Change the way you treat employees’ relationship to healthcare. The result? Increased satisfaction and decreased costs.
By John C. Stoddard
Faced with rising healthcare costs, employers are turning to consumer-driven strategies to transform their employees from passive patients to informed and actively involved healthcare consumers. They are doing this to empower employees to make more informed decisions about their care, and to better understand the associated costs. This is worthwhile for employers since empowered employees are more likely to seek and use information, consider different care options, and make choices that meet their preferences. When combined, these behaviors are powerful forces in helping to get more value at a lower cost from the healthcare system, which benefits employees and their employers who together pay for employer-sponsored healthcare.
Employers have implemented an array of different tactics as part of an effort to engage employees in their healthcare. These tactics range from implementing consumer-driven health plans with high deductibles designed to connect employees more closely to the healthcare financial marketplace to offering a variety of programs, tools, and information sources designed to engage and activate employees in managing their health and making informed decisions. Other consumerist approaches that employers have adopted include: having nurses call employees at home to educate them about their conditions; using incentives and social gaming to drive participation in wellness programs; and offering health information websites and cost transparency tools to make information more accessible.
The reality is that despite these investments, most employers find that the consumer-driven plans they’ve implemented increase complexity and frustration for employees, while the tools and programs they offer are underused. As a result, most employers have fallen well short of achieving their objective of creating informed consumers and lowering healthcare costs.
Start Treating Them Like Consumers
Benefits leaders can help their organizations avoid these obstacles and achieve their goals by following a very simple, yet profound principle: If you want your employees to act like consumers, start treating them like consumers.
To achieve this, benefits executives should see their role more as consumer marketers than as plan administrators and mimic the behaviors of great consumer businesses such as Apple or JetBlue. These organizations have transformed their industries by designing products from the consumer backwards, creating great user experiences that simplify unnecessary complexity. Executives who are able to create a great experience around how employees use their health benefits and simplify how they make decisions will be the ones who will reap the benefits healthcare consumerism affords.
In order to transform and simplify how employees use healthcare, employers must get a good appreciation for their needs and their current experience. Armed with this information, employers can then apply consumer-centered design principles to offer employees a service that they want, need, and value.
In most cases, people do not think about the “product” (their health benefits and the healthcare system) unless a situation arises in which they have to use them. When they do need them, employees find that their benefits are filled with complex terms and provisions. Then they are forced to use them within a healthcare system that is difficult to access and navigate, given how fragmented and unfamiliar it is to most people. Things are made more challenging because healthcare decisions typically need to be made at times when consumers are sick, scared, stressed, anxious, or confused. This complicates their ability think clearly, ask good questions, and effectively weigh options.
When employers understand this just-in-time consumer behavior, it will become more obvious why most of the traditional consumerism approaches tried by employers—websites, tools, incentives, targeted outbound calls—have fallen short of expectations. They are unclear, overwhelming, and irrelevant to the specific needs that employees have when they or a family member is sick.
Because employees don’t want to make a mistake when they use their benefits, they often turn to their health plan as their initial source of information, which poses two challenges. First, health plans do not provide a good customer experience. The Tempkin Group surveyed 10,000 United States consumers in 2012 and found health plans represented the lowest-rated industry in terms of customer service. Health plans have worked hard to lower costs while meeting minimal thresholds for service as employers have asked them to lower their fees. A key component of this has been moving consumers to self-service via the web. The result is that over time consumers have become more and more frustrated, because getting clear answers to even simple questions has become more challenging and complicated.
Second, health plans are not trusted by most consumers. A 2012 Peppers and Rogers Group study found that only two in five people trust their health insurer. Given the role that employers have asked their health plans to play in approving or denying payment for coverage, it will be hard for them to overcome this perception, despite their best intentions to improve service quality, since employees will never see their interests being aligned with insurance companies. Without trust, consumers are difficult to help, as they need to be able to confide what is really going on with their health, and they need to trust the options that they are being given.
What Consumers Want
What employees really want when a healthcare issue arises is to get the right care for themselves or their families, avoid making mistakes, and save themselves time, money, and hassle. To achieve this, they need information and support that is easy to access, simple to understand, and tailored to their personal situation so that they can make good decisions and overcome the barriers that keep them from acting on good decisions. Above all, this information needs to come from a trusted and credible source.
Until just a few years ago, it would have been difficult for employers to come up with different ways of creating great consumer experiences for their employees and simplify healthcare decision making. Professional health assistants are a newer option. As independent resources, professional health assistants are able to provide the kind of service experience and personalized information that employees need in order to be informed consumers and make informed decisions. They are often supported by a specially trained team of doctors, nurses, pharmacists, psychologists, lifestyle improvement and claims and benefits experts. This team typically has access to the benefits information, claims data, and clinical resources necessary to answer any question or resolve issues for the employee.
A number of leading employers have taken this approach of treating their employees as consumers and simplifying their decision making by offering professional health assistants.
In addition to lowering costs, employers are finding that employees value the level of service and appreciate their employer for providing this type of support.
Benefits of offering professional health assistants include:
• Employee engagement. Nearly 60 percent of all employee families and who generate 80 percent of the healthcare spend proactively use the service each year.
• Employee satisfaction. Ninety-eight percent of employees are very satisfied with this new benefit and value their employer for providing it to them.
• Cost savings. Health benefits costs have been lowered by nearly 10
percent after factoring out plan design changes and other discounts that they’ve negotiated with their health plan.
Benefits leaders who are able to redefine their role from managing benefits plans to managing great consumer experiences can empower their employees to become better consumers of healthcare. By providing them with a great service experience, tailored information, and personalized support from a trusted and credible professional health assistant, they will unleash the power of consumerism and stem the tide of growing healthcare costs.
John C. Stoddard is the chief operating officer of Accolade Inc.