Creating change: The right speed, not light speed

The stakes are high in the employee benefits industry — you know that. Employers struggle to foot rising insurance and health care costs. Employees face the awful task of determining and weighing risk – whether to see a health provider and incur medical debt, or forgo medical care and hope there will be no health consequences. How both tribes deal with those costs can have business-changing – and, sometimes, unfortunately, life-threatening – consequences. What can a broker or advisor do?

Some stick with the status quo and hope for the best. Others go all “mad scientist,” says Allison De Paoli, founder of  ALTIQE Consulting, experimenting with whatever is new and radical. Unfortunately, she says, “There aren’t too many in the middle. We need to change that for the sake of our clients.” In her session at BenefitsPRO Broker Expo in Austin on Monday, De Paoli delivered a pep talk on dealing with change, with practical tips for brokers and advisors in the middle.

Think strategically

Some strategies De Paoli discussed include the following to-do’s:

Uncover the cost drivers. “There’s no excuse for anyone to not get data. It’s not free, and it should not be free to your client.” Pair the appropriate cost savings strategy, she says, though remember that not every strategy works for every employer. Then roll it out.

Be on the lookout for solutions. Consider when and whether to use payment integrity audits, transparent PA contracts, claims management, direct contracting, captive cells. private insurance placement. And when it comes to tech solutions, “Vendors change. Sometimes a solution might be right right now, but not in the future. So we’re always looking for solutions.”

• Direct contracting: De Paoli says, when you can use it, do. It might not save money but it can prevent balance bills.
• Alternate sourcing for brand name medication: “It’s an easy lift,” De Paoli says, whether you use it on a voluntary basis or level-funded employer or self-funded employer.
• J code redirection: Services can be marked up significantly in a hospital setting, De Paoli says. “If you can pull any infusion care out of the hospital setting, to an outpatient or infusion center, you can have the drug drop shipped.”

Prioritize communications. “We have to stop treating customer service like we’re in the 1970s,” De Paoli says. Today, people expect a quick reply. Her company has split its service team into two areas of focus: internal accounts and consumer-facing to enhance communication.

Additionally, De Paoli’s team actually creates and sends communication campaigns to clients’ employees. “HR can send out info until the cows come home and people just hit delete,” she says. “I’m not sure it’s better when we do that, but it’s different. Our communication is much more relaxed, there’s bullets, ellipses, all kinds of things that are easier for the eye.”

• Year-round communications: De Paoli’s team builds email campaigns for the whole plan year. “Employees are getting a communication once a month that says ‘oh did you know this.’
• Mind the message: Email communications are meant to fit on a phone screen. Webinars are 30 minutes, no more.

Every step counts

Forget big change – you don’t have to change everything at once, she says. Consider small changes, and don’t fall in love too soon with a solution.

“The large part of what we do is helping people who don’t understand what we do use plans effectively,” De Paoli said. TPAs, brokers, advisors, employers – “we often end up in siloes and that doesn’t help the consumer. We have to work together. We can then get them to high quality care and get plans to a controllable state..