Inviting HR to the ‘personalization’ party

The consumer experience has changed dramatically in recent years. Thanks to online banking, waiting in line for a teller or physically depositing a check is a thing of the past. Ride share services are now the norm; the car finds you, rather than the other way around. And, depending on how hungry you are, you can track your pizza from the time they put it in the oven to the moment the delivery driver turns down your street.  

But it’s the emergence of a hyper-personalized experience that has made the biggest impact on today’s consumer. Online retailers recommend products based on your past purchases. Your internet browser knows what you’ve been looking for and serves up ads for those products. Media streaming services tell you what to watch or listen to next.

Today’s consumers expect brands to use data to engage with them on a more personal level than ever before. In fact, 72% of consumers say they only engage with personalized messaging, while 42% say they’re downright annoyed when marketing content isn’t personalized.

Why HR is late to the party

Certainly, there are many lessons to be taken from the marketing world. Not all apply to the HR professional, of course, mainly due to HIPAA requirements.

But, it’s important to note that employees are still a type of consumer—many of whom are disenchanted with the way their employer engages with them. A recent MetLife study of benefits trends found that only 37% of employees strongly believe their employers’ benefits communication is customized to address their personal situations

Failure to provide employees with a positive experience, including the one you deliver when it comes to their benefits, is an opportunity lost, says Citrix’s Customer Engagement Strategist and Researcher Chris Voce. “Ninety-five percent of employees reporting a positive experience with their company say they engage in activities that are beneficial to their organization but aren’t necessarily part of their job,” Voce notes. “That discretionary effort makes the difference between typical and extraordinary business results.”

It’s all about empathy

Consumer experiences and employee experiences share a lot in common, especially when you look at what’s happening psychologically. In both cases, a positive employee experience is the direct result of empathy. Like the marketer, an HR professional’s ability to create a positive employee experience is in direct correlation to their ability to see things from someone else’s perspective. A truly empathetic HR pro asks themselves questions like:

• What does this employee find valuable?
• How does this employee prefer to receive information?
• When will this employee need help taking action?

Perhaps your organization has already begun to adopt a more personalized and empathetic approach to benefits. For example, you may already provide your employees with access to a decision support tool during annual enrollment to help them build the most suitable benefits package. You may even proactively reach out to employees who have had a baby recently to remind them to add their child as a dependent.

Some employers are going the extra mile in delivering a more personalized and holistic benefits experience. In addition to facilitating personalized benefits selection and management, these HR pros are helping their employees take full advantage of their benefits when and where they need them, thereby supporting their overall health and well-being.

They’re doing this through a variety of technology-driven programs and resources that are highly personalized—the kind of personalization employers have come to expect in nearly every other consumer experience they encounter these days. In speaking with our clients, we’ve identified five opportunities for HR teams to level up the employee benefits experience that support both the individual’s overall well-being and the organization’s bottom line. Here are three of them.

Care Navigation

The U.S. health care system is not known for its simplicity. Since the 1990s, health care professionals—particularly those treating serious or chronic conditions—have recognized that health outcomes are often directly linked to the ability of patients to adequately navigate the complexities of the health care system.

In the years that followed, this resulted in an increased focus on primary care physicians as the central point of access for patients with complex needs—a natural development, since one of the key features of primary care is the coordination of that care.

Fast forward to today and many of these same strategies are now being used by third-party health care navigators (a.k.a., clinical advocates). Whether they’re a registered nurse or a highly trained layperson, care navigators’ responsibilities include:

• Helping patients find and access treatment.
• Maximizing employees’ understanding of their health care plans.
• Facilitating more effective use of available services to achieve better health outcomes.
• Coordinating individual patient care among multiple providers and services.

Helping your employees navigate the health care system is not only the right thing to do, it also makes good business sense. One study found that a group of layperson navigators yielded a 10-to-1 return on investment, with average costs for cancer patients receiving navigation declining by $781.29 per patient per quarter.

Another study sampled 28 employers and discovered a 17.6-to-1 return on investing in comprehensive care navigation based on the sustained lower-than-market per-member-per-year medical costs.

And, when it comes to care coordination for individuals with chronic conditions, employers have an opportunity to dramatically reduce their health care spend by more than $4,500 per patient per year.

Provider guidance

As pointed out above, patients see better health outcomes when they have help from someone who knows their benefits, knows the health care system and, perhaps most importantly, knows them and their unique health care needs. This is especially true for those with one or more chronic illnesses or those receiving temporary yet complex treatment.

But what about those employees and dependents who aren’t regular health care consumers? Perhaps they’re young and healthy. (According to the Kaiser Health Tracking Poll, 45% of millennials don’t even have a primary care physician.) Or maybe they’re part of the 80% of Americans who fail to seek routine preventive care each year because they’re simply too busy or are confused by the health care system.

Whatever their reasons, infrequent health care consumers run the risk of making less-than-optimal decisions when they eventually find themselves in the position of needing care. And, this can be expensive. In fact, the Agency for Healthcare Research and Quality estimates that 13% to 27% of emergency room visits in the U.S. could be managed in physician offices, clinics and urgent care centers, saving $4.4 billion annually.

To ensure their employees receive the right care from the right provider, more employers are turning to services that help their employees find, evaluate and book appointments with high-value providers in their network and geographical location. Today’s self-service technologies, many of which are accompanied by optional high-touch service centers, can help employees:

• Identify in-network providers.
• Schedule one-time and recurring appointments.
• Locate urgent care centers.
• Find high quality hospitals for inpatient care.
• Maximize appropriate use of primary care for common health needs.
• Recommend highly experienced outpatient surgery centers.

Claims support

According to a study by the American Medical Association, inaccurate health care claims waste $17 billion annually in administrative inefficiencies. Another study found that administrative tasks associated with avoidable errors, inefficiency and waste in the medical claims process resulted in an average administrative burden of $2.36 per claim — a cost often borne by patients and their employer-sponsored health plan.

While insurance carriers have made headway in reducing error rates, the employee experience with health care claims continues to be compromised by several factors, including:

• Surprise billing. A 2019 survey found that 44% of Americans have received a surprise out-of-network bill.
• Denials. With initial claim denial rates hovering around 9%, employees are spending a lot of time—often on the clock—talking to their provider, insurer or HR team to sort out why their claim was denied.
• Decreased benefits literacy. In the months that followed the spread of COVID-19, nearly 40% of employees reported high levels of confusion about their health benefits—an increase of 25+% over pre-pandemic levels.

Like care navigators, claims support representatives (i.e., advocates) can greatly improve the employee experience. Unlike care navigators, however, these highly trained professionals focus more on the financial side of receiving care. Today’s claims support services do this by:

Analyzing billing documents to uncover coding errors or troubleshoot issues related to network status

• Helping employees through the manual claims filing process when necessary (e.g., for out-of-network services).
• Working with providers and health plans to proactively address common claims filing errors.
• Establishing relationships with providers and health plans for expedited claims resolution, including reimbursements.
• Helping employees work with third-party entities, such as disability and workers’ compensation carriers.

To learn more about care navigation, provider guidance, claims support and two other opportunities for leveling up employee engagement, read The Case for a Personalized Employee Benefits Experience.