Managing Emergency Department Visits That Are Driving Unnecessary Costs

June 16, 2026

Data from our State of Employee Benefits Report 20261 reveals a striking reality: 64% of emergency department visits are classified as non-emergent or primary care treatable. That means nearly two-thirds of emergency department visits could be addressed in lower-cost care settings — a primary care office, urgent care clinic or telehealth platform — yet employees continue turning to the emergency department instead.

It's important to understand why this is happening and how employers have an opportunity to help reverse this trend. For some employees, the issue comes down to benefits literacy: they don't know where to go for care or that lower-cost alternatives exist. Nearly one-third lack an established primary care physician2, making the emergency department a default rather than a last resort. Employers that invest in clear, consistent care navigation education and more visibility into other healthcare options can help reduce future healthcare costs while supporting optimal outcomes for their people. 

This mini report offers a starting point to build your organization's approach to managing non-emergent emergency department utilization. Download now and discover how avoidable emergency department visits are driving up benefits spend — and what your organization can do about it.  

What's Inside the Report:

  • Emergency department utilization patterns by generation and demographics
  • The true cost comparison: emergency department vs. office visit vs. urgent care
  • Root causes behind non-emergent emergency department use, including low benefits literacy and primary care provider access gaps
  • Practical communication strategies to guide employees toward right-care, right-place decisions
  • And more!
Complete the form below to download the resource.

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1 The State of Employee Benefits 2026 was compiled from enrollment transactions aggregated across 316 large employers (1,000+ full time employees) within the Benefitfocus customer base, representing more than 1.8 million employees in total. The data was evaluated on an anonymous basis. Enrollment records include both active and passive enrollments made by a variety of industry roles (employee, carrier representative, broker, benefits administrator, etc) from the fall of 2023 through fall of 2025 for plan year effective dates of January 1. These measurements are not meant to be a nationally representative sample, but to represent the aggregate activity for large employers on the Benefitfocus platform. 

For data related to medical and prescription drug claims, Benefitfocus drew from 68 employers in our Health Insights Platform with a total population of approximately 600,000 employees and their dependents. Claims were assessed based on claim service dates from 1/1/24 through 12/31/2025, for year over year comparison periods. Population Health data was compiled using Johns Hopkins ACG® System (version 14.0.1). The underlying claims demographics and claims were sanitized per HIPAA Safe Harbor guidelines and were filtered to exclude generations older than Baby Boomers to comply with the age 90 cutoff mentioned in section (3) of “Guidance on De-identification of Protected Information. November 26, 2012” which cites the Code of Federal Regulations Title 45 §164.514(b)(2)(i)(C).” 

2 National Association of Community Health Centers (NACHC). (2023). Closing the primary care gap: How community health centers can address the nation’s primary care crisis. https://www.nachc.org/wp-content/uploads/2023/06/Closing-the-Primary-Care-Gap_Full-Report_2023_digital-final.pdf 

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