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Employers are increasingly turning to services that help their employees find, evaluate and book appointments with high-value, in-network providers.


Well, 2020 has certainly been a year to remember—or forget. As HR professionals look forward to ushering in a new year with the promise of a COVID-19 vaccine and a recovering economy, it’s important to understand that your employees may still need a lot of support in using their benefits in 2021. In fact, nearly 40% of them have already reported high levels of confusion about their benefits, an increase of 25% over pre-pandemic levels.

Low benefits literacy, combined with an increasingly complex health care system and rising costs, makes a strong case for helping your employees maximize their benefits. Fortunately, today’s employers have access to an ever-expanding array of technologies and services that can help their employees make the most of their benefits.

In this last installment of our four-part blog series, we’ll explore how integrating provider guidance into your employees’ overall benefits experience can improve their health and well-being while positively impacting your bottom line.

We all need care at some point

As pointed out in last week’s installment on care navigation, patients see better health outcomes when they have help from someone who knows their benefits, knows the health care system and, perhaps most importantly, knows them and their unique health care needs. This is especially true for those with one or more chronic illnesses or those receiving temporary yet complex treatment.

But what about those employees and dependents who aren’t regular health care consumers? Perhaps they’re young and healthy. (The Kaiser Family Foundation reports that 45% of millennials don’t even have a primary care physician.) Or perhaps they lack transportation, find it difficult to take time off from work, or don’t have a social network that supports seeking health care when necessary. Or maybe they’re part of the 80% of Americans who fail to seek routine preventive care each year because they’re simply too busy or are confused by the health care system.

Whatever their reasons, infrequent health care consumers run the risk of making less-than-optimal decisions when they eventually find themselves in the position of needing care. And, this can be expensive. In fact, the Agency for Healthcare Research and Quality estimates that 13% to 27% of emergency room visits in the U.S. could be managed in physician offices, clinics and urgent care centers, saving $4.4 billion annually.

Right care, right time, right place

Even when the situation isn’t urgent, people find themselves in the position of not having all the information needed to make optimal decisions regarding where to seek care. According to the Kaiser Family Foundation, nearly one in five inpatient admissions includes a claim from an out-of-network provider. (Check out next week’s installment in this blog series for more information about surprise billing.) Meanwhile, countless others find themselves unnecessarily readmitted to the hospital after failing to seek care from a provider participating in the health plan’s center of excellence program.

Self-service to the rescue

To ensure their employees receive the right care from the right provider, more employers are turning to services that help their employees find, evaluate and book appointments with high-value providers in their network and geographic location. Today’s self-service technologies can help employees:

  • Identify in-network providers.
  • Schedule one-time and recurring appointments.
  • Locate urgent care centers.
  • Take advantage of telemedicine options.
  • Find high quality hospitals for inpatient care.
  • Identify cost-effective imaging services.
  • Maximize appropriate use of primary care for common health needs.
  • Arrange care through highly experienced outpatient surgery centers.

Ready to learn more?

Provider guidance is just one of a variety of ever-expanding technologies and services that can help your employees maximize their benefits while reducing your health care spend. To learn about the others gaining popularity these days, read the white paper, The Case for a Personalized Employee Benefits Experience.

Today's consumers expect more

View all Posts by Sherri Bockhorst