3 misconceptions about integrated benefits
There are many misconceptions about integrating benefits under one carrier, as opposed to carving out benefits under separate carriers. What’s fact or fiction?
Employers who don’t integrate their benefits under one carrier may be missing out on key advantages that go along with that approach.
And while some brokers and consultants may believe their clients will perceive more value in their services if they piece together a benefits package to include a diverse mix of carriers, the reality is that it may lead to greater gaps in care, disjointed experiences and higher costs.
That’s why it’s important that brokers, consultants and employers realize the advantages that may be achieved when offering integrated benefits and how it can actually streamline the experience for everyone involved.
Contrary to common misconceptions, when medical benefits are integrated with pharmacy, specialty, behavioral health and other benefits and managed by one carrier, employers may see reduced administrative burden, more coordinated care and experiences, lower costs and healthier overall employees.
Let’s separate fact from fiction. Plus, find out why UnitedHealthcare may be one of the “most capable” carriers to deliver this approach.1
1. It’s too complicated to integrate benefits
When benefits are integrated, the administration and management of health plans may be easier. With fewer vendor contracts to maintain, benefit administrators may have greater capacity to focus on value-add activities, like getting a more complete picture of how their overall benefit package is performing and analyzing employee population trends to ensure it's meeting the needs of their workforce.
And getting to that complete picture may be easier with integration since access to health plan performance may be simpler with only one carrier supplying that data. Having those data points more centralized may lead to quicker identification of opportunities to close gaps in care, reduce costs or better address employee needs.
For employees and members, having one administrator of their benefits may lead to more coordinated care for better health outcomes, lower costs and more connected experiences. For instance, medications might be covered under an employee’s pharmacy benefit or their medical benefit — often depending on how they are administered — and sometimes they may fall under both. With integration, an employer can feel confident that their spend and their employees’ care and out-of-pocket costs are being better managed across their benefits.
And while the initial lift of integrating benefits may involve some research and change management planning, it may end up being simpler long term with:
- Fewer contracts and vendors to maintain and work with
- Simpler benefits administration and implementation
- More robust and centralized reporting capabilities
- Improved and more effective plan management across benefits
- More coordinated care with the potential for increased speed-to-care and better outcomes
2. It’s more expensive to switch to a single carrier
While carving out or purchasing benefits separately may come with a lower upfront price tag for employers, this often neglects to account for the long-term savings opportunities that can occur with integrated, or carved in, benefits. These greater long-term savings opportunities may result from more effective cross-benefit care management and greater visibility into data across medical, pharmacy, specialty, behavioral and other claims.2
For example, employers see up to $516 average per member per year (PMPY) savings when pharmacy and medical benefits are integrated.3 And when specialty is integrated with a UnitedHealthcare medical plan, employers see 1.5% in medical cost savings.4
When employers bundle benefits, they may be able to take advantage of pricing programs that offer premium discounts or administrative credits, which may add up to significant savings. And when bundling with a national carrier like UnitedHealthcare, employees may have access to larger networks with more provider and site of care options, which could result in their making more informed and cost-effective choices.
Employers with integrated benefits may also be able to access reporting that looks at their employee populations’ health across medical, pharmacy, specialty and behavioral claims, gaining a deeper understanding of their realized plan performance and the ability to better identify ongoing health insights and potential savings opportunities.
Integrated benefits models may lead to better resource allocation, reduced duplication of services and improved care coordination too, with the potential for reduced waste and lower costs.
3. There’s no difference in employee health outcomes or experience
Integrated benefits may also lead to a simpler, more connected and personalized experience for members too.
Consider the intersection of medical and behavioral health: In an average group plan population, 11% of UnitedHealthcare members had 2 or more linked medical and behavioral health conditions, accounting for 22% of employers’ costs.5 Integrating benefits may help employees better manage comorbidity conditions, which is when a person has 2 or more health conditions at the same time, because their care can be more coordinated across the related benefits.
For instance, research suggests people with diabetes are 2–3 times more likely to experience depression than those without.6 Other conditions with high rates of depression comorbidity include cancer and cardiovascular disease.7 When providers have a broader view of a member’s whole-person health needs, they are more likely able to take all underlying conditions into consideration when developing a treatment plan.
With integrated benefits, the number of steps required to get the care, support or answers members need may be reduced. For instance, while UnitedHealthcare does not require prior authorizations over 98% of the time and continues to identify opportunities to eliminate this step where appropriate, this process becomes even more streamlined or automated when benefits are integrated.8 Nearly 43% of prior authorization requests are bypassed when UnitedHealthcare medical and pharmacy benefits are integrated.8
Members may also appreciate having a single insurance ID card, streamlined login credentials and fewer apps and websites to jump between when looking to access and manage their benefits. For UnitedHealthcare members, the UnitedHealthcare® app and myuhc.com® serve as a “digital front door” for members where they can start their health care journey with one portal, one password and one place to search for care, costs and claims.
Integrating benefits can help empower employees to make better health care decisions by providing them with information, tools and resources to help better manage their health, leading to a more connected experience. For employers, that can often lead to healthier and more satisfied employees, increased productivity and lower costs — with more visibility into the needs of their workforce.
Key takeaway
At UnitedHealthcare, we leverage real data to drive real impact through truly integrated benefits. Our approach connects predictive analytics for cost optimization, coordinated care for improved health outcomes, and operational efficiency for enhanced member experiences into one ecosystem. When these elements work together rather than in silos, they create a powerful multiplier effect — data insights inform care strategies, which streamline operations, generating better outcomes at lower costs while elevating member satisfaction.
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