4 things employers want from health plans in a virtual world

In response to COVID-19, employers agree: a more convenient, digital approach is required to support employees’ health at home and help them better use and navigate the healthcare system. According to a recent survey, the majority of employers are enhancing healthcare and wellbeing programs in response to COVID-19. In fact, six in 10 employers have made or will make changes to their benefit programs over the next six months with two out of five planning to revise their health care strategies for 2021.

A new approach is required to meet employers’ demands and avoid ceding business to outsourced services for engagement, care management, or benefits management. Known as digital health management, this strategy helps health plans reimagine the relationships they can forge with members. As a result, organizations can deliver the following capabilities required to meet employees’ expectations in this challenging era.

woman with phone

1. Help employees navigate the healthcare system

  • Provide a single point of contact for employees through a convenient mobile app
  • Focus first on meeting the needs of employees to develop a trusted relationship over time
  • Help employees get financial and administrative questions answered, get support for chronic conditions, guidance following a hospital discharge, and more
  • Streamline outreach from providers, the health plan, and your third party services to deliver a better experience, rather than overwhelming employees
  • Integrate workflows of care management and customer service to capture key metrics on consumer actions, and better forecast employee needs
  • Identify higher-risk employees or employees who need more help and triage them to care management

2. Meet employees where they are

Deliver omnichannel engagement

  • Provide health support through a combination of phone calls, messaging, apps, web, and video chat so employees can choose the method that meets their needs in the moment
  • Ensure flexibility and accessibility with mobile messaging, so employees can engage and respond on their own time, rather than fielding calls during business hours

Provide a personalized experience

  • Instead of taking a one-size-fits all approach to patient education, make sure you can deliver dynamic, adaptable clinical programs

Build loyalty to engage employees on their terms

  • Provide daily, long-term support rather than intermittent outreach
  • Offer ongoing emotional support and encouragement through mobile messaging
  • Work with the employee over time to set and track progress toward specific, measurable actionable, relevant, and time-bound (SMART) goals
  • Demonstrate upfront value to employees, making it easier for care teams to hold them accountable for reaching their health goals, scheduling follow-up appointments, and closing care gaps

3. Support the whole person to deliver better results

Address mental and physical health

  • Given the high levels of employee stress and anxiety, deliver behavioral health support alongside condition-related guidance

Support multiple conditions in a single solution

  • Avoid treating diseases independently of one another, as one in four Americans have multiple chronic conditions*
  • Address overlapping symptoms and the challenges of polypharmacy by supporting conditions simultaneously, in consideration of one another
  • Offer a broad range of clinical programs in a single solution to support multiple chronic conditions like diabetes, COPD, asthma, and more, as well as transitional care and behavioral health

Meet both clinical and social healthcare needs

  • Utilize interactive surveys to screen for social determinant needs such as transportation, financial concerns, social support, and safety
  • Deliver personalized health education and guidance tailored to those social needs, within the context of their clinical need
  • Leverage mobile messaging to connect the employee to the appropriate resources—such as copay assistance or transportation programs—in a timely fashion
  • *CDC

4. Measure rigorously to demonstrate value to employers

Capture member insights for early interventions

  • Capture continuous inbound information from individuals’ activity within their digital health management program
  • Uncover insights into employee engagement, health status, gaps in care, alerts, and more
  • Examine data in aggregate for valuable insight into population preferences, engagement, and satisfaction

Create care team reports for workflow evolution

  • Measure data from care managers’ interactions with employees to determine individual productivity based on operational metrics such as recruitment volume, engagement rates, efficiency, and capacity
  • Utilize this data to empower supervisors to optimize resource allocation around needs and strengths–which in turn enable teams to engage more employees, more efficiently

Conduct impact evaluations with program reports

  • Capture data based on large scale, program-wide indicators that point to the larger impact of your health management programs
  • Enable new comparisons of cost and value that characterize the overall program ROI by measuring data from medical and pharmacy claims combined with data from patients and care teams
  • Differentiate your health plan to win employer business by quantifying results and demonstrating success

The current crisis has only intensified the pressures on health plans to evolve to meet the demands of their customers.

But by reimaging the relationships they forge with their members, health plans can help their employer partners control costs, engage employees, and improve employee satisfaction.