Employee benefit consultants act as trusted intermediaries between consumers (businesses and the employees they represent) and insurance companies, vendors, and providers. Anyone who’s ever selected a healthcare plan knows how complex insurance can be — benefit consultants do all of the research for their clients to help them choose a policy.
Consultants are especially attuned to the challenges employers are currently facing. Here are four obstacles benefit consultants report HR teams are grappling with right now (and how to solve them):
- Hiring. One big challenge in the wake of the COVID-19 pandemic for employer groups has been recruitment and retention. Instead of sourcing traditional telemedicine platforms that have low rates of utilization and don’t appeal to employees, the most innovative benefit consultants are suggesting new, integrated virtual primary care options as a way of appealing to existing and prospective employees.
- Benefits advocacy. When an insurance carrier takes unfair action against policyholders, HR teams often bear the brunt of that feedback. Consider the case of United Healthcare, who announced in June of 2021 that they would begin retroactively denying claims for emergency room visits they deemed nonurgent. Immediate criticism of the new policy came from patients, the American Hospital Association, and several other large hospital and doctors groups. United Healthcare ultimately decided to delay enforcing that policy.
“Patients are not medical experts and should not be expected to self-diagnose during what they believe is a medical emergency,” AHA wrote in its June 8 letter. “Threatening patients with a financial penalty for making the wrong decision could have a chilling effect on seeking emergency care. This is dangerous for patients’ health at any time, but is particularly unsafe in the midst of a public health emergency.”
While this is just one (extreme) example of the byzantine complexities of navigating health insurance claims, it’s clear that people (and HR teams) need access to expert resources who can help them navigate the ins and outs of healthcare navigation.
- Mental health support. According to the Centers for Disease Control and Prevention, as of June 2020, 13% of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19. Overdoses have also spiked since the onset of the pandemic.
The mental health toll of the pandemic is undeniable — and it’s one that employees may be grappling with in an ongoing capacity. Worldwide, many have struggled with the stress and anxiety of the initial lockdowns, the exacerbation of existing mental health issues, or grief associated with losing a loved one to COVID-19.
As employers look to find the best benefits for their employees, mental health support is a crucial integration that many telemedicine solutions currently lack, even when employees need those resources the most.
- Ongoing primary care. Many employers have a vested financial interest in reducing catastrophic claims — meaning they’re looking for ways to incorporate trusted preventative care into benefits packages that will reduce healthcare costs in the long-term. Consultants are considering ways to guide and treat employees with holistic care while avoiding unnecessary services and medical waste.
Why Consultants are Considering Virtual Primary Care Solutions Instead of Traditional Telemedicine Options
Given the challenges HR teams are facing today, employee benefit consultants are considering virtual, integrated care solutions that can serve as a primary care provider that solves for each challenge in a single point solution.
Eden Health is telemedicine, built to be better:
- 24/7 Primary Care
- Employees have access to a consistent team of providers, whether they engage virtually on the app or in-person at our medical offices
- Most diagnoses, treatments, and prescriptions can be addressed over the app
- We provide ongoing management for acute and chronic needs
- Healthcare Navigation
- Employee guidance on making the best use of selected health plans, thereby increasing engagement and delivering ROI to the employer
- Help navigating complex bills, claims, authorizations, and referrals
- Mental Health Support
- Virtual talk therapy integrated into employee care plans
- Depression and anxiety screening for all medical patients, whether or not they’re receiving one-on-one therapy with Eden
- Medication management
- Longitudinal Care
- Access to the same clinical Care Team that’s focused on cultivating long-term patient relationships, whether through the app or in-person
- A primary care component with complete knowledge of a patient’s medical history
- Continuity of care between primary care providers, specialists, and therapists
Learn more about how Eden’s collaborative care approach leads to higher engagement and lower overall costs.
