It is amazing to work in employee benefits – the ever-changing landscape, and ability to positively impact people’s lives. However being a benefit leader is a hard job.
You invest a significant amount of time designing the right benefit strategy, figure out the right plan design, what programs and providers to choose. However, one of the things we hear consistently that despite the considerable effort you are putting into designing benefit strategy, unfortunately the utilization remains poor and the cost of benefits continue to rise.
We’re entering an era in which health benefits have evolved from an employer benefit with virtually no decision-making or financial involvement from employees, to a cost-sharing model where employees have a real stake in the outcome. In this era, employees have started to expect personalization and suitability of offered benefits to their unique needs.
Sprite health provides consistent & improved member experience and at the same time makes all of company’s benefit programs more relevant, efficient & effective, for delivering better outcomes at lower costs.
Realize complete control
With Sprite health, you can take full control of your healthcare investments and run it like other business functions.
You are free to design your benefits ecosystem by choosing the best networks, providers and programs for medical, dental, vision, wellness and other needs of your employee population. Our technology platform integrates all of your chosen benefits in one place and provides you the line of sight to to see what’s working and fix what’s not.
With our ‘command and control’ center, you can group benefits into processes that work for your employees’ unique needs and produce better cost and quality outcomes. You can swap in and out benefit program (s) anytime, and measure the effectiveness and ROI of each program using real-time analytics.
Realize better engagement
Frustrated with 4% utilization of new benefits – no more.
Our technology provides the connective tissue that blends separate and siloed benefit programs in a meaningfully integrated way – delivering the most relevant choices to each employee according to relevance, personal preference and interest. This intuitive approach is both high-touch and high-tech — a single, encompassing portal that can successfully guide employees on their journey.
To encourage participation, the system precisely targets employees with highly personalized content, reward and incentives to match their specific needs – delivered via multiple channels such as email, mobile notifications at the ‘right’ time. Daily callout banners nudge people toward real-time opportunities relevant to their personal health, savings, and well-being. This approach guides and incentivizes members to find and utilize the right care, right provider or right benefit such as ‘Behavior Health’, ‘Second Opinion’ – which improves utilization and satisfaction with your benefit programs. We also provide real-time visibility into the campaign performance that helps you adjust, optimize and continuously drive engagement.
Realize lower costs
Sprite health reduces costs by optimizing employees’ care utilization and eliminating waste in care delivery.
Our system constantly analyzes the concerns and needs of your employee population and predicts those who aren’t yet, but are likely to become new high-cost members – “cost bloomers”. Once identified, it suggests precisely targeted interventions that maintain good care and help avoid their cost increase.
To optimize care utilization, we focus on reducing avoidable and inappropriate care by replacing high-cost, low-value care with proactive, high-touch, collaborative care from within your network that delivers superior outcomes at lower costs.
For top spend categories our technology highlights areas of waste, creates quality and cost optimized pathways and steers the network utilization towards most cost-efficient providers in your benefits ecosystem.
Realize better health outcomes
Because everyone is different, we customize the benefits ecosystem around each member’s personalized needs. Anchored by our dedicated, flexible care teams, and technology platform, we make it simple for members to connect with resources to help them with a wide set of needs, whenever and wherever they want.
Each member has a dedicated care coordinator who uses a proactive, collaborative and continuous coordination approach to create a personalized care journey for each member on her terms, not ours. The coordinator’s primary goal is to help members get the right care using the right benefit from the right provider at the right price, at the right time.
Also, because one person is responsible for coordinating each member’s care, the members are not subjected to duplicate treatments or other unnecessary inconveniences.
Realize pay for value
There is an explosion of new ‘point’ solutions – benefits, programs such as diabetes, nutrition, worksite clinics, digital coaching, mental health designed to complement and supplement your primary health coverage.
Sprite health helps you contract directly with these innovative providers, and reimburse them using payment models that reward high-quality and cost-effective care. The value-based payment models (such as pay for performance, risk-adjusted primary care, severity-adjusted bundles, shared savings, or ACO contracts) reward providers for good outcomes and high quality, not medical errors, unnecessary procedures and other low-value care.
With Sprite health, you can create commercially efficient contracts to build direct partnerships with your providers and make them more accountable for reducing costs and improving the quality of care provided to your employees.
Realize higher efficiency
Your benefit team spends 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 them.
Sprite health 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.