Originally published in the August 2015 issue of Veterinary Practice News. When the owners of a cat with a spinal issues wreaking havoc with its mobility brought their pet into Pen-Ohio Veterinary Services in West Middlesex, Pa., they were advised to proceed with a series of laser treatments for $150. "Before it was out of my mouth they said 'Let's do it,'" said Boomer Pearsall, the clinic's practice manager. "They said 'We don't' care about the price, we have pet insurance.'" The quick go-ahead was given on top of treatments for periodontal disease requiring anesthesia, digital X-rays and likely several extractions, a quoted expense of between $900 to $1,100, Pearsall said. Not only are insured pets brought into see the veterinarian more often, their owners tend to utilize services more and better follow doctor's advice. That's the consensus from pet insurance experts spoken with. "Insured pets do have more visits and greater spending on their care than non-insured pets," said Jack Stephens, DVM, founder of insurer Pets Best in Boise, Idaho. Several industry-conducted studies in the past five years seem to back this up. But it's not the just numbers, those in the pet insurance industry are hearing from insured and veterinary clinics about increased utilization. "Anecdotally, I can state I have seen thousands of letters, emails and testimonials from insured pet owners that stated that having the insurance allowed them to treat their pet, and prior to insurance, they could not have afforded to treat their pet due to cost," Stephens said. Stephens previously conducted his own study on insured pet visits. He looked at records before the pets were insured and recorded the number of visits and costs incurred. "Then we examined the records of same pet one year after being insured," Stephens said. "The visits were up 43 percent and spending was up 52 percent." The Numbers Pet insurer Trupanion of Seattle, conducted a study that analyzed 83,908 insured and uninsured pets and found that the mean annual revenue for veterinary practices increased from $437 per uninsured pet to $837 per insured pet, while mean annual visits nearly doubled as they increased from 2.4 for uninsured pets to 4.4 for insured pets. "Results suggest Trupanion clients take their pets to the veterinarian more often and are more likely to spend more on treatment," said Britta Gidican, Trupanion's director of public relations. Carol McConnell, DVM, vice president and chief veterinary medical officer for VPI of Brea, Calif., cited a 2011 study from Bayer, The Bayer Veterinary Care Usage Study, as evidence of the effectiveness that insurance is likely to have on getting clients through clinic doors. Among ways to increase veterinary visits, the study suggests providing "information about financing programs for veterinary care such as installment programs, pet health insurance, or special financing for emergencies or larger-than-ordinary costs." "Our own research shows that veterinary clients who have pet health insurance spend 55 percent more money annually for veterinary care than uninsured clients - and this includes pet-wellness plans," Dr. McConnell said. Pet owners are not only more likely to take their pets in, but they take them in earlier than uninsured pet owners. Research from VPI in 2013 shows that clients with pet insurance visited the veterinarian an average of 1.92 times per year and those without it visited 1.18 times per year. "With insurance, pet owners go when their concerns first pop up, heading to their pets' own veterinarians instead of consulting Dr. Google and hoping for the best," McConnell said. Among insured pet owns there is higher utilization of best-practice diagnostics, as well as higher-end treatment options, like certain surgical options and cancer treatments, McConnell said. "In many of these cases, pet health insurance is the difference between life and death," McConnell said. "Without the financial assistance of pet health insurance, many pet owners would be forced to choose economic euthanasia." Mary Beth Leininger, DVM, vice president of veterinary relations for the Hartville Group agreed. "Our internal data says that if people have pet insurance, they'll spend two to two-and-a-half times more on veterinary care," Dr. Leininger said. "When clients have financial assistance, I think they're much more likely to say 'Yes' and use it." That "Yes" is what they hear a lot from insured pet owners at Penn-Ohio Veterinary Services, a one-doctor practice that sees 30 to 35 patients per day. "I know for a fact that the ones with pet insurance do not hesitate to bring their pet in when there is any sign of an issue," Pearsall said. On the other hand, many without pet insurance tend to put off visits, especially those with older pets who see symptoms like lethargy and make their own diagnosis. "They'll just think their pet is slowing down, and then they wait until it's not eating and then they bring it in," Pearsall said. Compliance Compliance among insured clients also seems to be higher for insured pet owners than among uninsured pet owners. Though there are no statistics to back this up, Stephens said that higher compliance among insureds makes perfect sense, because those who have financial assistance to purchase medicine and pay for services a veterinarian recommends are clearly more likely to do so than those who don't. Insured owners with a typical 80-20 reimbursement policy, for example, are more likely to take referrals to specialist because they are paying only 20 percent of the cost, while the insurance is paying the other 80 percent. "Veterinarians report that they are able to utilize more diagnostics and not compromise on which test to run with insured pets," Stephens said. "Basically, it seems for the same reason — that client is only paying 20 percent, plus deductible, of the cost." Lower cost is part of the motivation. It's also human nature to try and "get what you paid for," Stephens added. One thing he hears from pet owners: Because they paid premiums all year long, they want to make certain to take advantage of having that insurance. "And some told me they paid more out of pocket with their deductible and copay than they would normally expend, but did so to recoup their investment of paying their premiums for years," he added. Utilization Stephens noted that the services these insureds use often tend to be pricey. Emergency facilities and specialists top of the list of those services that experience increased utilization by insured pet owners, followed by cancer treatments and anterior cruciate repair, he said. Gidican, who combed through Trupanion's recent claims records, noted that one of the most common conditions treated in puppies is foreign-body ingestion. Without insurance, pet owners are likely to "wait it out" by hoping the object passes through, but insured pet owners, on the other hand, know they're covered for anything unexpected. That means they're likely to immediately go to the veterinarian, Gidican said. "We also see a lot of fractures, especially in the small puppies," she added. "Once they reach adolescence, the conditions shift towards musculoskeletal - patella luxation for the small dogs and cruciate ruptures for the medium and large." Vomiting is another common condition Trupanion receives claims for, Gidican said. "Now the vomiting can be a symptom of almost anything, but insured pet owners know they're covered, so if they see their pet vomiting they're more likely to take their pet to the veterinarian, where other pet owners may wait it out," Gidican said. Talking to Clients Leininger, with the Hartville Group, suggested that veterinarians may want to talk to clients about increased utilization, particularly highlighting expensive treatments among insureds. In fact, she suggested making that talk a part of the protocols of a pet's visit to the clinic, such as having the receptions always ask "who's your insurer" as a pet owner is about to check out from a visit. "Something like, 'Who's your insurer, so we can give you a second invoice?'" Leininger said. Veterinarians and staff should also be ready with a good recommendation for an insurer, and be able to offer anecdotes of positive outcomes for insured pets while steering the conversation in a courteous, non-intrusive manner, she said. "Talk about pet insurance in a very casual but responsible way," Leininger said. The bottom-line is for a veterinarian or their staff is educate pet owners that pet insurance exists, and then recommend they get it, said Gidican with Trupanion. "This is the best way to begin the conversation, letting pet owners know there is a solution out there that will offset the cost of veterinary bills," Gidican said. "It's important to point out that having an insured pet gives the pet owner access to optimum care for their pet, and gives the veterinarian the ability to provide that optimum care to the pet without the awkward conversation about finances." Talking about pet insurance may not be a top priority in a busy clinic, and Stephens understands that. But the act of recommending pet insurance should be viewed as a way to keep an eye out for the owner's and pet's future welfare, he said. "Veterinarians and their staff have precious little time remaining by the time they diagnose, recommend and treat a pet," Stephens said. "Staff are already overwhelmed, but at least making pet owners aware that pet insurance is available is a must for every client to know about."
