How employers can help employees make better health care decisions
The health care system benefits from a lack of transparency, at the expense of consumers.
Employees have a tough time making smart decisions about their health care options. With a multitude of providers to choose from, constantly changing insurance networks, and a lack of unbiased cost and quality data, employees don’t have the information or support they need to choose providers that will give them the best care and the best outcome at the best price.
For example, let’s say an employee’s child needs a complicated spine surgery for scoliosis correction. In most cases, they’ll stick with the surgeon referral they receive from their pediatrician. But they have no idea whether that provider is a good choice for their child’s specific case. Is that orthopedic specialist still operating based on standards of care from the 80s, or are they up to date on the latest surgical techniques? Do they work on an occasional spine, or do they specialize in this extremely complex and delicate procedure? It’s nearly impossible for the employee to know in advance without significant research, which most people don’t have the time or interest to do.
Related: Consumers are still confused about health plans and savings
This example illustrates why many employees, even those dealing with significant health issues, often make critical decisions based on billboards, sponsored search results, or personal referrals. Or they simply walk into an emergency room or urgent care clinic and roll the dice with the physician on duty. This unscientific approach to health care decision-making can have a negative impact on employee health outcomes and medical costs—and consequently, on your company’s claims costs and workforce productivity.
Lack of transparency and complexity make provider decisions difficult
The health care system benefits from a lack of transparency. Exposing providers that perform lower-quality services or charge higher prices could potentially reduce the volume of patients coming in the door, so they tend to keep this data out of the hands of patients.
Even when health care data is available, interpreting cost, quality and outcome metrics is incredibly complicated. One provider may appear to have high complication rates and higher costs for a specific type of surgery. But is that because they’re inexperienced, or because they’re primarily treating high-risk patients with complicated needs? This is difficult to glean from the data without a deep level health care expertise, which most patients don’t have.
Because the system is so complex, and doing the research is so time-consuming and frustrating, employees usually follow the path of least resistance—which means they don’t get the right care at the right time and often choose expensive, low quality, or inexperienced providers that deliver poor outcomes.
Health care guidance supports employees (and benefits for your business)
Quality, convenience and cost don’t have to be mutually exclusive factors in health care. In fact, your organization has a tremendous opportunity to support employees by making the best choices the most convenient ones. Providing a digital care guidance solution that helps employees research and choose a provider isn’t just the right thing to do—it also has tangible benefits for your business.
- Improve recruiting and retention. You’ve already invested time, money, and effort into designing your benefits package. A care guidance platform can help employees make the most of their existing health benefits and ensures you get the most out of those investments.
- Reduce health care costs while improving quality of care. Often, employees choose expensive or inappropriate care options because they don’t know any better. With the right guidance platform, employees can find the best doctor or facility for their specific needs, receive more appropriate care, and save money by seeing the right provider in the right setting.
- Increase employee engagement by alleviating health-related stress. Providing a solution that helps employees navigate difficult health situations provides significant peace of mind that they’re making the smartest, most care-focused decisions, helping them stay engaged at work.
Make the best choice the easy choice
Supporting better employee health care decision-making doesn’t have to mean a rip-and-replace of your current benefits approach. A flexible health care guidance platform can point employees to high-value care choices while increasing utilization of your existing health benefits. Here’s how:
1. Simplify and consolidate access to care. Creating a single access point for health benefits, wellness programs, and in-network providers makes things easier for employees. By displaying providers and facilities that are in-network, experienced, safe, and affordable alongside other benefits options, employees can find the best care option with minimal effort.
2. Highlight high-value services like onsite clinics and virtual care. Employees want self-service options, especially for routine, non-acute ailments like ear infections, skin issues, and the flu. Partnering with an onsite clinic or telemedicine provider that’s convenient and high quality can help your employees get great care with less hassle and reduce spending on unnecessary urgent care and ER visits.
3. Set a high bar for the service your members receive from the programs you offer them. Any new benefit your organization brings on board should be easy to use, convenient, and trustworthy. Otherwise, the impact on your employees’ health care choices (and your program spend) will be negligible.
As an employer, providing tools and services that guide your employees to make better provider choices not only can increase benefits utilization and reduce health care costs for your company, but also help your employees get great care and stay healthy long-term.
David Vivero is co-founder and CEO of Amino.
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