Too many choices may lead to less effective use of benefits
BY JEREMY GALLUS
Consumers are living in a rapidly increasing digital and hybrid world, full of simplified options to complete daily tasks. I haven’t stepped into a grocery store for almost six months thanks to an app; dry cleaning is picked up and delivered with the click of a button and I can have nearly anything I want delivered in less than two days. We, as a society of consumers, have become accustomed to simplified convenience. But has our health-care industry done enough to cater to those needs?
The short answer is no. We tend to have good intentions when implementing point solutions, especially with the exploding need for mental health support and finding answers for members that don’t require a specialist. However, when you add a mental health app subscription as a part of a benefit plan and also offer access to a behavioral health specialist, EAP services, a health coach, and primary care providers, where does the member start? What questions should they be asking? Which one of these offerings is most convenient and cost-effective?
In my opinion, we don’t need to offer more self-service options to members, we need to optimize and simplify how they navigate the offerings they have already access to today.
Offering more self-service options to members only stands to complicate and overwhelm their decision-making process because with too many options, members may not be sure which services stand to benefit them the most. If members are unsure which new service, out of the plethora of new services, is right for them, then they may not be able to optimize their benefits with a healthcare provider.
This detriment stands to denigrate public health and alienate members. However, if providers work to simplify how members navigate the offerings they currently have access to, this could lead to members becoming more well-versed in their benefits.
Members becoming more familiar with the benefits already available to them also lessens the need for new self-service options, which may only stand to add further confusion for members. Optimizing and simplifying navigation of current plan offerings is crucial for members to get the most out of their services.
At Sutter Health | Aetna, we have seen increased member engagement and access of benefits through the implementation of navigation services. For example, when we simplified navigating our behavioral health services, we saw a 30% increase within the first month in member engagement.
Part of simplifying plan navigation is about building a better-connected experience for members. We in the healthcare industry must find ways to not only connect with members but improve engagement rates around our interactions and plan offerings
Now is the time for companies to audit their benefits strategies and decide if it’s important to add additional self-service options or be more intentional with the ones already available. If you are discussing new offerings for your clients, make sure you’re asking the right questions.
Here are a few helpful questions to ask when determining if a new offering is a good fit for members:
What is your engagement rate with members?
How do you interact with members, and what communication modalities are available?
Push for a per engagement fee, and ensure an “engaged member” is mutually defined to avoid misaligned outcomes.
As we enter open enrollment season still in the midst of the pandemic, the need for simplicity and is greater than ever before. Every one of us has more on our proverbial plates than usual. We can best support members by staying attuned to what is going to be efficient, streamlined, and readily accessible. Having a more personalized and connected experience must be embedded into the DNA of all healthcare providers by injecting intentionality into our offerings.
JEREMY GALLUS joined Sutter Health | Aetna as the head of Market Development in March 2021. In his role, he leads growth and market development efforts, ensuring Sutter Health |
Aetna’s value proposition is positioned appropriately to the market to win new g roups. He also leads overall sales enablement to the Aetna sales team s and has overall broker relations responsibility for national, middle-market, public & labor, small group, and student health.
Jeremy brings over ten years of sales and strategy experience from various roles within the healthcare industry where he’s spent his career helping payers (employers, health plans, health systems) and consumers understand and manage the complexities of today’s health care system. In his most recent role, Jeremy led commercial sales and strategy for the largest PBM transition in history, when CVS Health partnered with Anthem to build IngenioRx.
Before leading the Anthem team, Jeremy led strategic account management projects for large, regional health plans to create higher client sentiment and demonstrate the PBM’s performance by reconciling difficult data that was not readily available for human consumption. Email Jeremy at: Jeremy.Gallus@CVSHealth.com