The US healthcare system is well-known for its complexity.
And with so many insurance options, providers, and regulations, no wonder employees and their families struggle to navigate their healthcare benefits.
Case and point, according to a Bend Financial survey, 56% of participants feel “completely lost” about their health insurance.
What does this mean to your business?
It means that if employees struggle with benefits, it can lead to increased healthcare costs and dissatisfaction with leadership.
As you probably already know, the pressure caused between the complexity of healthcare vs. rising costs is a developing crisis in the US. And many have tried to come up with various healthcare navigation solutions to combat this.
But here’s the thing…
Not all benefits navigation tools are created equal.
So, how do you know which solution is the best for your company?
In this post, we’ll learn:
And we’ll delve into a game-changing healthcare navigation platform that uses AI to provide ultra-personalized, end-to-end care for each user. It’s called Healthee, and it happens to be our product 😉
Let’s jump in.
Healthcare navigation solutions, often referred to as benefits navigation tools, are specialized resources designed to simplify the complexities of the US healthcare system.
These tools guide employees and their beneficiaries to ensure they make informed and cost-effective decisions.
These tools are designed to:
Benefits navigation tools offer employees personalized assistance in understanding their healthcare options. They help individuals navigate insurance plans, identify in-network providers, and make informed decisions.
Benefits navigation tools provide clarity on healthcare costs. Employees can compare prices, estimate out-of-pocket expenses, and make financially sound choices when seeking medical care.
Benefits navigation tools can connect employees with healthcare experts, such as benefits advisors or licensed clinicians. These healthcare providers answer your employees’ questions, offer guidance, and provide support throughout the healthcare journey.
Health benefits navigation tools are vital for every business because they empower your workforce to maximize their healthcare benefits.
Now that you know what these navigation tools are…
What do they bring to the table?
Choosing the right healthcare navigation solution will allow you to enjoy the following perks:
Cost control is arguably the biggest reason companies implement navigation tools for their employees.
These navigation solutions help employees make informed choices regarding their healthcare. It allows them to:
All of which reduce long-term healthcare costs for both the company and the employees.
This is done through the price transparency features of apps like Healthee.
These tools provide clarity on healthcare costs, enabling employees to seek in-network providers, compare prices, know the out-of-pocket expenses, and make financially sound decisions.
Imagine how much time your HR team could save as a health navigation solution such as Healthee handles employee communication, resulting in streamlined administrative processes and simplified benefits-related tasks, thereby freeing your team to focus on more significant challenges.
Meaning, your HR staff will be able to devote their time to more strategic initiatives and focus on the things that will make the most significant impact.
The complexity of the healthcare system can leave a bad taste in employees’ mouths.
However, a healthcare navigation solution like Healthee can simplify the process through quick, personalized responses. This not only minimizes frustration and confusion but can also potentially help maximize health outcomes.
Not only that, but when employees feel supported and informed, their satisfaction and engagement with your leadership and culture skyrocket.
Robust health benefits navigation services will not only help you retain your top talent. They can also make your company more enticing for jobseekers.
That’s because potential hires are more likely to choose an employer offering clear and accessible healthcare resources. And that means strengthening the company’s ability to attract top talent.
When considering benefits navigation solutions, it’s best to be aware of the various options at your disposal.
The four types of healthcare navigation solutions are:
Let’s dig deeper into each type.
Traditional methods of healthcare navigation involve human or in-person assistance in navigating healthcare benefits.
These methods have been relied upon for years and provide a personal touch to guide individuals through the complexities of healthcare.
Here are a few examples of traditional solutions:
Traditional methods are suitable for individuals and employees who prefer direct human interaction and guidance when navigating healthcare benefits.
In other words, they can work well for those who value personal support and assistance in understanding and managing their healthcare options.
Additionally, this category is particularly beneficial for employees who require hands-on guidance, personalized advice, and a deeper level of engagement with their healthcare benefits.
However, the flip side is that traditional solutions are the most time-intensive and are subject to human errors.
Technological solutions leverage digital tools and platforms to simplify the process of understanding and managing healthcare benefits.
Some examples of technological solutions include
Additionally, it’s worth noting that there are options available that include the benefits of more than one of the above. For example, Healthee is an AI-driven benefits platform that employers provide as an employee benefits portal. Also, Healthee even performs all of the benefit calculations for users.
Technological solutions are suitable for users who prefer self-service, convenience, and digital access when managing healthcare benefits.
Additionally, these tools are particularly beneficial for companies and tech-savvy individuals who value the flexibility of accessing their benefits and healthcare information online at their convenience.
Hybrid methods combine the advantages of technology with human expertise to offer a comprehensive approach to healthcare benefits navigation.
These solutions provide the convenience of digital tools while ensuring access to human support when necessary.
Here are a couple of examples of hybrid model navigation solutions:
Hybrid methods are suitable for individuals who value the convenience and accessibility of technology but may also require personalized assistance in specific aspects of healthcare benefits.
As a result, employees can enjoy a balanced approach between the efficiency of technology and the assurance of a human touch.
Specialized navigation instruments are tailored to meet the unique healthcare needs of specific groups, providing targeted support and information for individuals facing distinctive healthcare challenges.
Real-life specialized navigation methods include:
A pediatric health benefits navigator helps parents and caregivers navigate health benefits for children. It does so by providing information on pediatric healthcare services, preventive care schedules, and ways to maximize benefits for their children, including coverage for check-ups, vaccinations, and child-specific treatments. Examples of this are the eHealthInsurance website and Every Child Pediatrics’ “Care Navigators” : eHealthInsurance website helps families find child-only health plans. There, users can filter the results by setting the primary member as the child and exploring plans tailored to their medical requirements. Finally, Every Child Pediatrics offers trained professionals to assist families in obtaining health insurance.
The Veteran’s health-benefits portal is tailored to the unique needs of veterans, including those covered by the Veterans Health Administration (VA). It does so by offering comprehensive information on VA health benefits, including eligibility criteria, services available, and assistance in coordinating primary care between VA benefits and private health insurance when applicable.
The Senior Health Benefits Aggregator is designed for seniors, especially those eligible for Medicare. It provides information on Medicare health plans, supplemental insurance options, prescription drug coverage, senior wellness programs, and retirement-related healthcare options. For example, Australian company Brevity has a feature specifically designed to help Aged Care Providers serve their HCP and CHSP clients effectively.
Disease-specific platforms are focused on assisting patients with specific disorders (for example, diabetes or mental health). As such, they can help users navigate through therapies, providers, and insurance alternatives that are targeted to their individual needs. For example, The American Diabetes Association offers resources to help people with diabetes navigate their insurance choices, understand their options, and learn how to obtain prior authorizations and file exceptions and appeals. Additionally, they even offer information about resources that may help with medical expenses for Diabetes patients.
Specialized navigation instruments are designed for individuals with specific healthcare needs, such as parents with children, veterans, or senior citizens.
As such, these tools provide targeted support and information to help these groups navigate their unique healthcare benefits more effectively.
There are so many options available in the market today…
So, how do you know which one is a perfect fit for your company?
Factors like:
All can play a vital role in determining the best solution for your organization.
So, let’s take a closer look at these factors and a few other things to consider before selecting a health benefits navigation tool that is right for your company.
The first step is to understand the unique situations, healthcare needs, and preferences of your employees, such as their
This can be done by conducting surveys, meetings, or reviewing your employee database.
As a result, you can find out as much as possible about your employees and their healthcare needs. And doing so helps you tailor the benefits navigation solution to your workforce’s specific needs and preferences.
For instance, if your employee population is predominantly young and tech-savvy, consider prioritizing digital solutions like AI-based navigation apps.
Conversely, if your employees are predominantly not tech-savvy and don’t know how to use online platforms, like apps, it might be worth considering specialized solutions catering to those demographics.
The cost of implementing and maintaining your benefits navigation tool is an important consideration.
Obviously it’s important to look at the cost-effectiveness of each option. In general, while traditional solutions offer a human-to-human connection, they can be costly to scale.
And generally speaking, the bigger the company gets, the more technology-driven navigation tools are more cost-effective because maintaining software is usually cheaper than hiring and training more support teams to cater to benefits-related inquiries.
The effectiveness of your benefits navigation tool depends entirely on your employees’ perception of it.
So, how do you assess if your solution is effective?
Therefore, it’s vital to gather employee feedback. And here are a few ways:
Then, after collecting feedback, you will want to analyze the specific health concerns and medical requirements of your employees.
Likewise, it’s important to be agile in implementing improvements based on employee feedback.
Finally, make sure employees see their suggestions and concerns addressed, which reinforces their belief that their voices matter.
Scalability is one of the biggest considerations when choosing a benefits navigation tool.
That’s why your solution should accommodate changes in your workforce’s evolving needs.
For instance, if your business is growing, ask yourself these questions:
Conversely, if you plan to shrink your workforce, you must still assess how the solution can scale down without unnecessary expenses. In that case a key question would be whether you can quickly and smoothly reduce the number of features or licenses.
Therefore, be prepared to adapt your scalability plan as circumstances change.
Safeguarding sensitive employee information is not just a best practice…
it’s a legal and ethical imperative.
So, here are a few questions to ensure your benefits solution keeps your data safe:
As you know, non-compliance with data privacy laws can have dire consequences like hefty fines, legal actions, and severe damage to your company’s reputation.
So, it is imperative to prioritize compliance with these laws to protect your employees and your organization.
The world of healthcare benefits is complex.
And to make them accessible and user-friendly means having the right solution in place. Otherwise, how will your employees be well-informed and make cost-effective decisions? How will they get the most out of their health benefits? The answer is, they won’t.
But here’s how you can give them a decidedly “Healthee” option.
Healthee’s AI-powered platform offers the benefits of technology and personalized user experience. With real-time answers, efficient open enrollment support, and a proactive approach toward health, Healthee promises a transformative experience for both employers and employees.
Dive into the future of healthcare navigation with Healthee and empower your organization with the best in class. Your employees deserve it.
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