Article

How second opinions may reduce health care costs

Virtual second opinions give members a checkpoint before major treatment decisions. Labor and trust funds may get better outcomes and smarter spend.

5-minute read

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Consider this scenario: After months of knee pain, a union carpenter gets an MRI. An orthopedic surgeon then recommends a total knee replacement — a surgery that often involves a lengthy recovery. The member schedules the procedure as the next step in his care plan.

What he doesn't know is that he could benefit from clinical education about his diagnosis and potential treatment approaches, including options such as targeted physical therapy or less invasive procedures, helping him have a more informed discussion with his treating provider.

Similar scenarios play out across cancer diagnoses, cardiac conditions and behavioral health evaluations. Members receive a diagnosis and treatment recommendation and may move forward without seeking additional information to help them better understand their condition and available options. In fact, just 29% of cancer patients do so after receiving a diagnosis.1

For union members, health concerns can be particularly significant. Many are in physically demanding roles, an injury, illness or ongoing pain can create challenges that extend beyond health and into work and daily life.

Virtual second opinion services provide an additional expert review for complex and disruptive health issues. By connecting members with independent specialists who review records, imaging, diagnoses and treatment recommendations, these programs help ensure members understand all their options before making major health care decisions.

For labor and trust fund leaders, this offers an opportunity to support members while being mindful of fund resources.

1. May reduce friction between members and specialist care

Union members may not often have the time for traditional second opinion appointments. They may be on jobsites, rotating between work sites, and typically not often behind a desk for long periods, which may leave less time to explore available information and resources.

Those logistics matter. Work schedules and length of appointments are two of the top reasons that adults skip or delay health care.2 For labor and trust plan members, those barriers may be steep. As a result, many members may not have the opportunity to explore additional information about their diagnosis, treatment options, and health care decisions.

Modern virtual second opinion services may potentially remove those barriers. Services like 2nd.MD, part of the Optum Hub, handle the legwork so members don’t have to. A dedicated care coordinator gathers the member’s medical records and matches them with an independent specialist. Within days, the member can talk to a specialist by phone or video. From there, they can receive a written summary to take back to their own doctor — or the specialist can reach out to their doctor directly.

These services are meant to complement — not replace — the member’s existing physician relationship. Members still make decisions with their doctors but with new input and guidance from a vetted specialist.

The virtual format also fits how members live and work. Mobile-friendly enrollment, 24/7 access, virtual consultations, text-based follow-up and bilingual support, all accessible on a device nearly every member has by their side: their cellphone.

2. Supports treatment plans with diagnosis-related clinical education

A second opinion might shift a member toward a more evidence-based or cutting edge treatment.

One study found that based on four cancer types, between 23% to 57% of cancer patients saw a major change to their treatment plan following a second opinion.3 In other words, many second opinions don’t overturn the diagnosis, but they can help sharpen it or evolve the treatment plan.

Those changes take different forms. It might change an existing plan to avoid certain side effects. Or it might simply help the member understand their options well enough to follow through with care.

The data in a 2026 study, about 1 in 3 cancer patients who got a second opinion from a subspecialist saw their treatment plan meaningfully change — usually toward less invasive care. Among that group, nearly 75% faced lower projected costs. Meanwhile, 10% of all patients had improved survival rates.4

Sometimes its simply helping members feel more confident and informed as they navigate important health care decisions. When patients are presented with a service to better understand their treatment, they are less likely to experience regret.5

3. Offers clinical education for labor populations facing complex health conditions

With a workforce made up of members who may have spent years painting, wiring, hauling or standing for long hours, it's understandable that musculoskeletal (MSK) issues like back pain and tendonitis may be a concern for some members. As an example, more than 40% of construction workers report limiting activity due to injury from work-related repetitive strain.6

For some members, surgeries may represent a significant part of the MSK puzzle. In a study of patients recommended for spinal surgery, only 34.7% received the same recommendation after a second opinion. More than 60% were advised to pursue physical therapy instead.7

That opportunity for additional clinical education and informed decision-making is where second opinions can provide meaningful support. When members receive a second opinion through a virtual service, 80% see an improved treatment plan and 24% voluntarily cancel a surgery.8

Behavioral health is also an important focus — particularly for certain trades such as construction, where opioid disorders are higher.9 Second opinions can sometimes provide additional insight earlier in a care journey. When members have questions or concerns about opioid use, they may feel comfortable seeking an independent perspective through a second opinion service.

A second opinion service is not intended to evaluate every aspect of a member's health situation. But for labor members facing complex health concerns, it can provide additional clinical education and an independent perspective before major health care decisions are made.

4. Helps members understand benefits and care options

Labor and trust leaders may often face the ongoing challenge of managing resources while supporting member benefits. Balancing these competing priorities requires careful decision-making.

Virtual second opinion services provide members with access to additional clinical education and insights from specialists when facing complex health concerns. They often can help members better understand their diagnosis, treatment options and potential next steps, while offering support during an often stressful and uncertain time. For unions and funds, these services may serve as an additional resource that supports members as they navigate important health care decisions.

When members are evaluating significant diagnoses or treatment options, having access to additional expert perspectives may help them better understand their choices and feel more informed about their path forward. Second opinion services can save up to $6,000 per case10, while providing leaders with valuable information about clinical outcomes.

The right information, before the decision

When a diagnosis hits, it’s critical that members have the right information to make an informed choice about their health. Virtual second opinion programs help plan members do just that — quickly and confidently.

Union members are already showing up — they access health care more often than non-union workers.11 Labor and trust leaders have an opportunity to offer resources, such as second opinion services, that provide clinical education and support for members facing complex health decisions.

Learn more about how Optum can help unions and funds deliver better health support for their members.

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Sources

  1. National Coalition for Cancer Survivorship. State of Survivorship. 2024.
  2. NBC News. A record number of Americans are anxious about health care costs going into next year. Nov. 17, 2025.
  3. Lipitz-Snyderman A, Chimonas S, Mailankody S, et al. Clinical value of second opinions in oncology: A retrospective review of changes in diagnosis and treatment recommendations. Cancer Med. 2023;12(7):8063-8072. DOI: 10.1002/cam4.5598.
  4. Memorial Sloan Kettering Cancer Center. A Second Opinion Can Reduce Cancer Costs and Improve Care. Jan. 20, 2026.
  5. Makkar D, Sauhta R, Jaganmohan S, Priyadarshini T, Devanand V, Raja A. Insights of shared decision-making and personalized treatment in orthopedics - A qualitative systematic review. J Clin Orthop Trauma. 2025; 65:102989.
  6. CPWR – The Center for Construction Research and Training. Musculoskeletal Disorder (MSD) Trends in Construction. Data Bulletin. June 2025.
  7. Antonioli, E., Tavares Malheiro, D., Damazio Teich, V. et al. Cost-effectiveness of a second opinion program on spine surgeries: an economic analysis. BMC Health Serv Res 23, 1441 (2023). https://doi.org/10.1186/s12913-023-10405-x.
  8. 2nd.MD Book of Business, 2023.
  9. The Center for Construction Research and Training. Resources to Prevent Opioid Deaths in Construction. Accessed June 2026.
  10. 2nd.MD Book of Business, 2023.
  11. Petach, L., Wyant, D.K. The union advantage: union membership, access to care, and the Affordable Care Act. Int J Health Econ Manag. 23, 1–26 (2023). https://doi.org/10.1007/s10754-022-09336-7.

Published: July 8, 2026

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