Bring all benefits together in one place
The world of healthcare is complex. 73% of employees say that they don’t understand their benefits and struggle to navigate the healthcare system. This is getting amplified with the proliferation of so many new options and programs, each having their own website, app, number to call. Fundamentally there is a lack of integration in the system, a lot of pieces in motion and not a single platform that can bring it all together.
Our engagement hub provides the technology foundation to bring your medical, dental, vision, pharmacy plans and programs together in one place.
Employees now have a simple way to understand and access all of the health benefits available to them. No matter where they are, they have the technology and tools to make better decisions to choose the right provider, the right care, the right benefit at the right time for the right price.
Fit benefits to each member’s specific needs
How can companies improve every employee’s health experience, regardless of their health status, eligibility for benefits, choice of health plan, or work location? Most benefits are designed as one-size-fit-all and providers often don’t have any incentives to make it work for the employees who need it most. It should be no surprise that about half of healthcare tools and solutions go unused.
Engagement hub solves this problem by first identifying “important” needs and conditions for your population and then configuring the right process, workflow and care pathway for each condition by leveraging services, resources from existing plans and programs to maximum effect. This makes sure that each person’s unique needs are met with the lowest cost, highest quality and experience possible.
By having structured evidence-based pathways, companies can also address unsupported treatment variances between providers, and optimize outcomes, quality and costs.
Engage members at the right time to guide them to better decisions
Most companies do not know when someone is going to make a significant health decision, and don’t have the right mechanism to segment the right populations, and target them with the right messages at the right time.
Our predictive models create ‘target’ member list, who are likely to require high-cost care in near future. With engagement hub, you can personalize messaging and content to groups of employees with specific needs at the moment that’s most relevant for them. In this way, you can connect your employees with the appropriate programs, services or types of care they might need – when they need it.
Leveraging multiple channels such as web, email, and mobile app to meet people where they are, on a timely basis helps them make better health decisions. It also provides you the visibility about what’s working and what’s not and then helps you iterate quickly to move the needle on behavior change.
Actionable insights to see what’s working and fix what’s not
It is quite difficult to drive business decisions just on claims data – which is often dated and incomplete. The complexity is getting amplified when you offer multiple benefits, each of which provide different types of data in different formats at different times. It is no surprise that benefit leaders often are confused about what programs are working, what type of communication is more effective, why their trend is going upwards, why medical services cost what they do and why the distribution of costs is so uneven between different providers?
Engagement hub brings health benefits on a single platform, provides you the insights into what’s working and flexibility to change what’s not. The advanced analytics provide clarity into how your employees use healthcare services, who your high-risk employees are and how to intervene effectively to lower costs, improve quality and outcomes.
By fully integrating data across programs, engagement hub enables companies use empirical evidence to truly understand the impact of their healthcare investments. With real-time understanding of plans’ performance, engagement, utilization and health spend – your team is much more effective in monitoring and managing the full spectrum of benefits.
Bring form, discipline and structure to operations
Benefit teams spend a considerable part of their day just to keep things going. The current systems are antiquated and require a lot of manual effort. Moving spreadsheets and physical paper files back and forth between health insurance carriers, third party providers such as telemedicine, EAP, onsite clinic etc. is the not the best use of time for your benefits team.
Engagement hub brings form, discipline and structure to plan administration processes using easy-to-use, rapid and automated workflows for enrollment, eligibility, invoice reconciliation and payments.
Instead of sending different eligibility files to different plans and providers – you simply send one eligibility file to Sprite health, and we’ll send it to all your plans in the format they desire. When the providers send you the bill or invoice, our system automatically reconcile the data to make sure that you are not overpaying.
Accelerate to Value-Based Care
Health benefit costs have been growing significantly in the last five years. The major contributors to this unabated trend is lack of accountability and misaligned business model of procuring care. Our current health care system is designed to pay for volume – the number of medical services delivered – not the value of those services. Providers have no incentive to work together to improve your employees’ overall health and experience in the health care system. The results are escalating costs, wasteful spending, significant quality gaps and poor satisfaction ratings.
Forward-looking employers are making in shift in their benefit strategy, with more focus on the inefficiencies of the health delivery system rather than changes in benefit design as a way to control costs.
Engagement hub accelerates the transformation of your benefit strategy from FFS to value-based care. It provides a proactive approach to controlling your health spend, by integrating ‘Pay for Value’ financial models into your benefit strategy. Companies can now apply our modern technology to every aspect of health benefits including value-based benefit procurement, design, management and administration.
Engagement hub provides comprehensive support for alternative payment models (Bundled, Shared Savings, Shared Risks, Capitated) that reward providers for good outcomes and high quality, not medical errors, unnecessary procedures and other low value care.
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Maximize the impact of your healthcare spend