Choosing the right health plan model can be confusing (at best). When there are so many options out there and little information to help you understand the benefits available to you, it can be easy to just settle for the familiar fully insured option. But let’s face...
People-Focused Healthcare: How We’re Taking the Burden Off of HR
By Anne Brunson, Vice President of Service Operations
Healthcare today is pretty tough to navigate. Rising costs, jargon-filled benefits documents and opaque data (if you even get any data) are just a few of the issues many employers and members face today.
We believe that healthcare should be accessible for everyone, including HR teams and their health plan members. But it’s pretty clear that it’s not—just check out our latest whitepaper blog for some eye-opening data. At the end of the day, a lot of the challenges people face boil down to two key points:
- HR and members don’t have the support and resources they need.
- Employers have little to no insight or control over what goes into plan designs or costs.
We’re tackling these challenges head-on with solutions designed to give employers and members more control, more support and more options. Our administrative services are designed to reduce the burden for everyone and help each employer administer a truly usable benefits plan for their members, from accessible care to understandable information.
Here’s a look at how we’re taking the burden off of HR and our members with better support and resources:
We’ve brought many services in-house.
We’ve brought many common services in-house and we have strong partnerships with vendors who can provide what we don’t. HR is able to spend more time on their people instead of juggling multiple vendors.
Each of our clients has a dedicated client experience manager, like a health plan concierge, to help coordinate needs, answer questions and more.
Here are just a few of the things we manage and coordinate for our clients:
- Open enrollment
- Coordination of benefits
- Pharmacy benefit (PBM) management
- Claims processing and repricing
- Stop-loss administration
- Benefit accounts administration
- Regular health plan status and insight reports
- Wellness management
We’re giving employers access to their health claims data—no strings attached.
One of the most frustrating things about many of today’s health plans is the lack of insight employers have. Health plan data is a critical part of defining a good health plan for both the bottom line and the member.
One of the biggest differences when it comes to working with Maestro Health is that we give our clients access to their health claims and plan data at no extra charge. Plus, our client service teams work right alongside you to make sure you’re getting the right insights at the right time through our Maestro Health Analytics™ platform and with regular reporting, like the Health Plan Snapshot.
Here are some of the most sought-after insights we provide our clients:
- Potentially avoidable ER visits and hospital admissions
- High-cost members
- Plan costs by month and year
- Demographic risk analytics
- Utilization metrics
We believe in real member engagement.
People need to understand their benefits in order to use them. Some of HR’s biggest headaches when it comes to managing a health plan is trying to navigate and explain a system to their members that they themselves may not fully understand or have the time to explain.
Our member engagement strategy is designed to work two-fold: take the burden off of HR and de-mystify benefits materials. Our strategy extends beyond the open-enrollment period with materials, resources, support and communications designed to foster engagement all year long.
Here are just a few of the ways we help our clients deliver a better benefits experience:
- We have an extensive library of member engagement materials that our clients can customize with their logo and content tailored to their member demographics.
- Our member education site provides a single source of truth for members, like health plan resources, access to their benefits portal and more.
- Our customer service teams are just one phone number away to help answer questions and resolve issues.
At the end of the day, our goal is to put people at the center of what we do. We’re here to truly help our clients manage their health plans and members connect with their health. We’re a lot more than just a standard TPA. We’re advocates, partners and navigators.
Get in touch with us to learn more about how our self-funded benefits are designed to support our clients and members.