Traditional healthcare models just aren’t working for employers. Outrageous costs, confusing benefits information, poor claims processing and little to no data means that employers and employees are stuck with solutions that just aren’t built to care for their health.
Brokers and consultants are more than just a middleman between health plans and employers. They’re problem solvers working closely with their clients to find solutions and benefits that are designed around the needs of their clients, not the other way around.
We’re working with brokers to break out of the old healthcare system and redefine healthcare with a fresh self-funded approach to benefits.
Here are the six things brokers need more of to create a tailored solution for their clients.
You need access to data and actionable analytics.
Access to claims data is critical – it empowers employers to shape their benefits plans around the needs of their employees, understand how benefits are being used (or not used), know when to target the right care at the right time for the right member and much more.
Arming employers with their claims data can help them better understand what’s impacting their employees and the bottom line. These insights can empower brokers to help their clients design health plans around the people using them.
You need mindful claims auditing, not autopilot.
Many of today’s claims processing procedures are mostly, if not fully, automated, which means a lot of issues slip through the cracks and land in the lap of the employees. We’re talking fraudulent claims, inaccurate billing, unbundled procedures and unfair costs.
Automated processes don’t hold providers accountable; they just make it easier to shift the responsibility to a member instead. Claims processing needs to come off autopilot and handled by real people to ensure accuracy and fairness.
You need better pricing and negotiating tools.
The price of healthcare today is outrageous, especially when you look at how much providers are padding the bill. In fact, a lot of the “discounts” offered by major carriers barely bring prices down to a reasonable cost differential.
Fair pricing should be based on the cost and quality of care received. Reference-based pricing strategies using validated market data can help employers negotiate better prices that are more aligned with the cost and quality of care, not hospital profits.
You need benefits education strategies that work.
Benefits packets delivered once a year at open enrollment just aren’t helpful. Half the information doesn’t make sense and the rest might not even be relevant to the employee. Chances are, they click “enroll” once a year when they need to and never refer back to the materials when they need care.
Employers need communication strategies designed around educating their employees with the right materials at the right time through the right channels.
From text message reminders to emails to one-stop mobile apps, education strategies designed around meeting employees where they’re at means getting critical information and education into their hands when it matters most.
You need care management that’s focused on people.
Staying healthy isn’t just about going to the doctor for a yearly check-up and refilling your prescriptions. It’s about managing the overall wellbeing of a person—physically, mentally, financially and beyond.
Employers need a dedicated care management team that can help them find their healthy, whether that’s managing a chronic condition, finding healthier habits or delivering personalized support. A strong support system that’s focused on the person can result in more than just improved health outcomes, it can help lower costs and improve overall stability for employees.
You need better customer service and support.
We’ve all been there before: endless phone trees that leave you with more questions than answers, a lack of information about the services you want to use, and worse, disappearing client support partners.
Brokers need a partner who can be there to support their clients, from onboarding to billing questions to arming their clients with the data they need to manage their plan. Customer support needs to shift from an unhelpful help desk to dedicated support teams.
We believe brokers need more than just the basics for their clients. We’re on a mission to change how people experience their healthcare, from the tools we use to help design plans to delivering healthy outcomes.
We work closely with our brokers and their clients as dedicated partners to deliver a better health and benefits experience. From arming brokers and employers with the data they need to manage their plan to providing personalized support, our people are here for your people.