Seamless Care Management Caters to Member Needs, Drives Savings
Jul 21, 2020
3 min read
Every top-notch employer wants to take good care of its employees, and every smart employer wants to keep costs as low as possible. The good news is that a self-insured health plan with seamless care coordination can accomplish both goals. In fact, taking care of employees isn’t just the responsible thing to do; it’s the key to sustainable savings.
When plan participants have access to good care management, they don’t just feel heard and cared for, but also connected via ongoing guidance and decision support as they navigate the healthcare system. As qualified care managers help plan participants make important decisions about their healthcare, they can also provide information about costs and other important factors. Plus, research shows that when employees have more information about cost and quality, they will search out the least invasive and least expensive option.
Accomplishing the twin goals of employee care and cost savings requires a revolutionary approach to care management. Employers who want to provide a self-insured health plan that can truly meet the needs of employees and simultaneously keep costs down must seek a third-party administrator (TPA) that understands how these two objectives are interrelated and how care management can provide a joint solution.
Stressed-Out Employees Need Intuitive Care Management
Not surprisingly, Americans are stressed about their healthcare and their finances. For instance, one survey of adults showed that 85% are worried about medical costs. That figure is higher than those worried about retirement costs (73%), those worried about the cost of higher education (73%) and those concerned about the cost of housing (66%).
High-deductible health plans (HDHPs) were introduced in 2004 and have become increasingly popular in recent years. For instance, enrollment in HDHPs increased from 20% of covered employees in 2014 to 30% in 2019, according to Kaiser Family Foundation research.
The rise in HDHPs has led to more out-of-pocket costs for employees. As a result, employees are expected to behave like consumers, making their own healthcare decisions even though they may not have the training or tools to make thoughtful healthcare decisions, such as determining whether to undergo (and pay for) an elective procedure, or selecting the right doctor for a necessary surgery.
In the same way that consumers now rely on mobile devices to inform or enable buying decisions in other areas of their lives, patients also want mobile devices to play a role in simplifying their healthcare purchasing experiences, providing tools that compare cost and quality, according to research from Deloitte. Such tools can also help patients stay on track with medication compliance and other healthcare goals, improving healthcare outcomes over the long run.
Additionally, patients--especially those who suffer from chronic conditions--value care coordination. According to research, patients feel that coordinated care keeps them healthy and they want all their healthcare providers to communicate with each other about their care. They want their healthcare providers to have their current and complete medical information, regardless of where they receive care. A highly focused care management team can help facilitate that coordination, providing help and answers for both the patient and the healthcare provider.
Care Management Should Be Integral
Many self-insured health plan providers simply administer claims and push papers, leaving the care management up to an outside vendor. For instance, a TPA may offer employers access to an array of additional vendors to provide various care management solutions such as telehealth, chronic disease management and other services.
But care management is fundamentally tied to the ability to reduce costs and, as a result, should be integrated with the administrative components of the plan. With a fundamental care management solution, a self-insured plan can offer the anxiety-easing, hand-holding care that employees may need during a stressful time, along with information about cost-saving strategies and options. Those less-expensive options can save money for both the individual employee and the employer.
Lucent Health offers an integrated care management solution, powered by Narus Health, which is a fundamental component of its plan management product. At Lucent Health, care management includes an experienced team of nurses in various specialties, an intuitive online platform, and a real-time data sharing process. With this combination, Lucent Health can help self-insured employers better care for their employees while managing costs at the same time.