Using Advocacy to Encourage Employees to Be Smarter Healthcare Consumers

For self-insured employers, your employees ability to make smart, cost-effective decisions directly impacts your bottom line. In a world where there is a wealth of information available at the click of a button, people seem to be more unsure than ever before when it comes to healthcare decisions – who to see, what treatment to receive, or where to seek care.

Whether it’s choosing to go to urgent care or the emergency room, determining the best place to fill a prescription, or finding support to manage a chronic illness, your employees need an advocate to make decisions that lead to better health for themselves and better financial outcomes for everyone.

Current Problems Facing Employees

According to the Center for Disease Control and Prevention (CDC), health literacy refers to someone’s ability to not just understand health information but to use it and make well-informed decisions. Unfortunately, in 2022, the Milken Institute released a report that only 12 percent of adults living in the United States have a proficient level of health literacy¹.

If you have an employee with a below-proficient level of health literacy, they are more likely to:

• Return incomplete medical forms/assessment tools
• Miss appointments with health providers
• Neglect follow-ups to required medical procedures
• Postpone communications with health providers and have difficulty maintaining consistent medical histories

A contributing factor to low health literacy rates among adults are the complexities associated with our healthcare system. This can range from not fully understanding their coverage or not having a primary care physician to misunderstanding test results resulting in unnecessary treatment or services.

When this happens, these types of behaviors result in inconsistent care, missed treatment opportunities, and oftentimes, higher costs for self-insured employers.

The Solution: Member Advocacy

To counter lower health literacy rates, self-insured employers need to lean into member advocacy. Healthcare advocates provide employees and their families direct, customized assistance in navigating the healthcare system which improves their health literacy and leads to cost control for all parties.

Healthgram Connect pairs members with a dedicated advisor to provide one-on-one guidance. The goals of this relationship are to:

• Help members make the best decisions for themselves and their families.
• Reduce stress on members during a health crisis.
• Maximize financial outcomes for members and their employers. 

“Connect offers members an opportunity to get the most out of their healthcare plan,” Keri Downer, Chief Operating Officer at Healthgram explains. “It’s going beyond digital support and connecting someone who is prepared to help them make the best choices for their overall health and wellbeing.”

Here are some benefits from implementing a member advocacy program:

Navigate Coverage and Benefits

Connect advisors are equipped to answer questions ranging from general benefits questions to finding a fair-cost facility for an elective procedure. They are supported by a robust team of benefits and medical experts to encourage appropriate utilization – highest values, lowest cost.

Navigating coverage can also include valuable support such as:

• Explaining copays and coinsurance 
• Investigating in-network and out-of-network provider options
• Researching fair-cost facility options 
• Care coordination
• Educating on coverage limits 

This personalized care creates a more connected healthcare experience for employees.

Conduct Proactive Outreach

Advocacy goes beyond being reactive and answering benefits and claims questions as they come up. Using proactive data, Connect advisors provide guidance before employees know they need it.

The timing of outreach is critical when it comes to advocacy engagement and steerage outcomes.

Empower Employees to Make Decisions

After speaking with a Connect advisor, 93% of members feel more confident making healthcare decisions.

Member advocacy does this by providing whole-person guidance across a broad number of health care needs from utilization and steerage guidance to financial and benefits/claims education. Our high-touch approach ensures that employees have the right information at hand before, during, and after treatment to make the best decision possible.

As employees increase their health literacy levels, they will make better healthcare decisions that impact their overall health and your bottom line.

To learn more about how Healthgram approaches member advocacy, reach out to a member of our team.

¹ https://milkeninstitute.org/sites/default/files/2022-05/Health_Literacy_United_States_Final_Report.pdf