Using design and innovation principles to reduce avoidable emergency department visits among employees of a large academic medical center.

1: Most large employers self-insure their employee health benefits, creating a motivation for employers to improve health care's value. 2: Employers who are also health care providers can aim for value through the direct provision of clinical services, not just through wellness programs or the design of insurance products. 3: Innovation and design methods can be systematically applied to health care problems to guide decisions about solutions which should or should not be scaled. 4: A virtual, on-demand urgent care service provided by a health care provider organization to its employees has the potential to reduce unnecessary emergency department visits and decrease the total cost of care.