Although 2016 is only halfway complete, Employee Benefit News has identified several key trends in the employee benefits world. Coming as no surprise (to those of us in the HR tech field anyways), technology is playing a critical role in two of these trends –transparency/advocacy tools and telemedicine.
With employee out-of-pocket cost-sharing, deductibles and premiums on the rise and more employers moving to self-insured medical plans, employees’ need to access high-quality outcome with lower cost providers and facilities has become even more apparent. In order to gain access to high-quality outcomes, employees must have the data and a means to use the data to help guide their decisions. Enter cost transparency and advocacy providers.
With cost transparency providers, however, these third party vendors (or apps) will arm end-users with the actual cost of a plan (even factoring in how their specific plan will pay). As with most other HR technology solutions, most of the good transparency solutions are mobile-ready and can enable the user to make appointments or give driving directions with the click of a button. Some of the vendors in this space include Castlight, Compass, Healthcare Blue Book, GoodRX and PokitDok.
Insurance carriers also are joining the cost transparency game. The Health4Me application from United Healthcare was recently updated so that UHC members are able to price out an entire claim end-to-end. Users are given the option to select providers and see costs along the way. The app will also configure costs based on the medical plan the member is enrolled in, save the treatment plan and assist with scheduling.
Member advocacy is also wrapped up in this trend. Most HR professionals would say a good portion of their day is consumed with helping employees navigate a confusing Explanation of Benefits (EOB) or helping them access care if they are not successful in navigating their health plan. Patient advocacy is now being included in most of these cost transparency vendors’ solutions. They can provide assistance in explaining or negotiating a disputed bill, help in finding doctors/specialists, coordinating a complicated treatment plan, or even scheduling an appointment. Can I get a “woot woot!” from HR on that? This not only takes work off HR’s desks, but also reduces exposure to some uncomfortable HIPAA situations.
Telemedicine has received widespread adoption from plan sponsors and insurance carriers. From providers such as Anthem’s Live Health Online, United Healthcare’s Virtual Visits to third party providers like MeMed or TeleDoc, telemedicine is growing in popularity.
Telemedicine technology allows for members to connect with a doctor — over a phone call or video conference via their mobile device — to diagnose (and prescribe medicine) for relatively simple conditions, such as a sinus infection or rash. These types of conditions are normally resolved with one visit and do not require follow-up care. In my experience, many employees love this approach to care for its convenience, and plan sponsors endorse it for the lower cost of delivering an office visit and reduced absenteeism from its workforce. In 2015 alone, the American Telemedicine Association reported 1.25 million telephonic/virtual visits.
Despite the increase in popularity, telemedicine has received some push back from states such as Utah and Texas trying to strictly regulate it, which makes it more difficult to access telemedicine in those states. Most insurance is regulated on a state-by-state basis, with some states only allowing patients to speak with telemedicine providers physically located within their same state.
So far, 2016 seems to be a year of companies seeking to support optimal employee health at realistic costs, which translates to high productivity and engagement, and strong overall company performance. Can these trends help achieve these end results? We will have to wait and see!