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TODAY’S EMPLOYEE BENEFIT PLANS: 3 REASONS UTILIZATION IS CRITICAL

May, 30 2017

How do you gauge success of the benefit plans you sell to your groups? Maybe it’s staying within your client’s budget, keeping coverage for spouses and families, and ticking off boxes of the “must-haves.” 

Those things absolutely matter. But, in today’s consumer-driven health care system, utilization is an important piece of the puzzle in the success of a total benefits package. Utilization reflects the group’s satisfaction, improves their ROI, and increases retention year after year. These results all strengthen loyalty and reflect on you as the trusted consultant. 

I’m sharing 3 points on how utilization is critical to ROI.

1. High utilization is the new math 

In the insurance space, you typically want low utilization, right? But the inclusion of non-insurance services within the total benefits package turns that thinking around. When an employee uses telehealth instead of an in-office, urgent care or ER visit, it keeps costs from hitting the employer health plan (while improving the out-of-pocket expense and convenience factors for the employee). High use of certain services go up, and costs stemming from other types of care go down. So, it’s easy to see why a strategy to drive high utilization makes sense. But it does take a strategy…

2. “Included” doesn’t equal usage

The most common concern I address daily is, “Why pay for something that’s included in the medical plan?” On the surface, this question makes sense. However, looking at usage will quickly bring the idea of utilization into play.

For example, the average usage of carrier-installed telehealth is 2%. Imagine a group of 100 employees having only 2 consults for the entire year. That won’t deliver savings (to the employer or the employees). What if we look at industry-wide telehealth utilization? Not a huge difference, the average is still just 7%. So why aren’t employees using it? 

They are! At freshbenies, we see an average telehealth utilization of 58% (and 90% when employers follow our 3 best practices). That same example of 100 employees would have 58 consults a year. When each visit can save hundreds of dollars, the savings from that kind of use delivers a real ROI

Once you realize the employee engagement is very low with an “included” carrier-plan, you quickly realize high utilization is infinitely more valuable than a lower monthly cost.

Telehealth Comparison Checklist

3. Delivery drives utilization (and savings!)

The difference between 2% and 58% utilization comes down to delivery. If you want a winning strategy to drive use of consumerism tools like advocacy, telehealth and online specialty consults, you must evaluate how services are delivered to the employees. 

• What turnkey communications are in place to drive awareness?

• How is the member experience? (i.e. Is there an additional cost to use the services? What technology is available to use the service? Is the family included in a membership?) 

• What kind of support is in place to support the employer? (i.e. Can they monitor utilization throughout the year? Is there an expert available to help employers foster usage?)

There are some great options available that truly drive utilization, so you don’t have to rely on an inefficient solution just to quickly tick the box of offering a benefit. Wouldn’t you rather advise your groups on the best strategy and have the employer and employees “utilize” you for years to come?

Now it’s your turn! How have you been evaluating utilization with your clients? How do you approach use of consumerism tools in the total benefits plan? Comment below or email me at jadd@freshbenies.com.

Jadd

Having started his career in 2013, Jadd is a relative newcomer to the health insurance industry. With the disruption of the Affordable Care Act, he comes with a fresh outlook that drives him to pursue innovative and strategic solutions. He also writes articles to help spread those solutions to others!

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Tanya Boyd
Tanya Boyd
President of Tanya Boyd & Associates

I didn’t want to go to urgent care or the ER. Using Doctors Online in my freshbenies membership, I went online to ask a doctor. The doctor responded and said to check my blood pressure. He followed up with the next day to make sure my numbers were OK. By then, the feeling was starting to go away. He told me if it persists to contact my doctor. It was great that I didn’t have to go somewhere and wait forever, and it was free.” - Kelli from Texas

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Shannon
Shannon from TX
beniebeliever

It was Sunday night at 10pm and my husband was feeling very sick. He was considering going to an emergency room since he had a very busy work week ahead.

Using the freshbenies Telehealth service, we registered him online for a visit and within 15 minutes he received a call from a doctor. The doctor informed him he had the flu and called in a prescription to a local 24 hour pharmacy.

We avoided paying for an emergency room visit and my husband was back at work by Wednesday!