5 health care experiences ripe for transformation
From health plan confusion to high costs, the health care landscape is poised for transformation.
More than 60% of Americans surveyed say dealing with the U.S. health care system is a hassle.1 What’s more, those health care experiences are causing some to defer care, leading to a decline in their health and productivity.1
That’s why UnitedHealthcare is working to help make it easier for people to navigate the health system and create a better overall member experience. Employers may also take action by ensuring their benefits package delivers on what matters to employees today.
Member and employer data reveal 5 areas of focus that are ripe for transformation:
1. Making health care more affordable
Health care spending has begun to outpace overall economic growth and will eventually represent nearly 20% of GDP by 2031.2 These high costs have created headaches for many employees, with 48% of insured adults surveyed saying they worried about affording their monthly health insurance.3 Many employers are monitoring this closely, too, with 82% of those surveyed saying they’re concerned about rising health care costs impacting their organization’s competitiveness.4
These high costs are prompting carriers to develop strategies to help reduce the cost of care for employers and employees. One approach involves redesigning health plans to provide more value right from the start, including $0 copays for certain essential services — like primary care, urgent care and virtual visits — and vital medications, like insulin and epinephrine. This structure may help employees more easily access care without worrying about immediate costs and may encourage them to seek timely medical attention before issues require more complex and expensive treatments.
And with the cost of pharmacy care — especially specialty drugs — threatening both employer and employee wallets, the demand for more effective care management has become a key to making health care more affordable. As such, employers may want to consider integrating their medical and pharmacy benefits. When these benefits are managed together, it may enable a more seamless and connected care experience and help ensure that members receive more appropriate and lower-cost medication options.
Additionally, employers may look at solutions designed to help employees manage unexpected health care costs. This could include a preloaded debit card, health savings account (HSA), flexible spending account (FSA) or health reimbursement account (HRA) to use on certain health-related expenses, as well as supplemental and financial protection benefits to help ease the financial impact of challenging health and life events or out-of-network bill management programs.
2. Enabling more informed health care decisions with increased transparency
Recent surveys reveal that many Americans are confused by their health benefits. In fact, 65% of Americans surveyed said they don’t feel insurance companies are transparent about what they cover.1
That means that there is a significant opportunity for carriers to make health benefits more understandable with clearer choices and trusted support that is accessible when and how employees want it.
65%
of Americans surveyed said they don’t feel insurance companies are transparent about what they cover1
UnitedHealthcare, for instance, is working to provide employees with more visibility into health care costs before they receive care through cost estimation tools on the UnitedHealthcare app® and myuhc.com®.
Copay-driven plans like Surest®, which allow members to compare care options and see their full costs in advance, are built around the idea of demystifying costs. That way, employees may make informed decisions that align with their financial and health needs.
Even still, there are steps employers can take to help ensure employees understand how to make more informed health care decisions.
“More and more employers are growing in their awareness that, for instance, going to an ambulatory surgical center for a tonsillectomy is going to cost you 50% of what the outpatient hospital is going to cost you,” says Craig Kurtzweil, chief data and analytics officer for UnitedHealthcare Employer & Individual, adding that, even though their doctors might send them to the hospital.
In addition to the communication and marketing efforts led by carriers to help navigate members to more cost-effective options or care settings, employers may help educate and boost engagement by sending employees targeted communications, personalized onboarding videos and resources.
3. Making it easier for members to manage their care digitally
Increasingly, employees want their experiences with health care to mimic their retail-like experiences. To that end, carriers are working to evolve their digital experience to be simpler and more connected, personalized and predictable while also driving adoption of the advances they’ve made.
At UnitedHealthcare, personalization via the UnitedHealthcare app or myuhc.com gives employees clear indicators about which facilities and providers are in network, as well as ones that are recognized for quality and cost efficiency. Beyond that, members also want their digital experiences with health care to account for their personal preferences.
“We’re seeing that Millennial and Generation Z members don’t necessarily want 20 options when it comes to choosing a provider. That’s why we’ve built our digital experience to surface personalized recommendations based off insights from our data and their preferences,” Kurtzweil says.
The concept also extends to other aspects of the UnitedHealthcare digital platform, in an effort to unite all aspects of health care and create a more cohesive and integrated experience. At UnitedHealthcare, members have a single point of entry via the UnitedHealthcare app and myuhc.com to:
- Access primary, specialist, behavioral and on-demand care as well as vendors available to them via the UHC HubTM , which complement existing UnitedHealthcare solutions
- Earn and redeem dollars for completing healthy actions via UnitedHealthcare Rewards
- Pay claims using debit, credit or electronic bank transfer
- Access resources and other benefits offered by UnitedHealthcare, such as vision, dental, behavioral health and pharmacy benefits
“By logging into our UHC app or myuhc.com, we’ve made it easier for members to understand and utilize their health benefits,” says Samantha Baker, chief consumer officer for UnitedHealthcare Employer & Individual.
4. Personalizing care to a member’s unique needs
Navigating health care may be confusing, time consuming and stressful for employees and their family members. When employees connect with their carrier’s customer service representatives and receive difficult-to-understand, unhelpful or conflicting information, stress levels and frustration may rise.
In fact, 89% of consumers surveyed said they think contacting customer service should be easier and more convenient, while 77% of consumers said they like being communicated with in a proactive and personalized way.5
It’s critical to ensure that service representatives are equipped to handle the many different situations employees may be facing.
That’s why UnitedHealthcare Advocacy solutions are built to deliver personalized support. These solutions connect employees with compassionate, trained experts called Advocates who provide 1-on-1 guidance.
“We work to understand our members. We want to know the decisions that our members are about to make and the decisions that they don’t even know they need to make,” says Rebecca Madsen, chief executive officer of Advocacy for UnitedHealthcare Employer & Individual. “With real-time data, we may help steer to enable choices that may lead to the best health outcomes at the lowest costs.”
For employees with special needs or complex conditions in their families, these Advocates play a more active role. They serve as that employee or family’s single point of contact, providing emotional support and helping them navigate unique health care situations.
“Our insights power everything,” Kurtzweil says about the abilities of UnitedHealthcare member data. “Our Advocates may have a conversation about everything from a member’s gaps in care to social drivers of health risks and wellness rewards, which is all aimed at getting the best outcome for that member.”
5. Helping members navigate network changes
With news about hospital closures,6 primary care provider (PCP) shortages7 and nursing strikes,8 the disruption and changes that are occurring within provider networks are causing widespread concern.
“Employers have been concerned that they’re going to get hit with these significant unit cost increases,” says Kurtzweil. “The good news is that we’re seeing only slight increases in unit costs — not the anticipated crazy spikes.”
But in different pockets of the country, network issues loom larger than in others. Whether it’s a network that limits an employee’s choices or a directory that simply isn’t up to date or accurate, provider networks may be a source of frustration for employees as well.
1.7M+
physicians and health care professionals in UnitedHealthcare networks⁹
Actively working to boost the number of value-based providers, while also improving the accuracy of provider directories and network configurations to prevent issues like out-of-network charges — which may significantly inflate health care costs for unsuspecting employees — may be help reduce friction. By ensuring that provider information is up to date and accurately reflected, and by designing networks that balance cost and access, UnitedHealthcare helps employees avoid unexpected fees and promotes a more predictable health care spending environment.
At UnitedHealthcare, we recognize the frustration that may be experienced by members when the network they are in isn’t providing an optimal experience, which is why we are continually reevaluating our network strategies to ensure they are meeting the needs of employers and employees, and working with provider groups to ensure our provider directories are reflecting accurate information,” says Stephanie Alberti, vice president of commercial medical products for UnitedHealthcare Employer & Individual.
These efforts collectively demonstrate an end-to-end approach to making health care more affordable by addressing both the immediate and long-term financial impacts on employers and employees and helping them navigate the health system.
