Blog Post How Maestro Health Does Clinical Care Management Better. Going self-funded has big benefits for many employers which can result in serious cost savings and better health outcomes. Our in-house clinical care management program leverages a data-driven approach...
Working Toward a Better Healthcare System
This is not a new story: the U.S. healthcare system is in poor health. At a time when many Americans are already struggling to get by, many are now faced with unnerving choice: their health or their financial stability.
Here are the concerning facts: 1 in 5 Americans suffer from a mental illness; 6 in 10 have a chronic disease. Yet, fewer Americans each year have health insurance—in fact, the number of those without coverage increased from 7.9% in 2017 to 8.5% in 2018. People shouldn’t be forced to prioritize their financial wellbeing over their own health. But still, it’s happening.
We recently surveyed 1,000 Americans to understand the barriers that many Americans face when it comes to navigating, affording and understanding their health and benefits. The data paints a bleak picture, but also illuminates how industry stakeholders can improve.
Here’s a look at what we found:
High costs are driving many to make tough choices.
Of all our findings, the cost of healthcare quite possibly had the most serious implications for those surveyed, putting many in a tough position.
- 55% of people have avoided getting care due to high costs.
- 52% have made a financial sacrifice to pay a medical bill.
- 39% have had to fight an unfair medical bill.
But it doesn’t have to be that way. We’re helping our clients leverage solutions like alternative reimbursement strategies, narrow networks and direct contracting to connect members with quality, affordable care. Implementing strategies like these mean members have a better sense of what to expect, from how much the visit will cost to where to seek out the care they need. No more choosing bills over groceries.
Many are disengaged due to a lack of support.
Engagement is a critical component to understanding and using health benefits, as well as managing one’s own health and wellbeing. Yet, our data shows that many Americans lack the support and resources they desperately need.
- 70% of people said the healthcare system is difficult to navigate.
- 65% don’t understand their medical bills.
- 39% don’t feel they have the support they need or know where to go to understand their healthcare.
Even more frustrating is how systemic this issue actually is: HR and benefits teams don’t have the details and resources they need, resulting in a lack of time, support and resources for their people, contributing to a cycle of low health literacy rates and disengagement.
From understanding bills to knowing where to seek out care, having a support system in place is essential to engaging everyone (HR teams included) with their healthcare.
Benefits shouldn’t be confusing. We partner with our clients to equip everyone—from members to HR—with the tools, resources and support they need to understand and engage with their benefits. Our member engagement strategies and administrative services are designed to meet our clients and members where they are all year round and alleviate the burden of navigating the system alone.
Healthcare isn’t designed to make sense.
The lack of transparency and accessibility in today’s healthcare system has made navigating the healthcare landscape difficult. Our data shows that many Americans are left to decipher their health and benefits alone, often without any advocacy or support.
- 31% of people don’t know how to tell if a provider is in-network or not.
- 44% don’t think their providers consult each other.
The healthcare system is its own barrier to providing the access and advocacy that many need when it comes to understanding their benefits and connecting with their health. Having access to care is a critical part of our wellbeing, but many are left to fend for their health alone.
We work with our members and our clients every step of the way to provide the advocacy and support they need, like having just one phone number to call for help, centralized support teams who work together to resolve issues and an in-house clinical care management program.
Here’s the bottom line: healthcare needs to put people first.
Maestro Health is partnering with employers and their trusted advisors to deliver a better benefits experience with a self-funded solution that’s designed around their needs. We use data, real-time feedback and market insights to help us and our clients make informed decisions and continuously tailor our options around people and their wellbeing.
You can read our full findings in our whitepaper The Poor Health of America’s Healthcare System.