Help Workers Choose And Use Care With Confidence

It’s hard to believe that a year has passed since COVID-19 made its way to the U.S., altering just about every aspect of life as we knew it. Since then, the pandemic has remained at the forefront of nearly every headline, conversation and political stage.

COVID-19 shed light on several overlooked aspects of health care, such as employee well-being benefits and telemedicine services. In turn, workers started paying closer attention to their health care benefits and asking, “Do I have the coverage I need?” Even the answer to that question evolved throughout 2020 as the impacts of the pandemic unfolded – from the side effects of COVID-19 to the toll of prolonged social distancing and delayed appointments. Human resource teams were overwhelmed with inquiries from workers about how to use their coverage, when their coverage applied and how to keep costs down.

As employers and employees alike navigate the new normal, health benefit brokers have stepped in with education, information and decision support services, tools and technology. Here are some important points to keep in mind.

1. Employees are thirsty for information — and are seeking personalized information.

A recent consumer survey showed that a startling number of workers have self-educated about employee benefits. Yet workers who have had the opportunity for one-on-one benefits education said it is the single most helpful way to learn about their benefits options and how those options relate to their health care needs. More than two-thirds of respondents said one-on-one conversations were “very” or “extremely” helpful — emphasizing that talking to experts matters.

Encourage your clients to offer opportunities throughout the year — or even year-round — to engage with benefits experts to get their workers’ questions answered. Employers can no longer communicate about health care once a year and expect their workers to fully understand their health plans and benefits. Given the generally low health care literacy in the U.S. and the ever-changing benefits landscape, benefits education must be an ongoing process. Otherwise, it’s easy for employees to lose sight of what resources and best practices are available to them.

2. Workers are more receptive to and interested in supplementing their coverage.

With the pandemic focusing our attention on our physical and financial well-being, individuals are taking a closer look at where they can boost their coverage or fill in gaps. As a result, interest in critical illness (especially those with contagious disease riders), hospital indemnity and supplemental life plans has skyrocketed. Remind your clients that because these are voluntary coverages, there is flexibility as to when they can be offered. So you might want to suggest an off-cycle voluntary benefits enrollment period.

Be sure to draw clear connections between how these supplemental coverages can work together to provide comprehensive protection for your clients’ employees and their families. These plans can be confusing and it is helpful to have concrete examples to head off employee questions. Having these enrollments throughout the year can ensure workers have the coverage they need and feel secure in their ability to pay when health care expenses arise.

3. Employees are more receptive to and likely to use ancillary programs like telemedicine and advocacy and transparency services.

Telemedicine and virtual care usage shot up from an average of 8% to 14% in the first half of 2020, according to one recent survey. Another study reported that fully 30% of doctor’s visits from January to June of last year were telemedicine visits! And at DirectPath, our advocacy and transparency team saw 22% usage during 2020 — well above the industry average.

Particularly when employees may be required to work from home or are hesitant to sit in waiting rooms with sick patients, virtual solutions can fill an important need in maintaining their physical, mental and financial health.

Of course, putting a program in place — no matter how useful or appealing — isn’t enough to drive workers to use it. In addition to identifying and implementing such services, brokers should work with employers to ensure the programs are widely promoted and communicated.

4. Remember the idea of “shopping for care” can be overwhelming.

One of the best ways for workers to take control of costs is to shop around for care. As brokers know, the cost of any given service can differ drastically based on doctor, facility and even region. In a review of 2020, DirectPath saw average savings of $19,498 for an arthroplasty, while workers who compared costs saved an average of $2,447 for an MRI and $2,732 for a colonoscopy. But few workers know that they can shop for care, have any idea how to go about it, or see the value in making the effort.

With news stories about the high – and varying – cost of health care services, and new regulations requiring employers to share information about negotiated in- and out-of-network costs in the years ahead, now is the time to help workers take control of their health care spending.

According to a 2021 DirectPath survey, 83% of brokers are currently providing some sort of health care transparency and clinical advocacy services to help workers contain costs. Another 23% of respondents said they will add new advocacy and transparency-focused services to meet this growing demand. These services ensure that workers can call a health care advocate when they have questions about their network, coverage, billing and more.

The pandemic highlighted several existing employer health care-related challenges – from overlooked programs to worker knowledge gaps. Brokers can help. Workers need a strong foundational knowledge of their health care benefits so that when their needs become complicated – such as during a pandemic – they can choose and use care with confidence.

Kim Buckey is vice president of client services with DirectPath. She may be contacted at [email protected].

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Kim Buckey is vice president of client services with Optavise. Kim may be contacted at [email protected].