The American healthcare system is unique in that employers, or plan sponsors, typically bear the responsibility of providing healthcare benefit solutions to their employees. Recognizing the needs of their plan members means being in tune with what gaps members have in their care journey and what benefits will have the biggest impact on their overall health. Simply put, picking a health plan is only part of the solution these days.
So what is it that plan members really want out of their benefits and where does their employer come in? Here are four things plan members are looking for and how employers can support a better care journey.
1. An easy way to find providers
For many Americans, being insured doesn’t guarantee that they can find a provider by navigating the healthcare system. Just take into consideration that 5% of all Google searches are healthcare related. This equates to 280 million healthcare related searches per day, revealing how nebulous healthcare remains.
For many, their healthcare journey may begin with a carrier tool designed to help members find a provider. The only problem is that historically, these carrier tools have proven to provide a disjointed search experience largely due to outdated, inaccurate provider data. A 2018 report by CMS found that 52 percent of physician listings in Medicare Advantage (MA) provider directories contained at least one inaccuracy. And in a New York Times article, one woman found that only 15% of listed primary care doctors in her network were actually primary care physicians taking new patients. Carrier tools also often don’t incorporate cost or quality data into their platforms, making it difficult for members to pick a provider with confidence.
So, what’s the solution? A digital healthcare guidance platform that allows members to easily search for high-quality, in-network care. Even better, with a unified search bar, members can search any type of query and see predictive text for facilities, providers, or conditions. Imagine hopping onto a platform whenever a health need arises and getting quick, reliable recommendations on where to get care. Whether it’s to find a new PCP, treat an acute health need, manage a chronic condition, or schedule a complex surgery, a guidance platform can help members take the right next step—no Googling required.
2. Cost estimates up front
The high cost of healthcare is a well documented barrier to patient access. Just look at the news and you’ll likely read a story about surprise hospital bills, making it easy to understand why nearly 30% of Americans skip medical care due to high costs. Noted in the same study by West Health and Gallup, the high cost of healthcare is a major driver of stress in daily lives and it’s only predicted to get worse if we continue down this path.
In order for plan members to actively engage in their healthcare, cost estimates must be made available up front. While this certainly isn’t a silver bullet, giving plan members the tools to actively plan for and book routine preventative care can help lessen the burden and fear of engaging with the healthcare system. Provide plan members with a tool that surfaces cost estimates for hundreds of common services like annual physicals, EKG tests or even bypass surgery. Providing these cost estimates based on the member's specific plan information gives plan members the control and predictability they so desire in healthcare.
3. A simpler way to remember and find their benefits
Additional healthcare tools, or point solutions, are here to stay in healthcare—and for good reason. They provide affordable alternatives for acute care conditions and can divert patients away from in-clinic visits, a really expensive portion of someone’s care journey. The only problem is that point solutions can get forgotten about past open enrollment and they typically aren’t integrated with a member’s health plan. In fact, two-thirds of employees (66%) say they want their plan sponsor to help them better understand their employee benefits throughout the year — not just at open enrollment. This way, when members are looking for care, they can utilize the breadth of options available to them past an in-clinic visit.
Building a great healthcare benefits portfolio is important, but the work doesn’t end there. To ensure employees are satisfied with and using their benefits portfolio, plan sponsors need to remind members of all the ways their benefits program can support their healthcare needs. Leverage a tool that provides a centralized place for members to access their plan’s network of providers and all their additional benefit programs, driving additional utilization. On average, you can expect to see 3X the engagement with supplemental health benefits as members are directed to relevant services when they're primed to take action.
4. Proactive referral follow-up
Each year 33% of patients receive a referral to a specialist, yet over 65% of referrals go unfilled due to inconvenience of booking and scheduling issues. When appointments are postponed or ignored, conditions can go undiagnosed leading to a decline in population health and increased healthcare costs.
To ensure lower rates of drop-off, plan sponsors should preemptively prompt their members with notifications about follow-up appointments. By providing members with an intuitive, simple way to continue booking with high-quality, low-cost providers, plan sponsors increase the odds that their members adhere to the recommended care plan and achieve improved health outcomes.
Putting these strategies into action
With the cost of healthcare rising nearly 5% each year, plan sponsors must actively look for ways to reduce their healthcare spend and provide a better care journey to their members. Luckily, once you recognize what will move the needle for member satisfaction and overall health outcomes, it becomes clearer how to achieve these goals.
Ready to add into your portfolio a tool that will save plan sponsors money and provide their members the healthcare experience they’ve been searching for? Request a demo with Amino Health today.