Especially with this new wave of digital transformation, benefits teams need a trusted advisor to help them architect a simple digital experience for their members and make clearer data-based decisions.
With the onset of the global pandemic, the digital transformation of health care moved into high gear for everyone. Now that most people are comfortable using technology in their health care journey and chances are even your grandparents have had at least one online interaction with a medical professional, how should savvy benefits leaders be looking to leverage these shifts to improve health outcomes for employees and their families and deliver even more value in spend for their company?
While there is no shortage of virtual provider solutions emerging on the scene, the cost of treating chronic conditions continues to soar. Pile on imminent worldwide doctor shortages and the business case for major change that can support increasing scale is evident. However, this transition faces some major hurdles–from patients' lack of understanding of the system and how these solutions fit, to how to create trusted and seamless patient access points, to the complexity of regulations facing the industry as well as the fragmentation and diverse needs of the various stakeholders. Finally, there's also little clarity or transparency around engagement, costs, and the outcomes that many of these solutions deliver.

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Through our deep relationships with many of the most forward-thinking benefits leaders, we see that even those who have invested heavily in creating a digital health care experience are still struggling to create a seamless member experience that optimizes outcomes and spend. Especially with this new wave of digital transformation, benefits teams need a trusted advisor to help them architect a simple digital experience for their members and make clearer data-based decisions.
To help people and benefits leaders make decisions on health care strategy related to virtual solutions, we partner with consultants to help clients evaluate impact in four core areas: Member experience, health outcomes, cost, and lift on internal resources. Using this framework helps employers have what they need to ensure a point solution delivers the desired member impact but also helps provide the value and impact metrics they need to take to their C-Suite.
1. Member experience
When working with clients to evaluate the latest and greatest virtual solution, it is important to consider several criteria including:
Employee Value Proposition – Does the solution solve a relevant problem for your employees or a key group of employees? Does having it differentiate your organization or just help you to keep pace with others? What does a successful outcome from the solution give you (e.g., healthier more productive employees, sick employees being able to work, addresses acute needs vs chronic management)
Access – how will members access this new solution? Is it condition-specific or will it touch the whole population? Will access come through a personalized referral/recommendation from a trusted source or will members have to know about it or self-select to find it?
Navigation – how does the solution integrate into your ecosystem? Would members flow from primary care or virtual primary care to this solution? Do you have a platform that can naturally embed the navigation for members? How seamless can you make the experience?
Ease of understanding – is the solution easy for employees to understand and value or will it require a communications campaign? How much complexity does it introduce?
Taking the time to understand how any virtual solution could be embedded in your member journey from first access through to outcome is one of the most important aspects to evaluate. Better engagement and results are achieved when members are able to access a solution through a trusted source and navigation is enabled through a simple, connected digital experience.
2. Health outcomes
Happy healthy employees are more productive and more engaged. Our point of view is that adding more digital solutions does not necessarily lead to better outcomes for employees yet. Until digital platforms are able to integrate in real time with all medical system access points, a better approach is to simplify and offer a narrower range of solutions with a proven track record across your population's highest-priority clinical conditions.
Benefits leaders should consider working with a partner that can both support in the decision-making process ahead of annual enrollment, as well as one that can properly feedback the data and health outcomes of the programs. By measuring engagement and results through anonymized claims data, employers will finally be able to assess both the impact and value of their investments.
3. Costs
The cost impact is another critical piece of the framework. There are two components to costs that we think are important to plan around. First, the cost and the implementation of the solution needs to be factored into your budget. Secondly, the cost impact the solution will have on your health care spend. Some of the hottest digital solutions (think fertility, family building and mental health) are also the ones that will increase your health care spend.
This doesn't mean that there isn't an ROI in terms of amazing outcomes for these types of solutions, it just means you need to build a strong business case for them. We work with our clients and their consultants to assess both the cost/implementation of the solution as well as project the impact on future health care spend.
4. Administrative lift for the HR team
The employer experience in adding digital solutions is another factor that should be considered. The reality is that each digital health solution can create more fragmentation which can lead to an increase in work for your internal teams. Whether it is managing the reporting, member engagement, member experience or dealing with the contracting and invoicing, you need to consider the potential impact of the solution vs the additional work involved.
In working with clients we help them analyze these considerations. However, they specifically benefit from having Collective Health play the role of a consolidator using our technology to streamline and simplify some of the additional work that burdens lean HR teams when adding additional solutions.
The member experience is key
There is no doubt a lot to consider in evolving and adding to your organization's digital health care strategy and solutions. Starting with a framework that puts the member at the center is key. Well-designed member experiences go a long way to unlocking the value in these solutions.
More broadly, there is so much potential still to be uncovered in the digital health revolution (e.g., increased accessibility, better health outcomes etc.), not to mention we're on the road to creating better, more equitable solutions for all. The digital transformation of health care is here, and benefits leaders should begin having these discussions to determine which digital services will best benefit the health and workflow of their business.
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