How Your Workforce Can Drive Down Healthcare Costs

How Your Workforce Can Drive Down Healthcare Costs

Have you ever noticed that buying healthcare is unlike buying anything else in the U.S.? It’s an entirely different experience from going to the shopping mall or the car dealership. In many ways, it’s the absolute opposite experience from what we expect as consumers of nearly every other service. When shopping for common medical treatment like a CT scan, it can be almost impossible to find basic information like the price and quality of different providers. As consumers, we’ve collectively lowered our standards of what to expect when it comes to shopping for medical care. This phenomenon can largely be explained through a concept known as moral hazard. We’ll take a closer look at what healthcare’s moral hazard issue is, what it means for healthcare, and how we can drive down healthcare costs.

What is Moral Hazard?

Going shopping is an activity we often associate with wastefulness, buyer’s remorse, or “retail therapy.” Shopping is also full of opportunities to save money through price matching, store-by-store comparisons, and online research. In the world of healthcare, this is what shopping is all about. A shoppable service is a common healthcare procedure that can be researched or “shopped” in advance and is offered by multiple providers. These services include things like MRIs and colonoscopies, and often have price and quality data available. Simply taking the time to “shop around” for the best place to receive treatment can yield huge savings, because the prices and quality of these services vary widely between providers. Sadly, we don’t shop around nearly enough as consumers of healthcare, due to a phenomenon that economists call moral hazard.

Moral hazard is a behavior that consumers display when insurance covers them. They tend to take more risks and become less careful about spending decisions, merely because they know that someone else will foot the bill if any mishap does arise. In other words, we care less when we know we’re not paying.

In healthcare, this behavior is visible every time we walk into the doctor’s office. Since it’s implied that we are not responsible for a large chunk of the bill, we tend to pay less attention to how much medical services cost. We don’t usually pry or look closely at the pricing details before receiving care, partly because that information is hard to come by, but also because we’ve come to rely on insurance to keep us off the hook for the full cost of our care.

In a similar vein, we may not be picky as we should be in choosing how much care to receive. Instead of sticking solely to the treatments we need, we seek unnecessary care when we know insurance covers it. This incentive to order too much care is the very reason deductibles were created; they impose an amount that patients must pay towards their care out-of-pocket before insurance coverage begins. Consumers aren’t the biggest issue, though—healthcare providers today have become notorious for overtreatment and providing unnecessary care. Doctors tend to order unnecessary procedures because they face profit motives and for legal protection against lawsuits. After all, they have the expertise and informational advantage, so who are we to question their decisions?

The Consequences of Moral Hazard

What does moral hazard mean for healthcare costs? For one, it means we regularly overpay for services that are available at a much lower price. Doctors and hospitals that provide the same treatments at lower costs while maintaining quality are out there, but people don’t know how to find them. When every individual across an entire nation fails to check their options for medical treatment and overpays, it quickly adds up. In fact, the Health Care Cost Institute finds that nearly half of the $524.2 billion spent on health care by individuals with employer-sponsored insurance is shoppable. This means that merely helping people make better decisions in their healthcare spending can substantially cut down on the bill. Smart shoppers save a great deal of money over a lifetime, and this fact rings especially true in the healthcare market.

Cost containment isn’t the only thing we’re missing out on because of moral hazard. As consumers, usually, we demand high-quality, all-around fantastic customer service. If a store or restaurant doesn’t deliver this, we take our business elsewhere. We know our options, and we reward the companies that meet our demands.

In healthcare, on the other hand, it seems we have settled for a system that provides a subpar customer experience. Hours on hold, unreadable and incorrect bills and confusing insurance policies are things that would not fly in any other industry. If more people were willing to make informed shopping decisions in healthcare as they do for everything else, the confusion would vanish quickly. Customers would demand clarity around prices as well as an immediate end to thick booklets that health insurance companies send out.

All this is to say that a solution to unreasonably high healthcare costs is to listen to the age-old rule that the customer is always right. We need to bring consumerism back to healthcare; only then will there be pressure for the market to act in the way it should—with more reasonable prices, a high priority for customer satisfaction, and better care outcomes.

How to Become a Consumer of Healthcare

With plenty of political backfire by both parties against even the smallest health care reform, it can be hard to imagine how we’ll ever bring about the type of change that is needed. Luckily, third-party innovators are opening the horizon of possibility for improving our healthcare system.

Take healthcare navigation platforms – these are powerful tools for finding the best price and quality for any given procedure. To do so, they perform research and shop for the best provider possible using reputable sources that most people don’t realize exist. On top of saving you hours of online browsing and pinpointing the provider who gives you the best value for your dollar, a healthcare guidance platform might even save you a trip to the doctor’s office altogether. Using tools like telemedicine, you can resolve many health issues by merely consulting an online medical provider.

The idea that someone else is covering most of your healthcare bill is a myth. We need to realize how much we truly spend to fund this system over our lifetimes, and that rising costs are not resulting in better care. Patients can only make smart decisions and drive the market towards cost-effectiveness if they can navigate the system and tell right from wrong and left from right. They need advocates to guide them through the tricky terrain of using healthcare. In short, the secret to eliminating moral hazard and empowering employees to drive down healthcare costs is to lead them to the right spending decisions in the easiest, most enjoyable way possible.

 

How Artificial Intelligence Is Changing Healthcare Guidance

How Artificial Intelligence Is Changing Healthcare Guidance

It’s no secret that artificial intelligence is reshaping the way we think about healthcare and reducing unnecessary waste from all corners of the industry. There are endless possibilities for AI to improve healthcare, from quickly processing large patient data sets through machine learning to Google’s AR microscope detecting a cancer cell that would otherwise go unseen by the human eye. Perhaps a more unexpected application of AI is found in healthcare guidance platforms– a tool created to help employees navigate their health benefits.

When you add AI to the equation of employee benefits, healthcare guidance goes from a passive service that just “exists” to active engagement that proactively reaches out to patients. Comparing the two systems side-by-side reveals just how powerful AI can be in a healthcare guidance setting.

Before AI: Phone Systems

Traditional healthcare guidance platforms offer a phone-based service that subscribers rarely utilize. Many phone-based advocacy programs and nurse lines claim to lower costs by giving employees a hotline to call whenever they have a medical issue, but this reactive approach is futile because few people remember the service exists. HR may briefly mention the service during the yearly benefits meeting, but it is soon forgotten. In order to achieve industry-leading cost containment in modern times, a guidance platform must perform consistent outreach and reminders to lead users to smarter healthcare decisions. Sitting back and waiting for users to call will result in close to zero change and a total lack of ROI.

The top reason that many guidance platforms fail to perform outbound engagement is cost. Having workers reaching out to members in real-time is expensive: the average general call center employee costs a minimum of $1 per minute of service, and healthcare-specific call center employees will cost at least double that amount. It’s, therefore, no surprise that traditional healthcare guidance platforms have opted for cheaper phone services with little to no outreach. The services that do offer proactive outreach may do so only for members with especially high utilization rates– the people that spend the top 1-2% on the service– but that’s it.

As public health research has found in recent decades, it is inefficient and costly to treat medical conditions and provide care in a reactionary manner. The current shift towards preventive medicine as a solution for a healthier and more financially stable population has rendered these traditional guidance platforms obsolete. The care they provide is too little, too late.

The Age of AI: Fast and Proactive Healthcare Guidance

Now, the story of healthcare guidance is changing with AI. Newly automated processes enable modern guidance platforms to reach a scale and cost-efficiency beyond anything the industry has ever seen. AI creates two game-changing advantages: faster service and proactive outreach. Our AI-powered virtual assistant JOY is able to handle over 80% of our inbound requests and 95% of our outbound chats. This frees up our healthcare concierges to complete higher-level tasks rather than spend time collecting basic information. In addition, AI makes it possible to consistently and inexpensively perform outreach at scale.

AI Lets Humans Focus on Key Tasks

AI-powered technology makes the lives of our healthcare concierges easier by assisting them in the response-writing process. HealthJoy’s “Concierge Care Center,” our custom CRM, is programmed to provide real-time recommendations that enable concierges to craft responses to member inquiries at a much quicker pace. All this saved time then enables them to focus their attention on the tasks that require human judgment, such as researching low-cost, high-quality facilities, answering benefits questions, resolving claims issues, and scheduling appointments for users.

Another situation where AI can dramatically simplify a human task is in eligibility file management. In the benefits world, the administrative burden of paperwork puts a significant drag on any HR system. Eligibility files, which are documents that contain employee personal/contact information necessary to enroll them in a benefit plan, are at the center of this issue. Since enrollment usually needs to be done across several company’s benefit platforms, formatting errors and typos make the process tedious and frustrating. Benefits administrators must spend precious time shuffling through pages and pages of documentation in order to find one typo so that the system will accept the files.

Once again, a winning solution is found through powerful AI technology. Instead of us wasting human capital on cleaning up eligibility files, processes like “fuzzy matching” enable several documents containing tiny discrepancies to be merged. Whereas traditional eligibility file management usually requires that each document contains exactly identical information in order to be joined together, fuzzy matching allows for a more lenient margin of a “close match”. Through this method, countless hours of tedious searching for typos are conserved.

AI is Proactive, not Reactive

Have you ever felt the pressure to constantly be taking initiative in your workplace or personal life? It can be exhausting. Lucky for us, AI cuts our healthcare concierges a break by automating the process of taking initiative in regards to our members’ care. HealthJoy’s virtual assistant is programmed to automatically review historic claims data and perform ongoing outreach where it sees opportunities for someone to be healthier. As long as a company provides access to this data, our AI-powered chatbot sends notices (known as Health Opportunities) to members when discovered. If a member wants to take action on a given Health Opportunity, they can easily chat with a concierge. Thus, we are only expending Concierge time when the member is motivated and ready to move forward.

Our AI assistant also initiates proactive outbound campaigns with members to consistently remind them to take advantage of HealthJoy’s offerings and maintain their health. Whereas traditional employee benefits are typically ignored after open enrollment, our modernized platform is something you’ll constantly want to experience. The system sends friendly notifications, reminding you of all the ways it can help you make the most out of your benefits plan. For example, it will reach out to you about online doctor consultations, provider recommendations, and savings opportunities, all of which are just a few taps away on your smartphone.

New Frontiers: What’s Next for AI in healthcare tech?

Today’s AI-powered healthcare guidance platforms will restore your hope in the healthcare system. No more waiting on hold for hours to fix an issue with your claims, schedule an appointment, or find information on your benefits. You can finally relax now that healthcare concierges and smart outreach systems, whose entire job is to make your healthcare experience simple and quick, have emerged as a solution to our wholly broken system.

What’s next for AI in health tech? At HealthJoy, we are currently using AI to further simplify tasks like digitizing your insurance card with JOY Vision. This program makes the onboarding process easy for new members. Simply taking a photo of an insurance membership ID converts the photo into a virtual card in the benefits wallet. In doing so, this function reduces human error, makes data entry less tedious, and contributes to our goal of making healthcare as easy as possible.

AI ushers in a new era of patient care and employee benefits, one where seeing the doctor doesn’t require scheduling an appointment weeks ahead of time and your benefits are easy to understand at last. Gone are the days when you had to wait on hold for hours before speaking with a human being– now, affordable and accessible care is available at your fingertips. All this goes to say, it’s time for humans to let AI take care of the tedious, time-consuming tasks in healthcare. We need to stop spending time seeking out spelling errors and start spending time seeking out the best providers the medical field has to offer.

Why The Healthcare Experience Is Broken

Why The Healthcare Experience Is Broken

With so much conversation surrounding the broken U.S. healthcare system, we often overlook what this brokenness means for patients themselves. Our patchwork system of insurance carriers, TPAs, employers, brokers, and private doctors and facilities translates into a messy patient experience. Healthcare’s different players don’t communicate or collaborate over a single unified platform, which means patients must struggle to connect the dots between their insurance coverage, choices of doctors, and employee benefits. The result is a healthcare experience that is overwhelming, disunified, and much more complicated than it needs to be.

Diagnosing the Patient Experience

Today’s patient experience is like watching a dysfunctional baseball team play. The players don’t communicate, they are unable to share key information with one another, and each player has different motivations. We, as the audience members, must bear one loss after another and unhappily sit through a game that we can only describe as a poor viewing experience. Breaking apart and investigating each symptom of the broken healthcare experience is the best way to develop an effective treatment.

Symptom 1: Players Don’t Communicate

The key to any winning team is a strong flow of communication between its members. Expectations should be clear, and collaboration must be convenient for the team to achieve outstanding results. Unfortunately, players within the healthcare system utterly lack the ability to communicate with each other.

Siloed communication is one of healthcare’s worst inefficiencies. Doctors, insurance companies, and employers have no easy way to interact on a consistent basis. This means your doctor doesn’t know your insurance plan, prescription formulary, or whether they’re referring you to an in or out-of-network specialist. They’re unsure of a drug’s formulary tier or what the pharmacy you are going to will charge, so sometimes you’re in for a shock when it comes time to pick up a prescription. The average doctor visit is only 15.7 minutes long, so don’t expect them to be able to figure it out either.

When doctors and hospitals don’t communicate with payers (employers, TPAs, and insurance carriers), it’s almost a guarantee that the healthcare experience will be inefficient and overpriced. The communication dilemma can be solved simply by providing a space where healthcare players can congregate, much like a team dugout where teammates gather. From achieving faster treatment approval from insurers to eliminating wasteful duplicate testing, a mode of communication between healthcare players would drastically improve the patient experience. No one is at the center of the typical healthcare experience and helps the member.

Symptom 2: Players Don’t Share Data

While weak communication is one issue, a lack of data-sharing between healthcare players is a whole other beast. There’s no shortage of data in healthcare: doctors, insurers, hospitals, and third-party administrators all have huge repositories of data. What is lacking is the flow of data between these players. Instead of having free-flowing information across the various systems involved in care, we are stuck with information silos that make it hard to leverage the data in a useful way. On a macro level, patient data can allow researchers to identify important indicators like health trends and patient care best practices.

From the level of individual patients, a lack of integrated data systems makes it hard to be a consumer of healthcare services. When visiting the doctor’s office, patients don’t remember basic information like whether they have reached their deductible, what their past claims have looked like, and how much their insurance will cover for a given treatment. If this is the case, how can we expect them to be able to choose appropriate care? Patients need access to their health data wherever they are and whenever they need it to make fully-informed decisions. This information also needs to be presented in an easy to understand manner, but even if this happens patients either need a lot of education or on-demand guidance.

When put to good use, the possibilities for data to improve the patient experience are endless. Data that is properly harnessed can drastically lower healthcare costs, from recommendations on prescriptions to rerouting care to less expensive facilities. Opportunities for care based on industry best practices after analysis of data is an occasion to help patients become not only healthier but lower costs.

Right now, most patients enjoy little to no personalized or digital access to their data. Instead, they receive cryptic postal mailings or access to web portals that are more troublesome than helpful. The difficulties of finding and accessing one’s data are one of the worst parts of a patient’s experience and may lead people to feel as though the system is working against them. While industries like online shopping, social media, and entertainment are all racing to provide consumers with highly personalized experiences, healthcare services are not evolving nearly fast enough. While the digitization of our lifestyles is becoming the norm, many traditional institutions within healthcare push back on this inevitable change. This leads us to the 3rd symptom of our broken patient experience– conflicts of interest.

Symptom 3: Players Have Different Incentives

The traditional model of healthcare, which is usually described as “fee-for-service,” motivates providers to treat the largest number of patients in the shortest amount of time. Naturally, this approach leads to overtreatment, substandard quality of care, and overall low patient satisfaction. Thankfully, the old payment model of “more is better” is slowly being replaced by value-based models of care, such as accountable care organizations, which give providers monetary incentives to provide quality over quantity.

While incentives are being shifted for the better, many players in healthcare are still holding on to the traditional system because they fear what innovation will mean for them. Doctors may want to provide high-quality care, but fear what will happen if demand for their services goes down. To be lifted by the shifting tides of digitization, doctors must also embrace popular telemedicine opportunities that enable them to see more patients without the wasteful amount of paperwork and appointment scheduling. Insurers and third-party administrators may fear the consequences of their data becoming more transparent, but they should keep in mind all the ways that analytics and artificial intelligence can make their jobs easier and give them more time to focus on critical tasks. Ultimately, fixing the patient experience doesn’t mean patients win, and others lose. Rather, a more efficient system that harnesses modern technology will result in a better experience for all players.

How to Own the Employee Healthcare Experience

After diagnosing the patient experience, we can see that it is in a critical condition. The individual today is a ping pong ball in an ecosystem of different incentives and siloed datasets of the broker, employer, carrier, and the provider.

It’s time we redesign healthcare experience to cater to the patient’s experience, rather than to the insurers who hold the purse strings, or doctors who possess the medical expertise. Just as every successful company puts the customer experience first, healthcare must also adopt a patient-centered approach. After all, the entire reason the industry exists is to improve the patient’s health and well-being. The best part about improving the system, however, is that everyone who’s part of the system will benefit. We are embarking on the “Age of the Patient,” and healthcare players must decide on whether they will adapt or go the way of the dinosaur.

Why Office Workers Need Healthcare Guidance

Why Office Workers Need Healthcare Guidance

Modern work environments with schedules that require over a 40 hour work week can make it challenging to plan doctor’s appointments during the workday. Sometimes even figuring out which doctor to see can take a few hours of research. A trip to the doctor’s office requires at least a half-day off of work. While employees might enjoy having a break from the office, employers may not be as excited to lose valuable hours of labor productivity from their salaried workers. Luckily, healthcare guidance helps both workers meet their healthcare needs, and employers keep their business running.

Healthcare guidance tools in addition to telemedicine deliver healthcare access to workers where they are so that getting medical help no longer has to be a huge ordeal. For white-collar employees and their employers, this is a complete game changer. These tools are boosting workplace efficiency, increasing employee satisfaction, and are completely changing our primitive notions of the benefits experience. Here are the key reasons that office workers especially benefit from a healthcare guidance platform:

Healthcare guidance brings healthcare to employees

Imagine that you have a senior programmer that you pay $120,00 a year has three kids that need to be taken to a doctor a few times a year. You want their kids to receive the best care possible, but you know that each time they need to go to the doctor, they will be out of the office for half of the day. The productivity loss starts to add up over time, and that’s not counting the time it takes to manage other parts of their healthcare.

Now, picture that 60-70% of your programmer’s healthcare needs could be resolved through his iPhone using online doctors and Healthcare Concierges. Instead of leaving his desk to be in the doctor’s office physically, they can quickly ask a question regarding a health condition or procedure to an online doctor that is available anytime. Logistically, this opens up the employee’s schedule to not only miss fewer working hours but miss fewer hours spent on leisure activities at home. Concierges can also save them time by researching facilities, doctors, making appointments and much more.

In simple numbers, providing a healthcare guidance platform only costs about what a catered lunch costs once a month, as compared to the loss of half a day or more, several times a year. The logic is clear: logistics matter for white-collar workers. Healthcare guidance hugely simplifies how care is accessed, meaning employees don’t have to waste company time to stay healthy.

Healthcare guidance platforms are a luxury perk

If anything, employees appreciate when their employer looks out for them and truly cares about them as people. One way a company can express this is through providing employee perks that workers value deeply. The leading healthcare guidance platforms, by nature, are simple, elegant, and gives workers the ultimate luxury – time. The win-win they offer is providing a positive ROI for employers while making employees feel cared for and treated well by their company.

Not only does a perk make current employees feel valued and cared for by their company, but it also plays a critical role in recruiting and retaining new talent. In a competitive job market, a quality employee benefit can be the differentiating factor that helps a company stand out against their competitors. In the war for talent, employees (especially millennials) are even willing to accept a lower salary in exchange for a robust benefits offering. A 2015 Glassdoor survey reports that 79% of employees prefer new or additional benefits over a pay raise. Healthcare guidance platforms hit on a key concern for most white-collar workers: the affordability and accessibility of their health insurance coverage. If you can offer an app that is both a delightful user experience and a solution to difficult benefits questions, there is no question that it’ll give your firm a competitive edge in attracting the best talent.

Having an advanced benefits offering will keep employees coming back for more. When employees first open their healthcare guidance app and see that it is just as modern and sophisticated as their most-used social media apps, they will enjoy, rather than dread, navigating their health insurance and the healthcare system as a whole. This ensures high employee engagement within the platform and a high ROI. The favorable behaviors the employees will display upon using a healthcare guidance platform, such as choosing more cost-effective physicians and replacing costly in-person doctor’s visits with online telemedicine consults, will have greater impact when these behaviors are self-driven, shared with others, and repeated by employees. All this is achieved through a benefits guidance platform that workers will be amazed to discover after years of dealing with outdated health systems and old-school online portals.

Healthcare guidance allow for employees to be fully engaged at work

Health is a basic need and therefore supersedes work and career in a person’s list of priorities. If a worker has some unresolved health concern regularly on their minds, chances are they are unable to bring their full self to the office. The hassles of scheduling appointments, having the right documentation, and understanding what is covered by insurance can act as a significant mental drain for any employee.

When a healthcare guidance platform enters the picture, it simplifies everything. A healthcare concierge will take care of various administrative tasks such as choosing a high-quality in-network doctor, scheduling appointments and verifying insurance coverage. When workers are left to navigate the healthcare system on their own and complete all these time-sucking tasks that require sitting on the phone for minutes to hours, it can truly detract from their workplace responsibilities. Healthcare guidance will free up workers’ mental space by providing healthcare experts and leveraging AI to make the process streamlined and more efficient than ever. Low-hassle and convenience are true assets for a white-collar worker who has enough paperwork on their hands, to begin with.

Knowing that their health coverage is safely in the hands of experts and high-tech automation will minimize the distraction that workers would otherwise face in managing their medical care alone. Also, since the process of accessing a board-certified doctor is much easier through telemedicine, a health issue that once might have kept an employee’s attention for months before their doctor’s visit can be resolved within minutes.

Countless HR experts also cite the power of great employee perks to boost morale and motivation in the workplace. Not only does a robust benefits offering like a healthcare guidance platform simplify employees’ lives and make them more productive at work, it simply provides them with a source of positive energy and happiness. As a tool that works on top of and in sync with of their healthcare insurance, healthcare guidance platforms will bring your company’s coveted benefit package to the next level.

Healthcare benefits are a perk that all employees, regardless of status or background, cherish and depend on. In fact, having better health, dental, and vision insurance consistently tops the list of the most valued employee benefits. The reason is simple: we’re all human and susceptible to health ailments, and the cost of healthcare in the US threatens to bankrupt even the most financially stable family. Now, healthcare guidance platforms and telemedicine are defining the modern-day benefits experience as a low-hassle, convenient, and even enjoyable process. These tools are a channel for the quality and cost-effective care that employees yearn for, as well as the productive and competitive advantages that employers seek. What more of a win-win could you ask for?

How To Select The Right Telemedicine Company

How To Select The Right Telemedicine Company

Cost-effective online doctor consultations are quickly replacing expensive and time-consuming local doctor visits for many cases. Telemedicine expands a patients access to care, increases convenience, reduces travel time,  and delivers service at a lower cost. As an emerging player in modernized healthcare, the global telemedicine market is valued at around $18 billion in 2015 and projected to skyrocket to over $40 billion by 2021.

Despite its incredible potential, employers continue to struggle with low employee utilization of telemedicine services. In many cases, employees are confused, hesitant, or just unaware of the offerings available to them. For any employer who is serious about fully capturing the benefits of telemedicine, it’s crucial to choose the right telemedicine provider– one that does its job well and engages with employees to drive down healthcare costs. When it comes to selecting a telemedicine provider, asking a few questions can make the difference between an underutilized tool and a game-changing service that redefines how people view healthcare.

How does the telemedicine provider engage the user?

It’s not enough for a telemedicine service to merely list a phone number and hope that users will take the initiative to make the call. Not only are phone calls no longer the preferred mode of communication, but people today need constant contact to be top of mind. Whether it’s through a chat-based platform or simple reminder notifications, outbound campaigns that keep a telemedicine service top of mind are integral to staying relevant in today’s age of information overload. Passively offering a telemedicine service is like opening a store and not putting a sign on the door– no one will know it exists.

A provider that offers an integrated health solution, rather than a single solution, can be useful in guiding users to utilize telemedicine. If users are coming to a platform to access a wide variety of healthcare and benefits-related services, there is more opportunity to redirect them to telemedicine. With highly successful platforms, around 50% of telemedicine consults are initiated by members who came to the service for a different reason (e.g., searching for a local doctor) and were redirected to an online consultation. A provider offering a single, siloed service will never gain as much traction as an integrated platform that brings users in through a wide range of channels.

Do they integrate complementary services to enrich the offering?

Because healthcare consists of a web of several different players (employers, insurers, providers, and more), the best telemedicine providers offer a service that integrates within the bigger picture of an employee’s benefits package. If the ultimate goal is to contain rising medical costs and drive employees to make smarter healthcare decisions, telemedicine providers must combine forces with offerings like an employee benefits wallet, 401k and HSA accounts, appointment scheduling, and more.

Once you combine all these aspects of patient care through a single platform, you have a one-stop-shop where all healthcare needs can be taken care of, which simplifies the user experience dramatically. Integrating these components into one platform will also drive up utilization as users can keep coming back to a single app or website as the home base for all their benefits needs and information.

All in all, when you unite several components of employee benefits through a common platform, they help inform one another and lead to the best possible outcome for the user. Seek out a provider that integrates telemedicine into the grander scheme of employee benefits.

Do they offer pre- and post-consultation support?

Another way that quality telemedicine providers engage with patients is through pre-consultation support and guidance, as well as post-consultation follow-up. Accessing care through telemedicine is a new experience for most, and can be intimidating at first. A good telemedicine provider will guide and educate users in a way that makes the process go smoothly with minimal confusion. It should be clear how to reach a doctor, how long the process will take, and exactly which medical conditions can be treated through an online doctor consultation.

A provider that goes above and beyond will also integrate with services that exist in the patient’s real-world environment. It may store data on local doctors and pharmacies in case the user needs to reach out to a provider in-person. It should also leverage this information to craft individualized provider and facility recommendations based on their insurance plan – especially in an emergency.

Just as important as a telemedicine provider’s pre-consultation guidance offerings is their follow-up procedure. Follow-up may be as simple as a message delivered to the user’s inbox summarizing their diagnosis, prescription information, and care instructions/next steps. Patients should be prompted with the option to send this information to their primary care physician, and the results should also be stored locally to provide a more personalized member experience over time. Lastly, a great telemedicine provider will ask members about the quality of their experience, to ensure that the service was high caliber and enjoyable for the user.

Is the telemedicine easy to use?

A simple, refined member experience on a centralized platform are the hallmarks of a quality benefits product that employees will be eager to utilize. It can be hard to find a genuinely modernized and effective benefits experience, so discovering one will win you points across the board. Everyone in your workplace, from the newfangled techie to the older employee whose age is beginning to catch up with them, will thank you for simplifying their healthcare experience. Asking the right questions about your telemedicine provider will ensure you find the one that your employees won’t be able to live without.

4 Reasons Why Selecting The Right Doctor Is Critical

4 Reasons Why Selecting The Right Doctor Is Critical

When sickness strikes, which doctor do you choose to visit? If you’re like most, you’ll ask family members and close friends for recommendations for selecting the right doctor. If you’re ambitious, you’ll go web-hunting for reviews or even consult your insurance carrier for suggested providers in the area. Most people think these recommendations will find them the best doctor for costs and quality, but they would be mistaken.

Relying on word-of-mouth does not ensure you’ll end up in the right doctor’s office. For insurance carriers who give a list of suggested providers, their primary concern is not quality patient care. For your friends, most will be able to tell you if a doctor is friendly, but won’t be able to gauge medical competence. For websites that rate physicians, most don’t have enough visitors to give an accurate portrayal of a provider.

There’s so much you may overlook by relying on these limited sources of information. It’s doubtful that the doctor you find by asking around has the highest success rates, has a pleasant bedside manner,  takes the time to get to know patients personally, has knowledge and expertise in their treatment field, maintains sanitary facilities, and most importantly, is cost-effective in their treatment decisions.

Frankly, we do more research when choosing our homes, cars, and universities than when selecting a doctor. The problem is a wrong choice of healthcare provider can end up costing us a lot more. Here’s why:

What Happens When You Choose the Wrong Doctor?

 

1. You Might Be Overcharged

Unlike doctors in Europe, US doctors do not have fixed salaries. They benefit financially from running expensive tests on their patients and going through high-cost treatment plans. Don’t get me wrong– not all doctors are profit-maximizing machines. In fact, most of them genuinely care quite deeply about their patients. Still, when it comes down to individual care decisions, even the most empathetic doctor is faced with financial incentives that push them towards overtreatment and overly expensive tests.

Healthcare reform advocate David Goldhill finds that Medicare spends twice as much in Dallas, where there is a plentiful supply of healthcare providers per resident, compared to Salem, Oregon where physician supply is less abundant. Physicians who have fewer patients coming through their doors tend to order more tests and treatments to keep their practices full.

Physician overtreatment does not only arise from a pure profit motive, but also from fear of legal consequences. An entire industry of medical malpractice litigation has emerged, leading doctors to order more tests and procedures than is medically necessary. This behavior is primarily a protective measure against lawsuits or a phenomenon known as “defensive medicine

2. You’ll Be Taken Advantage Of, Information-Wise

“Informational advantage” is the upper hand that healthcare providers naturally have over their patients, due to their extensive medical training. This knowledge gap gives authority to physicians. When the doctor tells us a specific test or treatment is truly necessary, we aren’t usually in a position to deny it. Also, doctors can quickly overwhelm their patients with too much confusing information, and on the other end of the spectrum, failing to provide enough info surrounding their treatment, leaving the patient blindly following orders.

Another realm where patients lack information is pricing: few people know exactly how much medical services will end up costing them. The health insurance system makes accurate prices for medical care unclear.

The combination of medical providers benefiting from high-cost treatments and patients’ disadvantaged informational position means that physicians can (to an extent) generate demand for their services at will, a phenomenon called physician-induced demand. Choosing the wrong doctor, one that regularly exhibits this type of behavior, is costing you even when you don’t realize it.

3. You Could Fall Victim to Aggressive Advertising

Do you find the commercials on TV promoting certain medications to be annoying? It turns out that doctors have it way worse. Pew Research reports that while pharmaceutical companies spent $3 billion in 2012 marketing to consumers directly (mainly through TV ads), they spent a crazy $24 billion marketing to physicians.

Pharmaceutical companies market to doctors through several methods. These range from free drug samples, mailings, web and journal ads, and most concerningly, “detailing,” whereby drug sales reps promote their products face-to-face to physicians and even go so far as taking them out for meals or giving them gifts. In 2016, there were a total of 71,000 pharmaceutical sales representatives in the US. That’s almost one for every 14 doctor’s in the USA.

4. A Brand Name Pill Might Increase Your Bill

In the same vein, you could end up with a physician that routinely prescribes expensive brand-name drugs. In some cases, these brand-name drugs may even be less effective than generic alternatives. What’s more concerning is the fact that most physicians are in the dark about the costs of the very drugs they prescribe. They lack the information to compare prices and effectiveness across drugs, leading them to write prescriptions for drugs they are most familiar with, AKA brand-names that are heavily marketed by pharmaceutical companies.

A ProPublica analysis guided by Harvard researchers reveals that doctors who receive payments or other rewards from drug companies prescribe different medications than doctors who don’t, and the more money a doctor gets from drug companies, the more likely they are to prescribe brand-name medications. In other words, many physicians have loyalties to the pharmaceutical industry and prescribe expensive brand-name drugs to show support to the companies that offer them education, gifts, and generous rewards for participating in promotional activities. We all know drug costs are rising, and avoiding specific doctors goes a long way to control these costs.

How to Find the Right Doctor

The right doctor is someone whom a physician would trust with the care of their own family. How then can we go about choosing the best doctor available who can meet our needs? A healthcare guidance platform may be just the answer.

HealthJoy uses both artificial intelligence as well as old fashion legwork to ensure that we recommend the best provider to our members. Our healthcare concierge does the deep digging using reputable and accurate sources so that you don’t have to break a sweat when looking for your next doctor – this takes an average of 1-2 hours per recommendation.

First and foremost, HealthJoy’s concierge verifies the objective facts. It looks at several indicators of a physician’s quality: we search state boards for lawsuits or other red flags, we make sure board certifications are up to date, and we are also wary of doctors who are heavily influenced by drug company payments. Next, we look at the number of referrals received by the provider, as well as the number of times they have performed a particular procedure. We also review the rankings of their medical schools/residency programs, and the number of years they’ve been in practice.

The next item on the list is cost-effectiveness. Choosing the provider with the best price has a massive impact on the savings earned by both yourself and your payor (your self-insured employer and/or insurance carrier), and we check prices for all parties involved.

We then go the extra mile to find a provider that fits your personal preferences, creating a recommendation that is highly-tailored to your individual needs. We consider everything from gender, language, and age preferences, to checking the physician’s distance from your location, in-network status, and scheduling availability.

The Bottom Line on Selecting The Right Doctor

Your friends may (or may not) be able to provide you with excellent restaurant recommendations, but most of them will not know how to assess a doctor’s medical competence and cost-effectiveness. The best doctor does not over treat their patients, leverage their informational advantage for financial profit, or prescribe medications based on loyalty to a pharmaceutical company. However, not every doctor exhibits these traits, which causes the cost of care to vary wildly between Physician A and Physician B.

It is intimidating to navigate through all these moving parts on your own, so we understand why a simple recommendation from your neighbor might be your desired method for choosing a doctor. As you’ve read, though, this shortcut will probably cost you. Thankfully, HealthJoy’s artificial intelligence-powered concierge uses an algorithm to compile all the essential details about a provider, so finding the best doctor is just one tap away on your smartphone.