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HEALTHCARE cost of care. It wasn’t until recently that the industry began an equally concerted effort to focus on enhancing the customer experience. Today more payers are beginning to track Net Promoter Scores (NPS), a nationally recognized client loyalty metric. An NPS can range from a low of negative 100 to a high of positive 100. A score above zero is considered favorable and a score above 50 is outstanding. Many Fortune 100 companies—including Amazon, Apple and Verizon—use NPS to track customer satisfaction and benchmark year-overyear progress. In addition to member surveys, payers use NPS surveys to gain valuable insights from their large group employer clients on what they’re doing right and identify areas to improve. This allows them to pivot quicker than ever before when course correction is necessary, based on real-time customer data. Some health plans take a more personalized approach to gathering feedback from their clients through focus groups and special committees. These types of forums allow for honest, candid feedback on how key audiences perceive value and convenience, as well as provide an insider view of the client experience. Brokers should ask payers if they track NPS and learn more about what they are doing to listen to the voice of their large group clients. THE INTEGRATION OF CARE AND COVERAGE The industry continues to see more health plans and providers partnering together to integrate important aspects of care and coverage. In particular, providers see the value of owning and operating their own provider-sponsored health plans. These value-based payment models put health care decision making with providers and their patients—not the payers. This model encourages the provider system to invest in new care processes and access models tailored to meet the unique needs of each individual. This level of accountability encourages collaboration, coordination and innovation across the provider system. These models may also directly benefit the member. When the administra22 | CALIFORNIA BROKER

tive functions of a health plan are combined with the care delivery of a health care system, members are likely to get a more seamless approach to care. Many times, they can even contact a single member services center to get help with everything from scheduling provider appointments to understanding benefit plans to paying bills. Brokers are continually tasked by large group employers to find new ways to deliver more value to their employees. Adding a provider-sponsored health plan to their large group offerings can serve this purpose well. DIGITAL ADVANCES IN CUSTOMER SERVICE Consumers today want digital connectivity and convenience in health care— just as they have come to expect it in travel, retail and entertainment. Many payers offer large group employers online self-service portals to view and export employee rosters, plan documents, correspondence and premium bills. Members typically have access to online portals to view health plan accumulators, print ID cards, pay bills and view benefit documents and correspondence. Many providers also offer patient portals to email care teams, schedule appointments, request prescription renewals and see test results. When providers and payers make it easier to access and manage health care, patients may be more likely to take advantage of preventive and routine care, and proactively manage their health. We are also seeing providers use digital apps to take customer service to the next level and differentiate themselves in the marketplace. For example, Sutter Health is piloting a transportation program in select areas with rideshare companies such as Lyft to assist patients in traveling home from their appointments. The integration of a digital platform supporting the very real human need of accessing care is costeffective and helps alleviate patients’ health concerns that may be amplified by delayed or missed appointments. A CHANGING WORKFORCE Millennials remain the largest generation segment in the workplace. Employers have to change the traditional way they attract and retain quality tal- CalBrokerMag.com -

ent from this pool—even in how they communicate with employees. More employers are embracing social media and text messaging as effective communications vehicles. Many millennials are drawn to the lower monthly premiums available with high-deductible health plans (HDHPs) that are compatible with health savings accounts (HSAs). And with HSAs, individuals “own” the account so if they end up changing jobs (which millennials often do) in many instances they can take the account with them. IMPROVING ACCESS TO CARE Another trend in the marketplace is the focus on the retail clinic model— not all health care needs to take place in a physician’s office or during regular business hours. As an alternative to the traditional provider office, retail clinics offer a convenient access point for consumers who need care that can be managed by a nurse practitioner or physician assistant. This may include seeking treatment for common illnesses such as the flu or ear infections. Retail clinics may offer extended hours and shorter wait times in modern, comfortable settings. And retail clinics may provide a more cost-effective setting than emergency rooms or urgent care centers, which may help lower the overall cost of care for the employee. Large group employers continue to expect their brokers to quickly understand and explain any changes on the horizon that will affect their business. They need timely, relevant information to navigate the ever-changing health care industry and marketplace. Brokers who keep these sophisticated buyers up-to-date on emerging—and sustaining—trends and offer practical solutions will stand out above the competition. H Rob Carnaroli is VP of sales, Sutter Health Plus. His work with a wide range of employers includes Fortune 500 companies, school districts, municipalities, retirees, unions and private health care exchanges. His most recent experience includes building and growing Sutter Health Plus from a start-up organization to a successful health plan in Northern California. MARCH 2018

California Broker March 2018  

California Broker March 2018 edition

California Broker March 2018  

California Broker March 2018 edition