by Susan Denzio, director of information and administrative services, First Resource, Inc.

Mmmmm, pizza! When the order is placed, it typically is understood what options are available – size, toppings, additional side items, delivery and, of course, the total cost. Now, imagine if it were possible to create a healthcare delivery system that was as understandable to people as ordering a pizza. Believe it or not, a system does exist that is affordable and easy to use.

Ask any business leader about rising costs, and it is most likely that healthcare benefits escalation will be mentioned as one of the top three most important concerns. The issue, however, is that rarely are employees pleased with the insurance options and, in many situations, the benefit plans are under-utilized. Could this be a result of a lack of understanding, both in regard to what is available and how to gain access? The answer to this question is yes! Recent studies indicate that educating employees about their insurance benefits and how to use them at the critical “point of need” positively impacts outcomes and satisfaction levels.

Nearly every employer has experienced the pain of educating employees about benefit options. Communication efforts generally include flyers, mailers, posters and wall diagrams pinned in break rooms or cafeterias. Most employers use open enrollment meetings to deliver large amounts of benefit information, but in the end, employees are left with an abundance of questions. Even though support usually is made available from most plans through the phone number included on the back of the insurance card, many employees will not engage with this customer service option. Rather, questions are pointed directly to human resource professionals when a point of critical escalation has been reached; these interchanges can become quite personal and involve confidential health, claims and billing issues. Since most human resource teams don’t have the wherewithal to access the appropriate level of data to understand what an individual might be undergoing, the interchanges often are unproductive and extremely frustrating, causing employees to look unfavorably at the benefit offering. At the end of the day, company executives must consider other options to ensure investments in insurance benefit plans yield the positive impact expected on both employees and their families.

Best-in-class company leaders now are using concierge service professionals to eliminate the frustration and close the benefit education gaps for their employees. These services have proven to reduce the workload of management teams and improve the employees’ viewpoints of the company benefits provided, resulting in decreased employee turnover.

Employee concierge services focus on simplifying the healthcare journey for employees, especially when the journey is full of unknowns that tend to accompany critical life illnesses and injuries. With one simple call, employees have direct access to a concierge service (“pod”), or a dedicated team of medical technicians and specialists, to help them navigate the healthcare maze of delivery options. Embedded in the infrastructure of the overall solution and inserted into the confines of the administrator, the employee concierge’s dedicated team has access to the data, the member’s health records and the providers. Being better connected to the human element helps to resolve issues, clarify points of concern and provide the best direction for employees; these services have been proven to impact health outcomes.

From a finance and funding perspective, an actuarial study conducted over 15 years demonstrated that concierge services provided to employees and dependents actually reduced claims by 17.5%. The boutique concierge service platform eliminates the 1-800-number call-center feel and replaces it with a laser focused, high-performance team that does one thing – answer the questions and provide guidance for employees and their dependents – that’s it! Because the dedicated teams take a very focused, specialized approach to create a better experience, employees are able to navigate easily amidst the complex healthcare delivery system in such a way that no one feels alone. Imagine an employee who has just been diagnosed with a critical illness, receiving a communication similar to this:

“Hello, Mr. Smith. We are here to help you, we completely understand your health plan and we will ensure you receive the best services in the most expeditious manner possible. Now, let’s get started.”

Concierge services systems are proven to provide employees with better support in making consumer-driven healthcare decisions, which increases plan utilization. Return on investment studies have shown that claims decrease when usage increases. When employees routinely seek a doctor’s care, conditions that have a chance of becoming severe often can be caught early and are more easily treated, lowering the total cost of care.

MAPP’s CAPTIV8 solutions fully integrates employee concierge services for its members. To learn more, contact Susan Denzio at [email protected]