A health advocate may guide a consumer to alternatives to a spinal fusion, for example, that are less invasive, less costly, and that will provide a better quality of life afterward, Meier says. The patient benefits but so does the employer and the health plan.
The health advocacy program requires an investment from both HCSC and the employers choosing this option for their coverage, Meier says. The program is not overlaid on all HCSC plans because the additional expense must be covered by those employers who see the potential benefit, and that is why it appeals mostly to the largest employers.
"We have to look at whether this is something that will fit with their culture and whether the data show us that they're going to get the return that makes this worthwhile for them," Meier says. "If it looks right for them, we'll talk to them about switching over from one of our less intensive models to a solution like this health advocacy model. In those cases, we think there is a substantial yield to be had in managing their healthcare costs and in transforming their employees from passive to active participants in their care."
Gregory A. Freeman is a contributing writer for HealthLeaders.