-insurance/2022-primary-care-top-25-cpt-codes-and-pricing.pdf
Centers for Disease Control and Prevention. (2023). Ambulatory Care Use and Physician office visits. Retrieved from (https://www.cdc.gov/nchs/fastats/physician-visits.htm)
Sepúlveda, M. J., Roebuck, M. C., Fronstin, P., Vidales-Calderon, P., Parikh, A., and Rhee, K. (2016). Elimination of the Out-of-Pocket Charge for Children’s Primary Care Visits: An Application of Value-Based Insurance Design. The Journal of Pediatrics, 175, 195-200.
Whittaker W., Anselmi L., Kristensen S. R., Lau Y. S., Bailey S., Bower P., Checkland K., Elvey R., Rothwell K., Stokes J., and Hodgson D. (2016). Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis. PLOS Medicine 13(9): e1002113.
Devlin, R. A., Kpelitse, K. A., Li, L., Mehta, N., and Sarma, S. (2020, June). After-Hours Incentives and Emergency Department Visits: Evidence from Ontario. Canadian Public Policy, 46(2), 253-263.
Lippi Bruni, M., Mammi, I., and Ugolini, C. (2016). Does the Extension of Primary Care Practice Opening Hours Reduce the Use of Emergency Services? Journal of Health Economics, 50, 144-155.
United Health Group. (2019). The High Cost of Avoidable Hospital Emergency Department Visits. Retrieved from (https://www.unitedhealthgroup.com/newsroom/posts/2019-07-22-high-cost-emergency-department-visits.html)
Centers for Disease Control and Prevention. (2022). Emergency Department Visit Rates by Selected Characteristics: United States, 2019. Retrieved from (https://www.cdc.gov/nchs/products/databriefs/db434.htm)
Centers for Disease Control and Prevention. (2021). Urgent Care Center and Retail Health Clinic Utilization Among Adults: United States, 2019. Retrieved from (https://www.cdc.gov/nchs/products/databriefs/db409.htm )