Cost-effective, quality healthcare is intensely personal and involves a high level of trust between the member and the provider. When individuals engage with their caregivers and other healthcare professionals on a personal level, they build a foundation for holistic care management and better outcomes.
Employers incur an estimated $575 billion in expenses annually due to their employees’ poor health.
The challenge today, however, is that members have numerous options regarding where to get their care, making personalized, holistic engagement difficult. They may use an urgent care center for a sprained ankle, a pharmacy for an immunization, an ENT for an allergy, a telehealth service for a bladder infection, and a retail clinic for a cold. Having these options may provide convenience for members, but it also drives care fragmentation that leads to poorer outcomes and higher costs.
The best way to mitigate this fragmentation is to engage members in a way that helps them become better utilizers of their healthcare benefits. This requires finding ways to guide them toward becoming more informed participants in their care journey. Doing so can lower medical costs by 5.3% and reduce hospital admissions by 12.5%.1
What is an Actively Engaged Member?
An actively engaged member is one who understands their healthcare benefits from both a cost and utilization perspective. They realize the tradeoff that happens when choosing a plan with a lower monthly premium, but that comes with higher out-of-pocket costs throughout the year. They also possess a high level of health literacy, which is “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”2 High health literacy is essential for proper utilization and optimal outcomes.
The question for employers is how to ensure their members are appropriately engaged with their benefits plan. The answer is to create an effective, holistic engagement strategy. The following is a list of elements that should be included for an optimally performing program.
Putting it All Together
Employers incur an estimated $575 billion in expenses annually due to their employees’ poor health.3 They’ve seen the number of employees spending $100,000 a year increase by 50% in recent years.4 In these financially challenging times, employers must do all they can to remove barriers and optimize utilization among their members. Implementing a holistic engagement program is a great place to start.