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Healthcare in the U.S. remains a complex and costly item for all companies. From shifting regulations, to cumbersome enrollment requirements, and sometimes ambiguous claims process, organizations of all sizes struggle with how to get the most out of their coverage.

Rising healthcare costs for both employers and employees further drives the need to extract more value when it comes to selecting health insurance. According to a recent Kaiser Family Foundation employee health benefits survey, the annual cost of family health coverage in the U.S. for employers hit the $20,000 mark for the first time. However, costs are not rising for employers alone. The average employee contributes a little over $6,000 toward the family cost of coverage, another record for employee contributions.

For many employers and employees, the prospect of spending more while receiving less coverage has become a painful tradeoff. This cost increase, coupled with a recent Gallup survey stating a record 25% of Americans delayed medical care for a serious ailment in the past year due to cost, is not just impacting balance sheets, it is putting many lives at risk.

The healthcare market is not poised to resolve these issues in the near term. Given this new operating reality, it is imperative for employers to leverage all available resources that can assist employees with their healthcare management and facilitate claims payments. One such resource, which is often underutilized, is a patient advocate service.

Health Advocacy Services Helps Both Employers and Employees

Healthcare advocate services provide trained professionals who can ask questions, write down information, and speak up for covered employees so they can better understand medical issues, navigate claims filings, and help interpret insurance policy coverage. They augment the work of your insurance broker and HR team, to ensure employees receive needed care and best outcomes when working with insurance companies.

Risk Cooperative recommends employers utilize a hired professional health advocate to act in a third-party capacity to assist employees with healthcare needs.  Not only does this protect the privacy of workers and adhere to Health Insurance Portability and Accountability Act (HIPAA) regulation laws regarding health inquiries, it also does the following:

A health advocacy service allows the employer to remove itself from the daily tasks of issue resolution with health insurers and hospitals such as claims processing, appeals, billing discrepancies, provider research, etc. This employee benefit saves employers time, while empowering employees to manage their own care, benefitting all members and their families – whether they are experiencing complex/chronic care issues or commonplace coverage questions.

Health advocates provide concierge-style services including health and benefit education. These services are often available by phone, mobile app and website, offering employees the flexibility to address issues in real time. Tech-savvy employees have the option to use technology to get their questions answered, while also catering to employees who prefer traditional methods of communication.

Advocacy services help promote enhanced wellness and Employee Assistance Program (EAP) services. Increased wellness engagement by employees has significant impact on company culture and productivity – not to mention a reduction in healthcare related costs. That’s a win-win for members and employers.

Licensed and trained health and benefit experts ensures all operations remain in compliance. By providing health advocacy resources, employers reduce their risk from data and personal privacy exposures.

The cost for this employee benefit is minimal, typically $1.25 per month per employee, and research has found that an increasing number of companies are incorporating health advocate partners to facilitate employee well-being, care services, and benefits support.

Be an advocate for your employees today!

 


Risk Cooperative helps organizations navigate the complex world of health insurance and employee benefits.  Learn More