Health care benefits that will improve employee satisfaction in 2024

When thinking about the challenges facing the health care industry, we continue to encounter persistent complexity that patients experience when accessing their benefits coupled with an affordability crisis in our general economy.

Today’s insurance models include complicated plan design terms and provisions that very few people understand. When given basic plan design terms, only 4% of plan participants can match the term to the definition. Not only is it difficult for individuals to understand health plans benefits, but they are also struggling financially, avoiding health care services altogether. The recent spike in revolving credit card debt has just crossed the trillion-dollar level in the United States for the first time (up by $250 billion in the last 24 months), which has resulted in maxed out credit lines for households. Families do not have the financial means to afford the high out of-pocket costs within their medical plans and they no longer have lines of credit to support them through an unexpected health care event.

There is a better way. Fortunately, we are entering a new wave of alternative health insurance models that allow employers to bring innovative solutions to their employees. These advanced, alternative models have improved employee satisfaction in four ways:

1. Alternative models are easier for plan participants to understand by making health care and health insurance work like any other consumer purchase. These new models entirely transform the complex and administratively wasteful payment and reimbursement process within our industry. Instead, providers are reimbursed network contracted rates in full and patients would receive one monthly statement from the insurer that is simple and easy to understand. No EOBs for patients to spread across the kitchen table and no bills from providers.
2. These plans offer price certainty. Individuals know their out-of-pocket cost in advance for every covered medical and pharmacy service with fixed copays. A copay is a concrete price to the plan member that is known in advance and will not change at the time of service or after the service. A copay is understandable. A copay is knowable. The copay that the patient sees upfront when searching for a health care service is the same copay on their statement at the end of the month, just like any other consumer purchase in life.
3. Patients receive high-quality care at a lower cost. With these alternative plans, patients are in control of their health care. The copays are aligned around the quality of care delivered by the provider they choose to see. Lower copays are set for higher quality doctors because they are more efficient, have lower readmission rates, and fewer complications.
4. And better yet, these plans offer financial wellbeing solutions, such as a 0% line of credit and flexible payment options, to ensure that employees no longer forego necessary care. This allows patients to focus less on how they are going to pay for their medical bills and more on what truly matters: improving their health and wellbeing.

Related: What employees want in their health care benefits (and could be a deal breaker)

These alternative benefit plans are giving employees what they really want: to find the top providers in their community, to know the cost of care before they go to the doctor or pharmacy, and to not worry about the financial burden of their health care expenses.

When plan members understand their health insurance, then financial incentives to seek higher quality doctors and hospitals can actually work. And with an improved patient experience that leads them to better clinical outcomes and lower health care costs, employers will have a satisfied, healthy, productive, and talented workforce.

Wally Gomaa, co-founder of Simplepay Health