Cliff Sentell, Compass’ Chief Technology Officer, was the guest speaker during the August 2017 Compass Health Activation Webinar, where he discussed why healthcare doesn’t deliver in a click-and-ship world.
Employees are used to being able to purchase items on the Internet with just a few clicks of a mouse and have them arrive on their doorsteps the next day. Unfortunately, shopping for healthcare is more complicated. Because of the personal, complex and emotional aspects of healthcare, it’s impossible to replicate the “Amazon” online shopping experience in healthcare.
When employees use healthcare services, they are often confused about their benefits. They don’t know which doctors to use, don’t understand the cost of healthcare services and are confused by their healthcare bills. We created Compass Professional Health Services to redefine employee healthcare and dramatically improve the experience employees have as they navigate the healthcare system – with the ultimate goal of improving employee care and lowering employee and employer healthcare costs.
Companies often struggle to meet employees where they are in their healthcare journey. And healthcare solution providers have unsuccessfully tried to bring the convenience of consumer models from other areas in our lives (i.e. online shopping, real-time traffic navigation, customer service centers, etc.) to the healthcare tools of price transparency, patient advocacy and health benefits point solutions.
The Challenge of Price Transparency
Healthcare is expensive, but employees don’t want to pay a lot of money for healthcare services. This has led to the rise of healthcare price transparency services that enable patients to discover how much a medical service will cost prior to receiving treatment. The promise of traditional price-transparency tools was that if you give employees a list of doctors and/or procedures with cost and quality information, they will be able to make better healthcare decisions for themselves and their families.
“Every American should have access to a full range of information about the quality and cost of their healthcare options.” – Health and Human Services Secretary Mike Leavitt, 2007
Initially, there was a lot of excitement around this concept. However, the reality of traditional online transparency tools didn’t live up to the promise. When employees see a long list of options, it’s difficult for them to be able to interpret or trust that information and take action.
According to Catalyst for Payment Reform, only 2 percent of the total employee enrollment in commercial plans use online price transparency tools. In addition, when employees use them, it’s challenging for them to get the information they need because much of the data is incorrect. So, the goal of borrowing from traditional e-commerce solutions and applying them directly to healthcare simply falls flat.
The Challenge of Patient Advocacy
Patient advocacy services provide employees with expert guidance for healthcare situations, such as when they receive a medical bill they don’t understand or they don’t know how to use their insurance benefits.
Many of the advocacy solutions in the market have borrowed from the customer service industry. The traditional patient advocacy business model leverages the call center industry, putting agents on the phone who can help guide employees through making healthcare decisions. However, call centers often focus on using low cost resources as the frontline employees for talking with your employees. These agents can help triage calls, but most don’t have the skills to directly solve the caller’s healthcare problems. As a result, the caller is passed off to a series of people before the question is actually answered.
The traditional call center model also encourages short phone calls. As a result, employees often receive only basic information during these calls and don’t have the in-depth conversations needed to give them the information needed to truly address their questions – leading to a lack of trust in the service.
Dealing with the healthcare system can be a stressful and emotional time, and employees need a friendly expert who can quickly meet their needs. These experts should be great problem solvers and spend the necessary time, no matter how long, to help employees address their immediate issues – without having to pass employees along to another “expert” to answer their questions.
Watch the Compass Webinar below – then continue reading this week’s blog.
The Challenge of Point Solutions
Finally, employees need healthcare solutions that are personal and meet their specific healthcare needs.
This need for personalization has contributed to the rise of point solutions. These are unique programs that can help people address specific health issues, such as diabetes and pregnancy.
When utilized correctly, these types of programs provide great employee value. The challenge is that they are often underutilized because it’s difficult for employees to keep track of the numerous programs their company’s benefit program offers. In addition, it’s hard for health benefits professionals to effectively track and manage the large number of solutions. Finally, it’s also challenging to connect employees into these specialized programs just at the time they need them. The reality is that employees don’t think about their benefits until they actually need them.
The Solution: Healthcare Navigation Services
At Compass, we understand the healthcare problems employees face and have taken a unique approach to custom-build a solution that solves healthcare benefits challenges in the way that employees want them solved. We call this healthcare navigation, and our results from helping employees at more than 2,000 companies nationwide navigate the complexities of healthcare speak for themselves.
Instead of putting low-level support personnel on the phones (who have been trained for only a few weeks), our team of friendly, well-trained healthcare experts called Health Pros, provide employees with personal guidance as soon as they get an email or a phone call. This allows employees to get an excellent healthcare experience the minute they engage with Compass and the healthcare system.
Providing amazing experiences is fundamental to building trust, which helps us influence employee behavior. While an initial consult may answer an insurance benefit question, it quickly pivots to provide value-driven decision support. If employees are asking insurance benefit questions, it means they are about to engage with the healthcare system. When we provide doctor and procedure cost information, we avoid providing long lists of every acceptable doctor in an area like online price-transparency portals do. Instead, we provide three to four personalized recommendations that meet the employee’s unique situation. Each recommendation takes into account provider cost and quality information and is based on 4.2 billion price points across 66 payer networks for more than 13,000 procedures. Our simplified approach makes it easy for employees to actually take action on the information provided.
Finally, when employees are in the moment of needing care, we can help guide them to the right programs. We can steer employees with diabetes into a company’s diabetes management program. We can also offer them opportunities to connect with a doctor via telemedicine services, if that would be more convenient or more cost effective than going to urgent care.
With healthcare navigation, we can meet employees wherever they are in their healthcare journey. It’s not enough to be able to help employees at only a few points in their healthcare journey. In order to transform the employee healthcare experience, it’s important to help employees before, during and after care. With healthcare navigation, we’re able to provide employees with a great healthcare experience, which unlocks our ability to influence employee healthcare behavior.
So while healthcare may not deliver in our click-and-ship world, healthcare navigation services can help deliver on the promise of simpler, smarter healthcare and provide employees with an excellent healthcare and health benefits experience.
To learn more about Healthcare Navigation, we recommend that you sign up for ongoing invitations to the Compass Health Activation Webinar Series.
- Why Focusing on the Healthcare Experience is Critical to Solving the Employer Healthcare Cost Problem