Reward or punishment - which approach is more motivating? The debate might be relevant to child rearing, but when it comes to incentivizing your employees to be better healthcare decision makers, the answer is neither. Because the problem really isn't your employees. It's the system - a system that wasn't designed around care for the consumer, but instead for the operational needs of plans and providers, creating a complex, fragmented web of disconnected systems and processes.
In fact, according to NBGH, 90% of employers using incentives to motivate employees to participate in health and well-being programs are reevaluating this approach due to lack of traction in changing employee behavior.
If incentives aren't the answer, what is? For employers willing to think outside of the box, it's filling in critical gaps that providers and plans are not well positioned to address on their own. Here are four critical gaps in traditional healthcare approaches that high-touch, high-tech healthcare advocacy can fill:
1. Early and ongoing engagement with the entire population and over time.
To foster the efficient use of healthcare resources by your employees, it's critical to engage them early and often. This means interacting with the entire eligible population, not just those already in the healthcare system or the sickest 5%. When you stay with people over time, coaching and guiding them throughout the lifecycle of care to influence decisions and behavior, you can help people stay healthy or get on the optimal path to a healthier life.
2. Personalized healthcare support based on a 360-degree profile.
Providing the right care at the right time for a person starts with a complete 360-degree profile of the individual. It's a profile not limited to the structured, clinical data found in an electronic health record or personal health record, but instead one that includes a much broader set of personal information and health data -- medical and Rx claims, labs and biometrics results, risk scoring, utilization data, digital health point solution data and, critically, notes from every personal interaction with the individual. Interactions are an opportunity to uncover a wide range of contextual information that is relevant to a person's health, well-being and healthcare journey. Seek a healthcare advocacy partner that has the ability to bring in all of this data and information to create a “whole-person” profile and then use that data as a powerful decision support system in support of personalized healthcare.
3. Whole-person care that can make the difference between effective and ineffective care.
Trained to diagnose a condition in eight minutes, physicians take contextual issues - like workplace pressures, financial challenges or behavioral health issues -- into account less than 60% of the time, sometimes leading to failure to order tests or treatments considered essential for managing complex conditions and ineffective care. To improve health and financial outcomes, it's vital to understand a person's full medical, behavioral, and emotional needs, and the unique life circumstances or social determinants of health that impact healthcare decision-making and well-being. When healthcare advocates are trained to uncover these factors and provide support for the “whole person,” they can help ensure people get the support that meets their specific needs within the context of their life.
4. Unbiased, evidence-based guidance to help people get the right care at the right time.
With the consolidation of the healthcare industry, more and more physicians are feeling pressure to meet corporate financial goals at odds with what's best for patients. According to the U.S. Government Accountability Office, referrals for biopsies among self-referring physicians increased more than 100% between 2004 and 2010. By contrast, independent healthcare advocacy can provide completely unbiased, evidence-based guidance to determine unmet care needs, develop care plans, coordinate care and advocate for services. Offering unbiased guidance when a person needs it builds trust and the ability to influence consumer behavior.
Your employees want to make good healthcare decisions. They just need help to do it. High-touch, high-tech healthcare advocacy can get them there, resulting in a better healthcare experience for them and improved financial outcomes for everyone.
For more information about how it works, read The Case for Advocacy in Your 2018 Health Plan.