When most benefit administrators focus on employee engagement, they think about open enrollment. Of course choosing the right coverage is an important step, but it’s only one piece of the puzzle. It is equally important for employees to know how to find and use care included in their coverage.
Why? Because care and coverage go together and when employees are engaged to improve their health and wellness, they are more likely to take positive action and change behaviors.
Employee engagement can be improved by creating a positive and consistent experience across her journey. This requires a systematic approach of orchestrating touchpoints — a touchpoint being any interaction between the employee and her health plan.
The key is coordinating and integrating the touchpoints so that they seamlessly meld together.
Here are some touch points longitudinally mapped throughout the employee journey, and you can leverage each touchpoint to support the others in the journey.
Reaching out to members during enrollment is a great way to start the communication. This opportunity should be used for explaining plan design, options and answering coverage specific questions for each member.
New Member Welcome
Post enrollment (after the member has signed up) is an opportunity to determine satisfaction and understanding of the plan collateral, design and customer service for future improvements. During this interaction, be sure to track responses that require timely follow up for members needing additional assistance.
Health Risk Assessment
Many employers provide incentive to employees for completing assessments. Use this touch point to engage members, enhance wellness programs, segment your population for better targeting and determine the appropriate follow-up plan for each segment.
Preventive Care Outreach
Employees aren’t used to seeking preventive care – they may be confused about which tests to ask for, may view preventive care as costly and aren’t aware of the free benefits provided under the ACA. This issue leads to members avoiding care until the last minute or using the most expensive option available. Use the right timing to reach members for preventive care. Calls scheduled on the employee’s birthday can be very effective.
If your plan design include VBID elements, and it reduces the out of pocket costs for members to use high quality services, you can use this as an opportunity to not only explain the gaps in care , the impact of this gap on member’s health, but also what services are needed to close the gap, the costs and the right providers to help close the gap.
Care Plan Adherence
The adherence to the plan of care is important in improving health outcomes and reducing overall cost of care. Start with a proactive reminder, and follow-up with calls to determine root causes and identify reasons for non-adherence. The overall approach should be to inform, educate, and assist members with adherence challenges.
ER is expensive. A number of visits to ER are unnecessary or avoidable, and majority of such visits are taken by a small segment of members. Identifying such members and helping them locate in-network providers in alternative cost-effective setting can reduce costs for employers as well as employees. You can use this touch point to educate them on appointment scheduling, video visits, nurse line etc.
Appropriate care transition from one setting to another can have a significant impact on employee’s understanding and compliance, readmission status, and overall satisfaction. It should however be done in a timely manner (within 48 hours of discharge) to ensure the continuity of care.
We understand that most benefit teams are simply not naturally wired to think about the member’s journey through out the year. For teams that master it, the reward is cost reduction, better outcomes, higher employee satisfaction and loyalty. It is well worth it.
At Sprite Health, we work hard every day to help self-funded employers design simpler, lower-cost, higher-value musculoskeletal benefits. Sprite empowers your people with simple, transparent, upfront pricing for services and treatments that address their specific needs. With hands-on support by our concierge, your people get a seamless, personalized experience that makes accessing, understanding, navigating and paying for care effortless.