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        5 min read

        Why Healthcare Navigation is Key in Increasing the Adoption of Virtual Benefits

        Let’s address the problem. The US healthcare system is confusing, overwhelming, fragmented, and frustrating. 

        For employees, the consequences of this unapproachable system can range from mild annoyance to financial devastation. For employers, the financial stakes are also high. Companies spend 30% of total headcount expenses on benefit programs, yet costly decisions and a nontransparent system make it harder than ever to see a return on that investment. Couple that with the fact that many employees are using virtual benefits for the first time and you have a whole host of potential issues.

        Let’s take a look at the problems that exist and why healthcare navigation is essential when battling vital issues, especially in an increasingly virtual landscape. 

        The Problems

        Employee healthcare is already a huge expense for companies

        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 too

        At the same time, enrollment in high-deductible health plans (HDHPs) is increasing year over year. This is raising the stakes for employee finances. In a 2021 Kaiser Family Foundation study, 28% of covered workers enrolled in HDHPs, up from 20% in 2015.

        Employees don’t understand their healthcare benefits

        A survey from PolicyGenius found that fewer than one-third could correctly define “copay,” “deductible,” and “premium.” On top of that, employees are having to learn the differences and terminology related to virtual care options.

        Low healthcare literacy has a lasting impact on health outcomes

        In our 2021 Employee Benefits Insights Report, 40% of employer-insured consumers said they avoided care in the last year because they didn’t know what was covered. Especially with many companies offering more virtual options than ever, employees can get confused about where to go for the best care.

        Twenty-nine percent 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. 

        How a Healthcare Navigation Platform Can Help

        Employers who want to lower their skyrocketing healthcare costs don’t need a one-off, cost-containment measure or a new wellness program. They need a better way to help their employees get care. 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. One that helps people identify, access, and connect them with the care they need, when they need it. 

        They need a healthcare navigation solution to help navigate our new healthcare landscape.

        A healthcare navigation solution 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. This includes on-demand support and care redirection from our healthcare concierge team, plus steerage to appropriate virtual and on-site care. Depending on available benefits, that could mean directing employees to virtual urgent care, prescription discounts, onsite clinics, or specialty care such as fertility solutions or cardio-metabolic care. HealthJoy clients regularly save hundreds per employee per year thanks to these features and products. 

        A healthcare navigation solution improves employee healthcare 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. Delaying cancer screenings leads to worse outcomes and, during the coronavirus pandemic, drove a higher rate of deaths, according to a study published in the journal Nature. 

        Encouraging employees to engage in preventive activities is about approachability. Employees put off these activities for myriad reasons, including fear, forgetfulness, lack of time, and low understanding. A navigation solution breaks down these barriers. It not only reminds employees to take care of themselves, but also 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 site. With tools like live healthcare navigation support and case management, they never have to walk through their healthcare journey alone. 

        A healthcare navigation solution 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 Virtual MSK Care, Virtual Urgent Care , and more. These programs head off higher costs, but are 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. When they open the app, everything is clearly displayed and push notifications can draw attention to your high-priority initiatives more effectively than email. With higher participation and engagement, your wellness programs can yield greater ROI and boost employee satisfaction. In other words, a healthcare navigation platform can 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, self-funded 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 saved one 4,900-employee HealthJoy client nearly $350,000 in savings from healthcare concierge guidance. That’s over $380,000 in savings from telemedicine steerage, and $22,000 in savings from medical bill reviews. That number doesn’t even account for the nearly 2,500 hours saved by HR.  

        Navigating members to success 

        With a connected care 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. 

        Our benefits wallet ties everything together 

        The HealthJoy benefits wallet helps members get the facts, contact information, and plan details needed to make smart decisions.

        The benefits wallet can mean a smoother transition when you update or roll out new benefits. This is especially key when teams are remote and you don’t have in-person touch points. Employees don’t have to worry about where to find these changes because the benefits wallet serves as a single source of truth.

        Even an expected change in the yearly plan design can create confusion and a flood of questions for HR. The benefits wallet eliminates this problem by keeping the plan details updated. 

        We’re here to help you simplify and save

        HealthJoy’s platform brings all your benefits together, whether virtual or in-person. With flexible integration and the option to tailor around your existing offerings, we bring the power of connected care to your entire benefits package. Your employees will discover the best providers, virtual care, and savings opportunities so they can lead happier, healthier lives. 

        Learn more about how HealthJoy can help you today.

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