Optimizing the Employee Benefits Experience Using Care Navigation

Sandeep Gupta
Fri 04 Dec 2020
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Healthcare organizations today are faced with a complex set of demographic, technological and economic changes, forcing employers to reconsider and revamp their approach to ensure comprehensive healthcare delivery. These changes are taking place due to increased access to big data and advanced data analytics, which in turn compel organizations to redefine the employee benefits experience. This means empowering employees to access and optimize this data to actualize a personalized, preventive and predictive vision of healthcare.

A complex healthcare system presents navigational challenges where employees are left at the mercy of composite and disparate sources to make sense of a personalized benefits plan for themselves and their families. According to a survey of 238 organizations by Harvard Business Review Analytic Services (2019), 63% of employees don’t know how to leverage company-provided health benefits, and only 28% are actively engaged with all the benefits programs offered.

This under-utilization of benefits leaves value on the table and this is where an employee-centric care navigation experience comes into play. But how do employers enhance the overall healthcare experience for employees? And how do they ensure robust internal communication to empower employees and improve cost and utilization trends?

Empower Employees with Self-Service

Employers are gravitating towards integrated healthcare as it interweaves data from hospitals, public health agencies, labs, pharmacies and other sources into the employer’s health plan to facilitate effective communication between the employees’ providers. This facilitates engagement where employees take an active role in implementing targeted strategies to enhance their experience.

Data needs to be leveraged to provide opportunities for customization, drive engagement and improve coverage and care quality. Care navigator dashboards help care teams enable data-driven proactive outreach based on employer criteria, based on their health and social determinants of health risk profile. Such acute health triggers indicate a potential need for additional assistance and help remove barriers in accessing care.

For example, if the assessment reveals that chronic conditions like diabetes are contributing to higher costs for employers, adding a chronic care component to the benefits program can help employees access the resources they need to improve their health.

By identifying high-risk patients, employers can tailor support for employees who can navigate care on their own, and for those who want additional support, thus ensuring whole-person care with a longitudinal view of the patient’s healthcare journey. This can be done by enabling omni-channel communication based on the user’s preferences via text, chat, email or telephone and these would be “add-on” or “buy-up” services.

Simplify and Customize the Benefits Experience

In order to facilitate provider collaboration, Innovaccer’s care navigation and benefits engagement solution provides a centralized hub for the health benefits experience to employees, a convenient access to self-service tools and seamless integration across vendors. This gives employees access to a one-stop engagement portal to access services and address a range of things from getting a diabetes test to buying prescription medicine.

Additionally, this would help enable personalized care plans, alerts and recommendations for employees as they get necessary preventive care and close care gaps which would help them utilize relevant programs provided by the employers.

By offering employees a simple and user-friendly digital experience, employers can drive engagement by incorporating behavioral economics concepts, thereby implementing sustainable long-term changes and enhancing the overall health experience.

Enable Intelligent Personalization and Integrated Workflows

When actionable data is shared amongst healthcare providers, they are able to better diagnose and treat members, and guide them towards prevention and care management.

As real-time interpretations and analytics illuminate patterns, employers can develop personalized plans based on varying employee preferences and needs. And with behavioral economics, employers can develop strategies by understanding the drivers behind employees’ economic decision-making.

Address Potential Risks and Improve Health Outcomes

Another way employers can enhance the health outcomes for employees is by addressing factors like social isolation, physical inactivity, access to community resources, lack of transportation, and other social determinants.

In terms of coordinating care, employers need to use the data to identify individuals with social needs in order to build a healthcare team to serve them more holistically. This means employers need to enable predictive measures to identify the key trends that can be addressed by mapping community resources. Aggregating medical claims, demographics, and other clinical information would help them deliver adaptive, personalized experiences to drive behavior through clinically proven digital tools and health coaching.

Customized wellness plans result in happier, more productive employees, thereby contributing to employees’ emotional health. Employees can also leverage the digital tools like accessing benefits experts and health coaches via chat or phone call and wellbeing apps to boost resilience. These resources offer choice, are flexible and can serve varying needs.

This means the employers need to actively engage with employees, use the data to understand their concerns and offer potential solutions. By analyzing healthcare claims, developing aggregate personal health profiles and conducting health risk assessments, employers can identify and address high-cost employees, analyze gaps and detect risks to eliminate them.

This means meeting employees where they are on their health journey, navigating them to the right support/care team and helping them move to their personalized goals.

To learn more about how you can enhance the care you deliver to your employees with a unified healthcare data platform, get a demo.

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Tags: Care Navigation
Sandeep Gupta
Optimizing the Employee Benefits Experience Using Care Navigation

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