‘Tech’ it up a notch – BenefitsPro

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Technology engagement concept

We asked readers, “What are some of the most glaring areas where the benefits and health care industries have lagged in tech adoption? How have you seen COVID affect these areas?”

Connectivity issues

The technology has long been present to enable effective telemedicine interactions amongst patients and doctors. Over the past 10 years, we’ve seen remote monitoring technology for chronic conditions such as diabetes and hypertension. What we haven’t had aligned with the technology are policies that allow multi-regional and national employers to efficiently deploy solutions across their entire populations. But these and other roadblocks seemed to instantaneously disappear when COVID no longer allowed for patients to physically visit their doctors. So, was the technology lagging or were politics and lobbying prohibiting broader access and adoption?

person's hand holding light with a network coming off it
Related: Technology, politics and moving forward in the health care industry

(Photo: Shutterstock)

Now that we’ve seen it’s possible, there is a great opportunity to make things much more seamless and efficacious. It’s great if you can see your doctor via video and have a meaningful interaction, but how effective is it if you don’t have a remote blood pressure cuff at home? Due to the drop in in-patient care, outpatient services, urgent care etc., many employers are leveraging data more than pre-pandemic to determine what necessary care was delayed, what inappropriate care was avoided, and which tools need to be in place to address the most vulnerable within their populations. This is a trend that will continue—leveraging data and transparency to make strategic value-based benefit decisions.

More employers are also focused on social determinants of health, health equity and health disparities, outcomes-based care, adherence in care, access, chronic disease management and new Rx innovations. Transparency, identifying appropriate treatment, culturally competent care and fiduciary management are going to be developing focus areas for employers where tools, platforms, and innovation will have an opportunity to thrive.

Jessica Brooks, CEO/executive director, Pittsburgh Business Group On Health

What’s the hold-up?

The benefits and insurance industry have long been laggards in adopting new technology. Today, you’re able to have food delivered to your door, buy a plane ticket or book a ride in a matter of minutes, but the benefits space just isn’t there yet. COVID put work tech under a microscope, and now employers are much more receptive to the idea of leveraging technology and digital solutions that can alleviate some of their business problems. Moving forward, we expect this trend to stay strong and software solutions and services to continue to innovate to make it all possible.

Rachel Lyubovitzky, CEO & chairwoman, EverythingBenefits

Shifting ground

One of the first things employers observed during the pandemic was a dramatic decline in health care spending attributed to the reduction of direct, in-person care.

For years, data has pointed to a huge opportunity for telemedicine utilization in lieu of office-based primary care. Traditionally, advisors and their employers have implemented programs with very low penetration rates and low effect on spend. During the pandemic, the provider community quickly adapted by delivering more care through telemedicine. As a result, utilization increased more than 2,500%.

Last April, 40% of primary care was delivered via telemedicine compared to in-person office visits. While telemedicine is usually less expensive than office visits, employers did not see cost savings related to the astronomical growth of telemedicine during the pandemic because insurers, following Medicare’s lead, increased reimbursement rates for telemedicine to be comparable to those for in-person office visits. These rates should be questioned by the advisor community.

Over the past 10 months, data has also shown an increase in telemedicine use to treat mental health conditions such as anxiety, mood disorders and stress. Before COVID, telehealth adoption in psychiatry was 80%, but that jumped to 96% following the onset of the pandemic. Recognizing the toll that COVID prevention measures were having, employers promoted EAPs and online support tools to help employees. Data revealed downloads for the mental wellness app, calm.com, increased by 50% during the pandemic. Ginger, an on-demand, text-based mental health support app, saw a 302% increase in virtual therapy and psychiatry sessions.

As of October 2020, employer health care costs showed signs of rebounding, but still not to pre-pandemic levels. Telemedicine use lowered during the last months of the year, but remains higher than pre-epidemic levels. Continued monitoring of the data is needed to understand the varying impacts of the pandemic on employees’ willingness to seek preventive care and undergo elective procedures. However, our expectation is that telemedicine will continue to see wide use, particularly for mental health treatment.

Hugh O’Toole, CEO, Innovu

Hiding in the easy

The pandemic has challenged our notion of “normal” and continues to forcefully push us towards innovation. In benefits and health care, it continues to expose flaws within the system. Three areas that require this push are: self-funding, alternative access to health care, and transparency tools.

First, it has moved us towards a self-funded model. During the pandemic, employees have been “locked down.” Employers continued to pay premiums, but claims were super low. Therefore, insurance companies made huge gains. If employers were self-funded, that cash flow, and overall savings, would have been of immense value to employers—even savings jobs.

Second, health care access has expanded out of necessity. Options like telemedicine, virtual care, DPC, and on-site/ near-site clinics from the beginning would have allowed employees to utilize their benefits in a safe environment. These last three options could have developed and implemented a companywide COVID-19 testing operation.

Third, the need for transparency tools has increased. Although many employees did not access health care in 2020, they will look for care this year. How do they know where to go for high-quality and low-cost care? How is the plan helping them access this care? Transparency tools, enhanced advocacy solutions, and a strategy to engage members to be better health care consumers will ensure employers and employees spend their health benefit dollars wisely in 2021 and beyond.

Lester J. Morales, founder/CEO, Next Impact, LLC

A high bar

Technology to help Americans navigate the health care industry has lagged behind due to so many players, competing interests, and let’s face it, laziness. Our industry is often “fat and happy” and when that happens, innovation stalls. Has COVID affected tech adoption? Maybe. But it doesn’t matter because the industry was lagging way behind and needed to catch up way before COVID came along.

woman touching checkbox by happy face IBM’s Bridget van Kranlingen said, “The last best experience that anyone has anywhere becomes the minimum expectation for the experience they want everywhere.” (Photo: Shutterstock)

As health care leaders, it is upon us to improve the end-user experience and help Americans navigate their health care journey. We must realize that our competition isn’t who we think it is; we’re not in competition with each other. IBM’s Bridget van Kranlingen said, “The last best experience that anyone has anywhere becomes the minimum expectation for the experience they want everywhere.”

Our competition is the best tech experiences our users interact with seamlessly every day. It’s a high bar, but our free-market health care system depends on it—and Americans deserve a better health care experience.

Heidi Rasmussen, co-owner, freshbenies

Time to move on

If I had a dime for every time I’ve heard comments like “my client is old-school” or “we still do everything on paper,” I could retire. But if 2020 proved anything, it’s that the old way of doing things is no longer viable. The pandemic has been a catalyst for brokers and their clients to rethink benefits strategies, find new ways to communicate with employees, and embrace innovative solutions we should’ve been adopting years ago.

Half of employees are worried about their current financial situation, and 4 in 10 are saving less for retirement in response. Because they’re worried about their health and finances, 59% say they’re paying closer attention to their benefits this year. How can brokers ensure employees have the information they need, especially when many workforces are only available via Zoom or email, and quite possibly balancing a baby on their lap while listening to a benefits presentation?

Technology. Employees are asking for a personalized approach to benefits education, and they want interactive tools and one-on-one guidance. It’s time to leverage technology that meets them where they are, guides them towards smarter choices, and helps them and your clients save hundreds of thousands of dollars per year.

Gone are the days of spending all of your waking hours on plan design. For the amount of time spent on reviewing plan design changes, funding mechanisms and all the aspects of benefits packages, it is astounding how often communication and benefits engagement is overlooked. If you don’t communicate effectively or constantly engage employees in smart decisions, how can you change behavior?

Stop printing out benefits booklets that employees barely read. Put benefits communication strategy at the top of your agenda, and align on the technology that will make it happen.

Chad Schneider, VP, Strategic Alliances, Jellyvision

Wake up!

Our industry has been increasing our reliance on technology, but at a much slower rate than Americans. My grandmother has a smartphone and Google Home, my 4-year-old niece FaceTimed me from her mothers’ cell phone this weekend, and I used the internet to purchase auto insurance without printing out a document or talking to a live person.

Technology in all facets of our everyday life is now the norm, and the benefits industry has been behind in adapting. Look at how many carriers still rely on a paper claims process, and how many groups still use paper to enroll. 2020 has forced us to realize that we can either adapt or get left behind. Not adapting is to the detriment of both the corporation, which could benefit from the efficiencies created by technology, and consumers, who would benefit from consistent and clear communications, access to information at their fingertips, and an enrollment process similar to the shopping experience many prefer. We will only see increased demand for technology efficiencies in all facets of our industry from here, including mobile compatible decision support and engagement tools, mobile claims filing, auto claims adjudication, and platform integrations that work.

Heather Garbers, VP voluntary benefits, HUB International

Here’s the evidence…

I’m continually amazed that health care systems and practitioners haven’t done more to adopt technology to support the delivery of evidence-based medicine! Given the rapid growth rate of medical knowledge and the ongoing struggles and complaints about the administrative burden of dealing with insurance, one would think that there would be an extreme eagerness to adopt technology.

However, despite my offerings to “gold card” providers who license, utilize, and demonstrate ongoing adherence to evidence-based care pathways, I’ve yet to have a single provider take me up on it. Despite efforts to automate precertification processes, the AMA still pushes against it. Despite offers to pull data necessary to perform prior auth/pre-cert straight out of medical records, providers and EMR vendors have yet to allow access to records. It seems to me that focusing on “right care” would be a foundational place to start, and utilizing technology and integration with those who pay the claims would be a good place to start.

Deb Ault “Nurse Deb”, president, AAIM

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