Healthcare isn’t exactly known for its high-touch customer service. Getting in and out of the doctor’s office or the hospital in a reasonable amount of time is about as much as most people ask for, and even that can be a challenge. When you need to coordinate multiple physicians and specialists, the process becomes even more daunting.
Healthcare navigation is so daunting, an Aflac study found 26 percent of Millennials would rather clean their toilet than research health benefits. But the landscape is changing. Patient advocacy is increasing and people are starting to consider themselves consumers of healthcare products. That means they require a higher level of service and more communication.
That’s where care coordination and navigation comes in. Care coordination is fast becoming an essential component to many healthcare plans. The care coordination model keeps stakeholders informed and ensures the delivery of the best possible care for the patient. More specifically, all healthcare providers working with a particular patient share important clinical information and have clear, shared expectations about their roles.
Care coordination unplugs the traditional call center and replaces it with healthcare warriors and personal advocates. All calls route through them so members get the best service every time. Think of care coordination as the highest level of healthcare customer service, even exceeding some of the five-star standards set in the hospitality industry.
PROACTIVE CARE
If you’ve ever stayed at a high-end hotel, you know what the highest levels of customer service feel like. Staff seem to anticipate your every need and you get what you’re looking for without having to ask for it. That’s what care coordination is like.
Care coordination differs greatly from the traditional call center model favored by many insurers. Rather than approaching care in a reactive way, care coordinators work proactively to make people feel cared for. Care coordinators personally guide members, cutting through the complexity that causes confusion and drives up costs. These highly trained professionals resolve issues and help employees make better use of their benefits, limiting unnecessary medical events and associated costs along the way.
Imagine every member of your health insurance plan having someone to call to:
Discuss claims
Get referrals
Ask about prescriptions
Make treatment decisions based on estimated costs
Quote benefits
Advocate for claims resolution
Learn about wellness incentives
Ask about lifestyle programs
Care coordination is about rethinking the member experience and meeting members when and where they need help, making healthcare more efficient. By providing dedicated, trained care coordinators, members experience a white-glove approach to all of their healthcare needs.
CARE COORDINATOR: YOUR HEALTHCARE CONCIERGE
After you’ve had a pleasant vacation or hotel stay, you probably remember that one staff member who went out of his or her way to make your trip extra special. Maybe a concierge guided you to a hidden attraction or secured a seemingly impossible restaurant reservation.
Care coordinators act in much the same way by helping facilitate patient care and reducing stress and anxiety. Care coordinators provide a trusted and knowledgeable resource to guide participants through the often confusing process of getting the best healthcare services. These “healthcare warriors” act with the member in mind and produce savings one conversation and experience at a time.
Team of doctors working on laptop in medical officeCoordinators can answer questions about benefits, claims and healthcare services, and proactively connect plan participants with the best practitioners. For example, if a patient breaks a leg and needs to see an orthopedic doctor, the care coordinator can help track down the closest doctor who has the best track record and reputation, and who will be the best fiscal choice for the consumer. The care coordinator can also make sure any x-rays or MRIs are delivered to the doctor to avoid duplicate, costly and often painful tests.
Throughout the care process, coordinators proactively intercept redundant, delayed or questionable treatment to help plan participants, their families, and their physicians work together to ensure proper care and improve employee wellness. In time, care coordinators increase efficiency and reduce costs for plan participants and providers.
FIVE-STAR SERVICE AT A REDUCED COST
We all know the old adage “You get what you pay for.” Nowhere could that be more true than the hospitality industry. To stay at the finest hotels and receive the finest service, you need to pay for the privilege.
That’s where care coordination sets itself apart. You get the highest levels of service and reduce your healthcare costs.
Care coordination allows HR professionals to take back control of healthcare spending. Coordination reduces healthcare spending by making the care delivery process more efficient and actively helping members become healthier over time.
In fact, care coordination reduces wasteful spending and can cut healthcare costs by between 7 and 8 percent in the first year, and up to 20 percent by year three, without cutting benefits. Care coordinators facilitate this savings by intercepting treatment and claims in real-time and eliminating any redundant or unnecessary services.
If you recognize a lack of service in your current healthcare program, it might be time to consider working with a program provider that can deliver care coordination. Apta Health empowers employers to get the most out of their health benefit plans. Our extraordinary program combines the best solutions in the industry with cutting-edge technology to reduce wasteful spending and drastically bend the trend of rising healthcare costs.
Care coordination and navigation is at the heart of this program. Through care coordination we prioritize independence, transparency and expertise. Contact us to discuss how to proactively manage your group health plan and reduce wasteful spending.
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