Skip to main content

Analysis

Advocacy Programs of Increasing Interest to Insurers and Employers

By Gregory A. Freeman  
   March 28, 2018

Consumers may spend more and get lower-quality care when trying to navigate the healthcare system on their own. Everyone may benefit when insurers guide them.

Consumers are no match for a healthcare system that can seem complex, inefficient, and expensive, and the employers offering their health insurance often are the ones who pay the price in higher premiums and medical expenses. Some are seeing the benefit in health plans that offer more handholding to guide consumers through the experience.

Concierge-type services have been offered for years, but they often were seen as a perk for top-tier clients, a way to help the lucky few avoid the hassle that the typical consumer experiences in the healthcare system. The outlook is changing now that employers are seeing the potential for better care and reduced costs by offering personalized assistance to the rank and file worker.

Insurers and employers are recognizing the value of providing a consumer advocate who can work directly with a consumer, supported by a team of multidisciplinary professionals, says Tom Meier, vice president of market solutions at Health Care Service Corporation (HCSC), a consumer-owned health insurer in the United States and a licensee of Blue Cross Blue Shield, serving nearly 15 million members.

The increased interest comes partly from the realization that the higher deductibles currently in use don't make consumers more thoughtful and engaged in using healthcare resources wisely, as many employers hoped, according to a recent healthcare industry survey. Instead, they just make them avoid healthcare altogether, including preventive healthcare.

Better utilization, lower costs

Some health plans are developing health advocacy programs, and there are companies such as Accolade that offer services to both employers and health plans. Accolade promises employers savings of up to 15% and says health plans can improve utilization and the member experience while reducing medical claims spend.

HCSC is addressing those goals with a program called Health Advocacy Solutions for large employer customers. It's a personal concierge program to address healthcare issues, answer questions, and encourage members to become advocates for their own health, Meier says. The program launched in January 2018 after a yearlong pilot program with a large client.

Six large employers have adopted the health advocacy solutions program and several more are considering it for the 2019 benefit year. The goal is to improve care and the customer experience, Meier says.

"But it's more than excelling at customer service. It's about moving away from focusing only on resolving customer problems and more toward becoming true advocates for our members, helping them navigate an incredibly complex healthcare landscape in ways that ultimately are going to deliver a substantially improved member experience," he says.

Gregory A. Freeman is a contributing writer for HealthLeaders.


Get the latest on healthcare leadership in your inbox.