Self-insured employers negotiate a dizzyingly complex health care benefits landscape these days – managing inflation, escalating costs and point solution fatigue while keeping their employees healthy and happy with offerings tailored to their personal health journeys. Faced with tough decisions and trade-offs, employers are leaning more than ever on benefits consultants for trusted advice to help them manage the myriad choices available and plot a strategic course for their employee health care benefits.
Against this backdrop, we recently sponsored a first-of-its-kind survey to understand the mindset and direction of today's health and benefits consultants. Taken as a whole, the key findings of the Benefit Consultant Sentiment Index (The Index) offer a valuable consultant lens on trends and a glimpse of the near future of employer-based healthcare benefits.
Consolidation under a navigation solution is essential and inevitable.
There's no question that employers are overloaded and fatigued by point solution management. Over the past three to five years, the average employer brought on 13-17 digital health solutions, only to find that most are underutilized and account for little-to-no improvement in cost or health outcomes. The answer, 63% of consultants reported, is the inevitable consolidation of digital health point solutions under a navigation provider.
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Meanwhile, despite all the progress made toward digital transformation, the care experience for most patients remains both fragmented and frustrating. Employers pay the price with high costs and poor outcomes when their members are left to stitch together their care journeys with minimal to no guidance. Respondents overwhelmingly agree that the future is integrated navigation that can enable, "streamlined patient journeys leveraging longitudinal health records, bridging patients, providers and customized therapies from pharma and life sciences," as one consultant put it.
Navigation through employers' existing carriers doesn't meet the needs of employers.
Traditionally, insurance carriers have been the gatekeepers for health care navigation, but that's rapidly changing, according to findings from the Index. Sixty percent of consultants now say that employers' existing carriers are simply unable to meet their clients' evolving navigation needs. As employers take a more holistic view of care quality and cost – with greater focus on prevention and long-term outcomes – they are finding that carriers may be in conflict when working to steer to providers in their network. Further, as some consultants stressed in the survey, "members need more hand holding" and "higher levels of engagement" and employers need more transparency than carriers have historically delivered.
Instead, more than half (53%) of consultants said they more often guide their clients to an independent health care navigation company for "more holistic and independent service" that "generally delivers better results." Over the decades, we've learned that when members know their navigation partner's only interest is to guide them to the best care possible, they engage more regularly, with better results and greater satisfaction.
Cost management and health outcomes are paramount for ROI impact
As CFOs get more directly involved in evaluating their companies' health care benefits, they expect consultants to bring them solutions that deliver results. With cost management and health outcomes ranking first and second in navigation priorities in The Index, it's clear that employers can no longer justify plans or partners that can't prove their value. This ROI reality puts consultants on the hook to provide in-depth analyses for costs relative to utilization and health outcomes.
As The Index reflects, a high level of accountability is the new normal for the industry, and consultants can't bring anything less to their discriminating clients.
As difficult as recent years have been for self-insured employers and their populations, it has also been a catalyst for much-needed change. As trusted advisors to employers, consultants have had to step up strategically and help guide them through an uncertain and ever-shifting landscape. If The Index's findings offer a window onto what's next, the future of health care navigation looks promising: more integrated, more streamlined, and more centered than ever on members and their unique health journeys.
Missy Jaeger, Vice President Consulting Relations for Quantum Health, connects employers and consultants to help develop exceptional benefits strategies utilizing Quantum Health's unique navigation capability through Real-Time Intercept®, driving member engagement and proven cost savings.
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