Simply put: you want to make healthcare easier, more affordable and more accessible for your employees. You want that, and you want it done now.
When you're in charge of a healthcare plan, its your responsibility to make sure that it remains affordable, and that the people on the plan can get quality healthcare (the right care) every single time. We've dug through the best academic articles, scrutinized journals and read countless reviews and best practices to put together a comprehensive guide for assessing healthcare platforms. If you're in the market, you can't afford to rely news articles and Facebook ads. You need trusted sources to help guide your decisions.
Start with this: where did our healthcare system come from? How about health insurance? It may not seem important, but consider that corporate sponsored healthcare began around World War 2, when tax incentives made it cheaper for companies to sponsor health insurance than to pay that money out in salary. The cost of this insurance quickly grew and new cost savings mechanisms began to appear. PPO's (preferred provider organizations), HMO's (health maintenance organizations) and insurance networks exist to save money. But the system is highly fragmented. You have one company that supplies the doctor, another handles the insurance. Your premium is paid by your employer but is administered by a third party. In essence, the common person cannot keep up with the “demands and complexity of the health care system”. Patient engagement and health literacy has become known as a “blockbuster drug” for improving healthcare (and cost) outcomes in recent years. And there are a lot of great companies working towards making our system easier to understand. However, most of the efforts at improving outcomes are directed at working with hospital and clinician networks, even large (Fortune 100) companies. There's not a lot tailored for small to midsize corporations.
This guide will help you understand health literacy and consumer-focused healthcare platforms, and what you need to find one that's right for your company.
Defining Engagement: Before looking at how to improve engagement, it helps to start with a foundation of understanding where your employees are currently at. You might have a "thumb in the wind" understanding of how your employees manage their healthcare, but you can assume the following: In almost any business, employees commonly fall into 1 of 3 engagement demographics:
Somewhat Engaged – 45% of employees - They simply get their work done with only a few errors here and there, but they don’t go above and beyond.
Actively Engaged – 29% of employees - These people are the promoters of your brand and often the drivers of innovation and forward movement. They are the people that you want to hang on to.
Actively Unengaged - 26% of employees - Those that are actively unengaged will diminish your brand and your reputation with customers. They don’t like your company, but haven’t left yet. They are also a detriment to the “somewhat engaged” who may be swayed by negative encouragement.k
Using these categories as a barometer, we can estimate that there is a similar demographic for how engaged they are when it comes to healthcare. Although it seems strange to compare employee performance at the office with how they use their healthcare, we must consider that employees view their healthcare as being provided by their employer. That’s why they come to the HR department with questions, not the insurance company or hospital network that they use. Statistically speaking, they also assume that the details of their health plan (how much it costs, what it covers) is the fault of their employer. That means that if you get an increase in your costs, they will assume that you're simply charging them more.
Furthermore, we can use the corporate engagement rates above to gain a general understanding of how “engaged” your population will be when it comes to their healthcare.
"employees view their healthcare as being provided by their employer. That’s why they come to the HR department with questions, not the insurance company or hospital"
In terms of actualized “health literacy” the below figure illustrates the various levels of proficiency, and how many people fall into each category. While it may not be surprising to see that only 12% of people are “proficient”, and 53% of people are “intermediate”, the description for those categories is alarming. A person at an "intermediate" level is competent enough to read instructions on a pill bottle, but not enough to critically think about selecting a doctor. They would also be able to schedule an appointment, but not shop around for the price of that care. Now consider that a medication may be hundreds of dollars cheaper from a pharmacy next door to the one you use. Only 12% of your employees would be able to understand that information, if they're engaged enough to look it up at all.
Health Literacy Rates - From health.gov
Understanding the motivation of "consumers" (your employees in this instance) is important in assessing their level of involvement and understanding. According to a study by Deloitte, a motivated healthcare consumer strives to:
However, most common employees are not necessarily motivated by these factors. While statistics show that people are overwhelmingly prone to looking up information online, they don't necessarily know where to go, or even what to look for.
With an understanding of health literacy and engagement, and how it impacts your health plan, you know that your company's healthcare is more expensive (and less effective) than you want it to be. But understanding the problem isn't enough, and you need to have an outline of your specific strengths, weaknesses and issues in order to create an actionable plan.
Understand your workplace culture - Are you a manufacturing firm or do you provide a business service? Your industry will have an impact on the behavior of the employees and their spending habits. While you may think that you have a comprehensive understanding of your employees behavior, it is important to complete your due diligence as your findings may surprise you. For example, manufacturing firms maintain high success rates in cost reduction from implementing a comprehensive healthcare platform. While HR is accustomed to working with employees first hand, it is commonly assumed that more "blue collar" roles are adverse to adopting new practices, especially when it comes to healthcare and technology. However, this population is highly price sensitive and looks for outside guidance during the decision making process. Speak to a few of your employees (try to find a cross section of individuals that represent your population) and ask them about their healthcare habits. Do they look for other's opinions when buying healthcare? Do they price shop for medication? Who manages the healthcare expenses in their household? Make sure to be clear that this is regarding healthcare and not health practices (whether or not they workout or not is a very separate conversation). Try to put together a list of what they want out of their healthcare experiences, and if they prioritize cost reduction, quality or convenience. You can also ask your employees if they know things like your deductible and how far into their deductible they are. If they are able to provide a very detailed answer, you know that they are probably doing their homework. Don't be surprised if you get some questions like "what's a deductible?".
Look at your current benefits package - The first step to assessing your actual health plan is to grab your SPD (summary plan description) and see exactly what the fine print says. You want to pull out the details and see what the terms of your plan are. From here you can see exactly how conducive it is to your population.
Things to find:
Once you've found this information, you can start to dig deeper to begin assessing your actual needs. You can see how your company stacks up in relation to other companies to see exactly where your popultion needs the most work.
If you want to develop a budget, check out our pre-built budget spreadsheet. This should give you an understanding of how much money you'll need to spend, and...
Before considering a platform, you have to understand what kind of functionality you need. Based off the information listed above (particularly "Assessing Your Goals") of your goals and how to meet them. Below is a list of functional items that are most commonly found in benefits and engagement software services. It's important to note that you are going to run into a variety of services that will run the gamut of pricing. And because healthcare programs are often developed with a specific buyer (or network, or insurance provider) in mind, pricing might not be consistent. This means that two programs with similar functionality might have very different price points, due to the customer base and requirements within their market. Therefore, it's important that you understand what your population requires to be successful.
To assist your search, here are some of the most important elements that are contained in a common platform, and a description of how the features can help, and who they are most helpful for:
With these items considered, make a list of 3 categories including: “Must Haves”, “Desired” and “Not Important”. You’ll find that this will help you maintain perspective when looking at options. Without prioritization of goals, you may end up spending 2 to 3 times the necessary amount because of unnecessary services. As a product differentiator, firms will add unproven features that don’t add value to your bottom line.
One of the biggest perceived road blocks: will people actually use the program? The short answer is that there are multiple factors involved in getting people to change their behavior when it comes to healthcare. Although this is true with any sort of corporate behavior change initiative, healthcare is especially susceptible because of 2 things:
There are a few methods for ensuring that you can get people to use it, and it's mostly rooted in behavioral change and engagement theories. When we look at the foundations of managing change, we can look at some of the earliest models, chiefly, Kurt Lewin's model of change management (academic explanation, layman's explanation) to understand the implementation of lasting change.
In short, the process consists of 3 phases
It’s clear that there are 3 core behavioral stages that an individual will go through. While every platform or company will not base their strategies off the same exact theories, you can use this model as an outline to assess the credibility of their program. Are they engaging the employees at the beginning and making them aware of the program and why it’s there? Are they giving company leadership the tools that they need to implement the platform? It’s not your job to know how to promote a program. You need to let them do the research and tell you exactly how to work it into your corporate culture.
To ensure successful implementation, the platform needs to pay special attention to “unfreezing behavior” and “introducing change”. This means that HR should have access to training or implementation steps for a period of time. This might come in the form of a helpline, a series of videos or even guides (preferably a combination or a multi-media mix). Revisiting Kurt Lewin’s model of change management from the last section, we know that employees are going to need support and reassurance to break their current pattern of behavior.
One of the most challenging and important questions to answer is about pricing. You already know that a lot of time and money is spent (often ineffectively) on your healthcare platform. It makes sense to put in mechanisms to control the costs, but it isn’t always clear if you’re going to see any measurable or financial value. That isn’t to say that a product is only as good as its ROI, but to say that it isn’t an important factor is simply untrue.
While you can’t measure every facet or benefit of improving employee’s healthcare, you can track some items that can give you insight into their spending habits, and if they’re changing or not.
Before committing to an investment, you should have a general idea of how long it’s going to be until your investment pays off. Most firms find that despite being significantly smaller than their health insurance costs, any additional expense can be quite painful. However, as the adage goes “you have to spend money to make money” and the same holds true for healthcare platforms.
Your time to return on your investment is highly varied, due to several factors:
The ever-important question: How can you justify this cost? You’ll have to make sure that there are enough trackable and deliverable results to satisfy your requirements. Your real savings will come in the form of things that can’t be tracked, but you should justify the cost by using the things that you can track.
Looking at the examples above (items that can be tracked), consider basing your decision off possible corporate healthcare initiatives. For example, you can establish benchmarks based on the amount of people that stay below their deductible or use convenience care (like a minute clinic or telehealth). These are both serious cost saving mechanisms and will directly impact your bottom line.
It’s important to note that the non-events mentioned above are some of the most serious cost saving situations. But you won’t know about every time that a person chooses to get a second opinion and avoids a costly surgery or procedure. Because of this, you must ensure that a) you’re comfortable with the trackable results, and b) that you’re happy with the approach to pursuing the non-trackable costs.
Before doing a deep dive with any one platform you want to know if it’s a good fit for your company and if your employees are going to use it. While there’s no short answer to that question, you can do some legwork to make sure that you’re making a seriously educated decision.
Consider the platform’s past experiences with firms of similar industries. While healthcare is a universal challenge for companies of all types, there are unique idiosyncrasies for each industry. Take, for example, a manufacturing firm. Most employees won’t have computer access around the clock. They may rely more heavily on print materials and in-person recommendations for selecting a doctor. In contrast, a technology firm will likely be more research-focused and less likely to share information about their care with coworkers.
This isn’t necessarily a straight forward question. Each platform is going to have a slight learning curve, but you want to make sure that largescale adoption won’t be too challenging.
The number one concern that you should have in this category is the audience that the product was created for and making sure that it matches up with your population. If the platform was designed to be used by large corporations or by a small team of healthcare professionals, they clearly have a different audience in mind. Furthermore, some of these products may be targeting the patients of provider networks. This is also a distinctly different population that won’t necessarily translate to your needs. While these kinds of platforms can be adopted, it doesn’t mean that it's going to be the best fit for a small to midsize firm with a corporate health plan.
If we look back at section 2 (the part about embracing the platform), we can understand that there are serious challenges to getting people to change their behavior when it comes to healthcare. Even though we’re the most informed consumers that the world has ever seen (we google almost everything), our knowledge of navigating the healthcare world is shockingly low. Simply put, people aren’t used to making informed healthcare decisions, and the biggest step here is getting people to change that behavior.
Things to look out for:
What doses utilization look like? You want people to use it, but you need people to use it effectively. It would be great if every employee learned everything about the healthcare system, but that’s not going to happen. And even if it did, would it really help? Your initiatives in getting people to use the platform should be focused around a few critical times, such as prior to going to the doctor or purchasing a medication. Those are the times that (if they use it) you’ll see massive savings. However, it’s tough to see savings from utilization during non-critical points, like logging on to preemptively read about seeing the doctor. However, you will want to see regular logins to maintain awareness.
If you don’t read a most of this article, read this. While there are a multitude of healthcare platforms available in every area, the most common way that they differ is in their ongoing support, and in their approach to utilization. While you should find a style of support that suits your needs, you must be cognisant of the fact that there are up sides and downsides to every approach. Let’s take a closer look.
Healthcare is a challenging field, and there are a lot of moving parts to tackle. We’ve outlined a few of our key points that you can look at, and a checklist that you can use to ask questions during your demo. This list is not comprehensive but can get you well on your way to properly assessing a platform.
Jeremy is the VP of Operations at Trig. He specializes in behavior change in healthcare and the way that companies engage their people.
Jeremy Vang Trig