We’re entering an era in which health benefits have evolved 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.
Our high-value health plan offers your people a low-premium, zero-deductible alternative to traditional high-deductible plans. Built on a broad, nationwide network with hands-on support by our concierge, they now have a plan which addresses their unique needs and conditions, with no barriers like deductible and saves them 20% in wages.
Imagine if you could significantly reduce your healthcare spend and provide your people the benefits they would love.
Realize complete control
With Sprite health, you can take full control of your healthcare investments and run it like other business functions.
You get unprecedented flexibility to customize your health plan including decisions on specific benefits, cost sharing, quality metrics, payment methods and networks.
Our ‘command and control’ center provides complete visibility into all plan operations including enrollment, population health, care plans, member engagement, claims, payments and provider performance.
Realize better engagement
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 supported by our concierge 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. 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.
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.
Realize better health outcomes
Because everyone is different, we customize the benefits ecosystem around each member’s personalized needs. Anchored by our concierge team 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 designated care coordinator who uses a proactive and collaborative approach to help her 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 – direct primary care, COE, 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.
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.