The short version
Same problem, four settings, very different cost
Cost varies dramatically by site of care for the same complaint. The table below shows the general cost relationship employees should carry in their heads. Actual amounts depend entirely on your plan design, network, and whether the deductible has been met.
| Setting | Best for | Typical wait | Relative cost |
|---|---|---|---|
| Telehealth | Rashes, colds, sinus infections, UTIs, medication questions, behavioral health follow-up | Minutes to hours | Lowest |
| Primary care | Anything ongoing, anything chronic, anything that needs someone who knows the history | Same week to several weeks | Low |
| Urgent care | Sprains, minor cuts, possible fractures, fevers, infections, after-hours needs | Under an hour, typically | Moderate |
| Emergency room | Chest pain, stroke symptoms, difficulty breathing, severe bleeding, major trauma, suspected overdose | Varies widely | Highest by a wide margin |
This table describes relative cost and appropriate use, not specific dollar amounts. Confirm your own plan's copays, coinsurance, and network before relying on any figure.
Primary care
The relationship that quietly controls everything else
A primary care provider is the only person in the system with the whole picture. They catch things early, manage chronic conditions before they become admissions, coordinate specialists, and keep employees out of the emergency room. They are also the gatekeeper for referrals on many plan designs.
The problem in Southern New Hampshire is supply. Hillsborough County has roughly 1,210 residents per primary care physician and Rockingham County roughly 1,270, versus 1,160 statewide (County Health Rankings, 2025 data). New patient waits are real, and employees who cannot get a PCP appointment default to urgent care or the ER — the two most expensive doors.
What employers can do: tell people to establish with a PCP while they are healthy. It costs nothing and it is the single best predictor of lower downstream claims.
Primary care in Southern NH
- Southern New Hampshire Health — Nashua and surrounding towns
- Elliot Health System — Manchester and the surrounding region
- Catholic Medical Center — Manchester
- Dartmouth Health — statewide network of practices and affiliates
- Independent practices and community health centers — often the shortest wait for a new patient
Practice participation and panel availability change frequently. Always confirm with the practice and your carrier's directory before an employee relies on it.
Read the system profilesUrgent care
The setting most employees under-use
Use urgent care for
- Sprains, strains, and possible simple fractures
- Cuts that may need stitches
- Fevers, sore throats, ear infections
- Minor burns and rashes
- Anything that cannot wait for a PCP but is not dangerous
What's available
- Standalone urgent care centers across Nashua, Manchester, Derry, Salem, and the Seacoast
- Health-system-affiliated urgent care and convenient care locations
- Retail and walk-in clinics for narrow, routine needs
- Community health center walk-in hours
Verify network participation. An urgent care center two miles away can be out-of-network while one five miles away is in.
Why it matters to you
Hillsborough County records 2,856 preventable hospital stays per 100,000 Medicare enrollees, versus 2,528 statewide and 2,769 nationally (County Health Rankings, 2025 data). Preventable utilization is the clearest signal that people are entering the system through the wrong door.
Employers cannot change hospital pricing. They can absolutely change which door their employees walk through.
Emergency room
When the ER is the only right answer — and when it isn't
Go to the ER, immediately
- Chest pain or pressure
- Stroke symptoms — face drooping, arm weakness, speech difficulty
- Difficulty breathing
- Severe or uncontrolled bleeding
- Major trauma, head injury with confusion or loss of consciousness
- Suspected overdose or poisoning
- Thoughts of harming yourself or someone else
If it might be one of these, go. Cost is not the consideration in this list.
The ER is usually the wrong door for
- Sore throats, colds, flu-like symptoms
- Prescription refills
- Chronic pain flare-ups without new symptoms
- Minor injuries urgent care can treat
- Anything that started three weeks ago
An ER visit carries a facility fee no other setting charges, plus separate physician and imaging billing. It is the most expensive way to receive routine care in the United States.
Behavioral health
The hardest access problem in the region
Behavioral health does not fit the four-setting model. Availability, not cost, is usually the binding constraint — and in 2026 the supply picture in Manchester changed when the region's HCA-owned hospital ended outpatient mental health services, as reported in March 2026.
Employees need to know what exists before a crisis, not during one. That includes 988, community providers, telehealth platforms, and the EAP most employers are already paying for and nobody uses.
988 Suicide & Crisis Lifeline
Call or text 988 for free, confidential crisis support, 24 hours a day. It is available to anyone in the United States, including people worried about someone else.
New Hampshire's Rapid Response Access Point also provides 24/7 crisis response statewide at 1-833-710-6477.
See all crisis resourcesTurn this into something your employees will actually read
We help Southern New Hampshire employers build a simple, repeatable care-navigation message — in onboarding, at open enrollment, and on the break room wall.