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. The member schedules the procedure as the next step in his care plan.

What he may not know is that clinical education regarding his diagnosis and commonly utilized treatment approaches could help him better understand his condition and prepare him to have a more informed conversation with his treating provider about potential next steps.

For union members, health concerns may have the possibility to be 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 experienced review for certain complex and disruptive health issues. By connecting members with independent specialists who review records, imaging, diagnoses and treatment recommendations, these programs help equip members with educational information about their diagnosis and available care pathways so they can engage in informed discussions with their treating providers before making major healthcare 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 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.1 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 insights 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 by a cellphone.

2. Supports treatment plans with diagnosis-related clinical education

A second opinion may provide educational information regarding emerging or evidence-based care approaches that members can discuss with their treating provider.

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.2 In other words, while a clinical education consultation may not alter the diagnosis, it can provide additional context and educational insights that support more informed discussions with the member's treating provider.

Clinical education may help members better understand their diagnosis, potential considerations associated with different care approaches, and the questions they may wish to discuss with their treating provider. Clinical education may also have the ability to contribute to a member's understanding of their care options, this may potentially assist in the opportunity to feel confident while following recommendations.

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.3 Among that group, nearly 75% faced lower projected costs.3 Meanwhile, 10% of all patients had improved survival rates.3

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.4

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.5

For some members, surgery may be part of the treatment approach for an MSK condition. In a study of patients recommended for spinal surgery, only 34.7% received the same recommendation after a second opinion.6 More than 60% were advised to pursue physical therapy instead.6

That opportunity for additional clinical education and informed decision-making is where second opinions may 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.7

Behavioral health may also be an important factor for members — particularly for certain trades such as construction, where opioid disorders are higher.8 In some cases, obtaining a second opinion earlier may give members additional insight into their condition and the range of care options that may be available. When members have questions 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 that may support more informed discussions with their treating provider.

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 certain complex health concerns. Second opinions often may 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 seeks to support 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 case9, while providing leaders with valuable information.

Empowering informed decisions through clinical education

When members receive a diagnosis, having access to educational information about their condition and available care pathways may help them engage more confidently in discussions with their treating provider.

Union members are already showing up — they access health care more often than non-union workers.10 Labor and trust leaders have an opportunity to offer resources, such as second opinion services, that provide clinical education and support for members facing certain complex health decisions.

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

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Sources

  1. NBC News. A record number of Americans are anxious about health care costs going into next year. Nov. 17, 2025.
  2. 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.
  3. Memorial Sloan Kettering Cancer Center. A Second Opinion Can Reduce Cancer Costs and Improve Care. Jan. 20, 2026.
  4. 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.
  5. CPWR – The Center for Construction Research and Training. Musculoskeletal Disorder (MSD) Trends in Construction. Data Bulletin. June 2025.
  6. 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.
  7. 2nd.MD Book of Business, 2023.
  8. The Center for Construction Research and Training. Resources to Prevent Opioid Deaths in Construction. Accessed June 2026.
  9. 2nd.MD Book of Business, 2023.
  10. 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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