Now, more than ever, health insurers and employers are feeling the pressure to do better on behalf of their constituents. By easing employee confusion, stress, and financial strain, insurers and employers can be invaluable allies during this crisis—and visionary leaders in a rapidly changing health care environment.
Even before COVID-19, the inefficiencies inherent in U.S. health insurance held the public’s attention. Analyses estimate that over a quarter of total health care spending—$1 trillion dollars a year—does not actually benefit patients. A potentially deadly pandemic, combined with rising unemployment rates and a volatile economy, have only increased this scrutiny. People are worried about their finances and their health, they are fed up with what feels like ever-increasing costs, and they have very little clarity about where their money goes.
This leaves insurers and employers faced with a choice says MyHealthMath Chief Mission Officer, Elizabeth Cote, MD, MPA. “They can keep with the status quo and leave consumers in the lurch. Or, they can step up, make cost-efficient planning simple and accessible, and increase employee health, well-being, and overall satisfaction.”
Here are three places to start:
1. Make sure employees are not automatically rolling over their health plan options
More than nine out of 10 employees choose the same health plan option year after year—despite many studies that show that people are often in the wrong plan, spending thousands of extra dollars annually. Even if you did choose the best option, coverage on that plan can change from year to year—and so can your needs.
In light of COVID-19, breaking plan-choice inertia is more important now than ever. Every person is going through a life-changing event, and that means no one should be rolling plans over without careful consideration of their health needs. Given the economic uncertainty, choosing a more cost-efficient health plan can help families overcome financial setbacks.
“Think about it this way,” says Cote. “If you save over $1,000, that’s another stimulus check in your pocket.”
It is imperative that employers and insurers have a plan for engaging with employees before and during open enrollment and encouraging them to examine their options. Importantly, this plan needs to factor in the reality of an increasingly online workforce. Virtual benefits fairs with online resources; one-to-one counseling about individual health care needs and plan choices; a persistent communications strategy sharing changes and resources; and messaging that urges people to review their plan options considering COVID-19—these are all necessary strategies for ensuring employees get the nudge they need to make a change.
2. Prioritize cost-transparency
Even with increased communication and support, most employees will not make a change unless they really understand the potential benefits for them. However, calculating what plan is the best fit for your medical needs gets tricky fast. Employers and insurers can clarify the plan-selection process by investing in decision-support technology. These support services help employees choose the best health plan based on their expected medical usage and can result in significant cost savings for employees.
“The fact is: employees deserve to know what health plan is the best fit, but right now, it is just too complicated—really nearly impossible—for employees to calculate on their own,” says Cote.
Additionally, insurance companies can revolutionize health care planning with claims data — their detailed information on individual medical expenses, prescription costs, emergency room visits, wellness checks, and so on. Right now, people are often choosing health plans based on best guesses about their expenses and utilization the year before. While you can get claims data now, it’s incredibly confusing. By making it easier for employees to understand and use that data, health insurers can empower people to make good decisions—and that would be groundbreaking.
3) Provide a safety net
Physical distancing, while necessary, has weakened individuals’ health care safety net. For one, people are seeing less of their doctors. With prioritization of medical care for pandemic-related necessities and emergencies, people often don’t seek care even when they know they need it, they attend fewer annual checkups, and have less access to recommended preventive care services.
At the same time, people aren’t as connected to their friends and family, who are vital advocates for supporting their health and well-being. Friends and family will ask how you are feeling, advise you to see a doctor, and nudge you in the direction of supportive services like counseling. Right now, that social connection and advocacy is really limited.
Employers, who are already directly connected to health insurance and likely one of peoples’ biggest constants during these socially-distanced times, are uniquely positioned to reinforce the health care safety network. They can do this by offering individualized education about what their health insurance covers, not just directly related to COVID-19, but also regarding tele-health, mental health, and substance-use services—which are all the more important in these turbulent times. Also, they can regularly promote their sick-leave policies and develop internal communication campaigns to encourage and support employees in taking time off to get well and recharge.
“As a country, we are facing dual health and financial threats that make health insurance affordability and clarity matter more than ever,” says Cote. “Insurers and employers have an opportunity to seize this moment and stabilize the shifting financial and healthcare sands beneath the feet of their beneficiaries and employees. Those that step up will not only benefit from cost efficiencies, but they will be seen as visionary leaders in the healthcare market and protectors of individual employee health.”
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