Digitalizing benefits packages creates a world of opportunity
The pandemic has sparked a storm of digital health apps, platforms, services and new products.
Many digital health players saw demand skyrocket in 2020. While a large number of benefits packages already included these tools and products among their options, COVID brought them to the forefront, as plan members delved more deeply into their benefits, looking for virtual health care options. And fueled by the success of basics such as telemedicine and telebehavioral health, plan designers and employers quickly developed an appetite for other virtual-first health benefits.
Case in point: Virta Health’s completely virtual type 2 diabetes disease management/reversal program got a booster shot from COVID-19. Demand from employer plan sponsors shot up in 2020 and Virta capped the year with a $65 million Series D investment from Sequoia Capital to support new growth.
Going forward, the question then becomes: Will demand and plan member uptake continue to drive the fortunes of companies like Virta once the pandemic loses its grip?
Virta is betting the answer is yes. It has initiated an aggressive campaign to further boost engagement in its diabetes-battling platform among plan members who have type 2 diabetes, pre-diabetes conditions, and obesity.
For Virta, the 2020 demand accomplished two key goals. It vindicated its founders’ conviction that a diabetes disease reversal method would gain acceptance. (Virta now boasts more than 100 major clients.) And it expanded its reach to enough plan member lives to create a meaningful population to be treated, tracked and analyzed. Now the company will see how sticky its solution is with plan members.
Plot your path carefully
“The first question you want to ask is, ‘Where are we culturally and are we prepared to roll out a digital health menu?’”
The range of digital health apps, platforms, services and new products spawned or accelerated by the pandemic can hardly be mapped. There are so many virtual/digital solutions on the market that plan designers often don’t know where to begin or how to sort through them.
Brokers can help with those decisions, as they are often among the first to be approached by the vendors as potential partners. Virta is one of many companies that have leaned heavily on brokers to market to employer plan sponsors.
In other cases, the plan sponsor may ask the broker to find the right tool. Allison De Paoli, founder of Altiqe Consulting, says as often as not, her employer clients are asking for digital solutions ahead of the curve.
“They will tell me, ‘We want to do this and are being told we cannot.’ They understand there’s a problem and there should be a better way to do it; it’s my job to find the solution.”
Before plan design is upended to go full-on digital, the sponsor and broker need to set reasonable expectations, both for cost and engagement. For instance, when considering adding a virtual health consultation to the plan, it’s important to know whether the insurer and the provider have agreed upon a payment plan. Many physicians are still working out the billing details of virtual services, and may be resistant to offering them until they are satisfied with the remuneration.
There is a logical starting point for digital integration: Determine where the company, its culture and its plan members are right now with respect to digital health engagement. Then determine where the various products and services fit into the plan.
That’s the suggestion of Reid Rasmussen, co-founder of freshbenies, which includes telehealth consulting in its service model.
“The first question you want to ask is, ‘Where are we culturally and are we prepared to roll out a digital health menu?’” he says. “You need to ask. ‘Why are we doing this? What are we trying to set up? What are our goals? Are we willing to invest in digital health for our people?’ It will take time and money to do this, so you want to determine how much effort you’re willing and able to put in.”
Rasmussen champions the procurement of a digital health platform. Using a single platform provides flexibility and consistency that will win employees over and, as their comfort level with digital health increases, the platform can accommodate more options.
Ideally, the platform remains the same year after year, so that navigational ability increases. “The key to success here is consistency, consistency, consistency,” he says. “One good thing about a platform is that it can be agnostic to the medical plan. You can change up the plan, but if you have a consistent digital platform, you don’t have to download a new app and learn a new technology every year.”
Adopt & educate
“Until 2020, step one with digital health adoption was, ‘Stop making excuses for everyone not being able to use the technology.’”
Once a company has decided upon a level of digital health to include in its plan, management must let plan members know they are expected to take advantage of the elements available. “Until 2020, step one with digital health adoption was, ‘Stop making excuses for everyone not being able to use the technology,’” Rasmussen says. “All of a sudden in March, the excuses were decimated. People had to adapt. As we come out of the pandemic, we need to continue to move this forward.”
The HR department needs to make a key shift in order for engagement to occur, he says. Rather than spending time explaining benefits to plan members, HR should move toward educating them on accessing digital tools and their health data. “This is the time to get HR out of the legal problem of accessing employee health data,” he says.
The legal implications for employers of the digital tool age can be profound, says Allison De Paoli. As more tools that send health data straight to physician databases gain acceptance, employer concerns about liability will disappear. “Employers do not want to know this information; they know it’s risky to manage it. So in the digital era, we increasingly send the information straight to the medical people, and there’s no chance of a breach.”
Connect with your population
“Young people want to do everything from their phone. The caveat is, the experience has to be fully encompassing.”
Digital services can perform a valuable service by increasing the individual plan members’ knowledge about their own health. The pandemic quickly sorted individuals into virus risk groups. Now, armed with that knowledge, plan members will be more likely to seek virtual solutions to protect their health. But will they find the digital support they need in their health plan? Again, brokers can help sponsors determine what to offer, based upon member demographics and claims data.
An older workforce may seem like a good fit for services like Virta that address chronic conditions, but engagement with digital can be difficult to drive with older workers. So more emphasis (and dollars) must go to promoting and using the available tools.
Meanwhile, employers with lots of young remote workers do not have to worry as much about digital adoption, but the tool must be appealing, says Elie Goodman, vice president of marketing at MeMD, a provider of telehealth solutions.
Goodman says millennials, in particular, are quick to move to virtual health services. But they have high expectations for the digital experience. “Young people want to do everything from their phone. The caveat is, the experience has to be fully encompassing. So a new health app must meet high expectations for appearance and navigation.”
One myth that the pandemic exploded was that mental health therapy had to be conducted in person. Goodman says, “We saw 300% growth in behavioral health visits in 2020.”
Yet academic studies have shown that older patients and patients of color tend to be less willing to engage in a virtual therapy session than are young white patients. The message for plan sponsors is clear: If you want to safeguard the mental health of all your employees, extra effort must be made to reach out to certain plan members.
The digital world can be combined with the physical world to create a better environment for employee health care. The onsite or near-site clinic, owned or co-owned by the employer, offers plan members a dedicated medical team in a facility specifically for plan members.
De Paoli says digital services can be heavily integrated into such clinics so that the needs of employees are reflected in the services available. Onsite clinics provide a safe haven from emergency room visits and, in many cases, workers’ comp claims. Eye-popping cost savings can accrue as well; she cites one employer-owned clinic where rapid results COVID testing saved the plan more than $90,000.
Combined with direct primary care, these types of services will continue to expand as the compensation is worked out, she says.
Will every single digital bell and whistle that emerged in 2020 still be in high demand a few years down the road? De Paoli doubts it. But some certainly will. De Paoli and others agree that telehealth visits are here to stay. Personal health monitoring will grow and eventually be connected directly to one’s health care team. Meanwhile, high-risk workforce members will benefit from digital health tools that specifically treat their conditions. Health data will no longer flow through the employer, but go directly to those who need it.
And when the most effective digital solutions have secured a place in the core benefits offered to employees, the workplace should be better able to handle the next health crisis.
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