Future-state thinking: Reimagining value-based employee benefits

High-performing organizations are collaborating with industry innovators to expedite the delivery of personalized, value-based employee benefits.

Data is the architect of the new generation of flexible, value-based designs, which monitor, validate and engage enhanced performance and accountability controls. (Image: Shutterstock)

Transformation in health care is introducing new terms to the employer market: “clinical response under 20 seconds, digitally driven results, AI learning tools, improved medical literacy, cost-effective rise of blended physical and virtual worlds to improve care, metrics scoring of quantitative and qualitative measurements, data validation of pricing transparency.” Employers not only see these terms as realistic future state expectations but essential attributes when re-imagining the future of value-based employee benefit strategies for their workforce.

Businesses are finding new ways to grow and anticipate the rapid shifts occurring in the market. The past 20 months reaffirm high performing organizations who solve the complex human capital needs of five generations in the workforce are becoming the emerging leaders in this new dawn. Historical reference is being replaced by future state thinking — re-imagining value-based employee benefits begin with personalization. The specific health care needs of a complex workforce cannot be met by a one-size-fits-all approach.

Related: Unraveling the complexity of our health care billing system

To thrive under current conditions, high-performing organizations are collaborating with industry innovators to expedite the delivery of a personalized, value-based employee benefit offerings to their workforce. Industry disruptors, especially big tech firms, are answering the call.

Improving personalization comes down to four key elements:

1. Simplifying the user experience

Tech tools, which simplify the user experience utilizing “ease of use” designs, are becoming an integral component in the personalization of healthcare purchasing. AI decision trees simplify the user experience when selecting from a comprehensive suite of personalized offerings.

Ease of use tech tools effectively engage the consumer in other critical health care decisions. AI learning tools subtly educate highly intelligent consumers on health outcomes, which improves medical literacy by applying both art and science techniques. These tools provide real-time communication capabilities using clinical data analytics to incent better lifestyle choices. Preliminary data indicates favorable support in the efficacy of these tools, consumer satisfaction, quality improvement and a renewed optimism to eventually reduce the backfill of chronic conditions.

2. Advanced integration of care

Advanced integration of care begins by rebuilding the consumer’s relationship with a primary care physician.

Recent demands of virtual primary care demonstrate the ability to blend virtual and face-to-face approaches to improve care. Advanced primary care solutions powered by a virtual or telemedicine platform deliver cost-effective alternatives to more expensive forms of primary care. Realigning provider responsibility for clinical oversight reduces misdiagnosis and gaps in care. Introducing appropriate provider financial accountability engages cost-effective, high-quality care, and advances Quadruple Aim objectives.

3. Data analytics to design benefits

Data science with applied data analytics identifies real-time utilization trends, gaps in care, emerging health care risk(s) for risk scoring and predictive cost projections. The data enables the design of better, less costly and more sustainable health care services. Data is the architect of the new generation of flexible, value-based designs, which monitor, validate and engage enhanced performance and accountability controls.

Early adopters of this new generation of value-based benefit structures allow for mid-year consumer engagement incentives and the introduction of point solutions designed to personalize consumer engagement and support appropriate clinical alternatives to address emerging chronic diseases.

4. Controlling escalation of health care costs

The greatest employer demand is for healthcare price transparency tools. Employer adoption of future state strategies will require federal and state policy support for complete price transparency.

In the interim, purchasing alliances continue to grow to serve the market. Other drivers include cost-effective direct contracts with all components of the health care delivery systems (e.g., hospitals, transplants, dialysis, surgical centers, health care providers, and pharmaceutical companies, specifically for specialty and orphan drugs).

In the current state, organizations have only scratched the surface of addressing the needs of five generations in the workplace. Attracting, recruiting, and retaining key talent necessitates continued future state thinking. Maintaining a value-based employee benefits approach by adopting advanced care strategies, powered by state-of-the-art technologies driving intelligent efficiencies, will improve an organization’s ability to meet the changing demands.

Innovators and industry collaborators who support employers through this next wave of redesigning personalized, value-based employee benefits will create more efficient designs, advance innovation, improve the consumer experience and share knowledge that will be impactful for years to come.

Heidi Cottle is senior vice president of cost containment strategies at NFP, a global insurance brokerage.


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