What Is a Healthcare Navigation Platform?

The US healthcare system is overwhelming for the average employee. When choosing the wrong primary care provider can mean thousands in out-of-network penalties, how are we meant to handle the bigger decisions, like managing a chronic illness?

The truth is, we’re ill-equipped. One study found that just 12% of adults have the health literacy necessary to navigate the system. In our 2021 Employee Benefits Insights Report, 40% of consumers told us they’d delayed or skipped care in the last year because they didn’t know what was covered by their health benefits.

That means worse health outcomes over the short and long term. It also means higher costs for individuals and the companies sponsoring their health benefits. Companies spend 30% of total headcount expenses on benefit programs.

Healthcare Navigation Platforms: What They Are and Why Your Company Needs One

Employer healthcare costs are climbing. In 2020, the cost to insure employees topped $22,000. Workers paid $5,588 — about 17% of the total cost — toward their premiums, while employers footed the remaining $15,754.

Workers are paying more as well. At the same time, enrollment in high-deductible health plans is increasing year over year, raising the stakes for employee finances. In a 2019 Kaiser Family Foundation study, 30% of covered workers were enrolled in HDHPs, up from 20% in 2015.

Low healthcare literacy has a lasting impact on health outcomes. In our 2021 Employee Benefits Insights Report, 40% of employer-insured consumers said they’d avoided care in the last year because they didn’t know what was covered. Twenty-nine percent had avoided taking prescribed medication because of the cost. Low healthcare literacy often continues well after a doctor’s visit: 37% reported medical bills always or usually come as a surprise or seem inaccurate.

Healthcare costs put your employees at risk. For 2022, out-of-pocket maximums for families may reach as high as $17,400, yet the average American doesn't have $400 in savings. Low health literacy is associated with increased, repeated emergency room visits and worse health outcomes, according to the National Institutes of Health.

And they’re an existential threat to businesses, as well. Employees don’t feel responsible for how their healthcare choices impact their employer’s bottom line. Our 2021 Employee Benefits Insights Report surveyed over 1,500 employees and found that almost half of employees rarely or never consider how the cost of their healthcare choices impact their employer.

What Is a Healthcare Navigation Platform?

Employers who want to lower their skyrocketing healthcare costs don’t need a one-off cost-containment measure or a new wellness program. Point solutions won’t solve the problem, and education alone isn’t enough to prompt employees to make smarter healthcare choices. To truly drive behavioral change, employers need an always-on, approachable tool that helps their people identify, access, and interface with the right healthcare every step of the way.

They need a better way to help their employees get care. This is where a healthcare navigation platform comes in.

A healthcare navigation platform connects people with the right providers, services, and support at the right moment in their healthcare journey to positively impact both their health and the cost of care.

Three Key Benefits of a Healthcare Navigation Platform

A healthcare navigation platform lowers costs

Employees who don’t understand their benefits are likely to turn to costly options for care. For instance, they may choose a hospital imaging facility over a lower-cost standalone facility, simply because it’s in the same hospital network as the prescribing provider. 

Lower health literacy is also associated with higher rates of ER visits. Emergency room visits typically cost more than outpatient urgent care facility visits, yet employees who don’t know where to find urgent care may turn to these solutions first. It’s estimated that $18 billion could be saved annually if patients with non-emergent conditions chose urgent care over the ER.

With a healthcare navigation solution, employees benefit from tools that make it easy to find the right care, including on-demand support, care redirection, and steerage to virtual care solutions. HealthJoy clients regularly save hundreds per employee per year ‌thanks to these features and products.

A healthcare navigation platform improves employee health outcomes

A healthcare navigation solution can prompt employees to remember preventive screenings and improve healthcare outcomes through early detection. Employees who don’t understand their benefits are avoiding or delaying care, and that leads to worsening health outcomes.

Encouraging employees to engage in preventive activities is about ease of use. Employees put off these activities for myriad reasons, including fear, forgetfulness, lack of time, and low understanding. A healthcare navigation solution breaks down these barriers. It not only reminds employees to take care of themselves, but shows them how to do so. The right connected care experience can seamlessly transition employees from a push notification to scheduling an appointment without ever moving to another app or website. With tools like live healthcare navigation support and case management, they never have to walk through their healthcare journey alone.

A healthcare navigation platform makes all your health and wellness benefits more valuable

A healthcare navigation solution isn’t just about finding savings on big-ticket items, like surgery or imaging. It can also prompt engagement with your preventive measures, like wellness programs, fitness challenges, and more. These programs head off higher costs, but are often limited by low employee participation.

When you implement a fully-connected navigation platform that’s integrated with your benefits package, you’ll gain access to tools that make your wellness benefits more approachable. Everything is easily displayed when they open the app, and timely push notifications can draw attention to your health and wellness initiatives more effectively than email. A mobile navigation platform also unlocks personalized communication tools HR can use to send out timely reminders and announcements, whether related to new wellness initiatives or open enrollment.

With higher participation and engagement, your wellness programs can yield more ROI and higher returns in terms of employee satisfaction. In other words, a healthcare navigation platform can actually make all your benefits more valuable.

The results speak for themselves

When every piece is working together to make health and wellness easier, a healthcare navigation solution’s effectiveness should speak for itself. With the right solution, companies will notice a decrease in healthcare spending, as well as improved satisfaction and benefits engagement from employees.

How powerful are the results? Member engagement in our healthcare navigation solution is projected to save one 4,900-employee HealthJoy client $154-per employee per year in 2021. To break it down further, that’s derived from nearly $350,000 in projected savings from healthcare concierge guidance, over $380,000 in projected savings from telemedicine steerage, $22,000 in projected savings from medical bill reviews, and 2,500 hours saved for HR.

The Power of a Connected Healthcare Navigation Platform

Employees don’t know how to find cost-effective care, which drives up both theirout-of-pocket costs and your company’s expenses. Point solutions can address problems from different angles, but without a connected experience, they fall flat.

Here’s why.

• Healthcare decisions are stressful. Asking employees to make smart, informed choices at the time of a stressful healthcare event isn’t reasonable. Employees need support for every healthcare decision, throughout the year, without hours of research.

• Point solutions don’t work together, meaning employees must access a different site, download a different app, or call a different number for every resource. This siloed experience only increases confusion and frustration. As more point solutions flood the benefits landscape, there’s still a need for solutions that bring them together.

• A fragmented benefits experience makes it harder for HR to meet their goals. Juggling a maze of vendors is difficult for employees and your team. Each vendor requires a different implementation experience, provides a different level of support, and means a different navigation experience for employees.

How do we know it isn’t working? Rising costs and frustration aside, you likely see it in your office every day: despite investing in solutions, benefits professionals still spend an average of nine hours each week explaining benefits, according to our 2021 State of the Benefits Experience Report.

A healthcare navigation platform solves these problems. With a connected solution at the center of their benefits experience, employees can intuitively find the right care at the right time. Live, personalized guidance and an approachable interface make a confusing system more human. And when employees can make smart healthcare decisions with ease, healthcare costs go down — for them, and for your company.

HealthJoy’s Connected Healthcare Navigation Platform

Fully Integrated Premium Products

Our suite of fully integrated premium products lets you build a customized system to support employee wellbeing from every angle. 

• Premium products are deeply embedded into the HealthJoy healthcare navigation platform and are backed by live, human concierge support. 

• Our suite of products provide deeper reporting and insights into employee behavior than an integration with third-party benefits.

HealthJoy EAP

The line between work and life is blurry at best, so our holistic approach improves employees’ lives from every angle. We go beyond counseling with programs that address employee mental health and happiness, driving engagement, retention, and productivity.

HealthJoy Behavioral Health

Support the employees at the heart of your business with virtual mental healthcare. Our counselors will work with them on their schedule and develop a custom treatment plan tailored to their unique needs.

HealthJoy Virtual MSK Care

Give your employees an easy way to get the relief they need in just minutes per day. We integrated hands-on, world-class coaching into our connected care platform to drive adherence and provide results like no other program.

HealthJoy Virtual Urgent Care

Our fully-integrated virtual urgent care is approachable and always available. Employees can get a diagnosis, a new prescription, or even a refill sent to their local pharmacy.

HealthJoy Bill Review

Our medical billing experts can review any bill your employees suspect contains an error. Experts will answer any questions, explain benefits, and offer confidence in a bill’s accuracy.