Value-based care is quite a common term used amongst healthcare providers and members. However, it is rarely used by health plans and benefits managers.
Off late, benefits managers and health plans have been trying to understand better the correlation between employee health and wellness, and business productivity. With COVID-19 impacting businesses and the economy, employee wellbeing has become a priority for employers, and health benefits are being given more preference.
A recent 2020 survey conducted by the Business Group On Health reported that almost 45% of the employers, up from the 36% in 2019, were now considering investing in employee health and wellness, making it an integral part of their workplace strategies.
On the same lines, a 2020 Mercer study also projected a probable increase in the costs of health benefits in 2021, despite which, employers are still committed to offering the right employee benefits at the workplace.
COVID-19 has made employers realize the importance of employee health, social wellness, and financial wellbeing. And so, now is the right time to redefine the value of health care and wellness benefits.
What Is Value-Based Healthcare?
Value-based care is no strange concept in the healthcare sections. The Institute of Healthcare Improvement (IHI) has researched and put across a Triple Aim Initiative and a Quadruple Aim Initiative to improve the quality of healthcare initiatives in America. The primary objectives of the Quadruple Aim Initiative are –
- Improving Population Health
- Enhancing Healthcare Experience
- Reducing the Per-Capita Costs
- Boosting Staff Satisfaction
Aim 1: Improving Population Health
Every business is different, and so will be its employees, their demographics, and health and wellbeing needs. The one-size-fits-all strategy might not work out well when it comes to healthcare solutions. To be effective, health plan solutions must be able to cater to the specific health and wellbeing requirements of the worker’s population to provide tailored healthcare programs to address their clinical and non-clinical wellness demands. Although offering benefits programs that focus on specific health conditions like diabetes and heart disorders are good to start with, implementing programs that throw the spotlight on holistic wellness can help employees with their specific health and wellbeing needs. Also, this analysis must include diagnoses, clinical data, and socioeconomic factors to reduce healthcare costs and analyze outcomes.
Aim 2: Enhancing Healthcare Experience
A new study by Voya Financial, Inc., reported that this year, almost 71% of the American employees were looking to scrutinize their health benefits options, and more than 50% are expected to make changes to their existing coverage plans. The key objective of making these changes is to derive better healthcare services and satisfaction. Most employees look for smooth transactions with their healthcare plans and benefits. Be it their pharmacy benefits or in-patient care, they need frictionless processes. Also, employees who suffer from chronic health disorders may need personalized care and attention through their treatment. And so, benefits managers must consider customizable and high-quality services that reduce the financial risk for the employees, and also offer a better healthcare experience.
Aim 3: Reducing the Per-Capita Costs
With suitable clinical decisions driving the health benefits plans and coverage choices, employees can receive the right support to improve their healthcare services and get better outcomes. This, in turn, leads to reduced per capita healthcare costs, for the employer and employee. So, benefits managers must seek solutions that promise cost savings, along with keeping up with the trends. A true value-based model also becomes the essence for pay-for-performance models, which can also align with the outcomes of the employer or employee with that of the health benefit vendor’s income. And so, it is imperative that benefits managers and providers adopt a clinical, service-oriented approach that can add value, improve health outcomes, and ultimately reduce the total healthcare costs.
Aim 4: Boosting Staff Satisfaction
The last objective, more often considered the unofficial aim, focuses on engaging and satisfying the healthcare providers. Engaged and satisfied health care providers are more likely to make better decisions, driving more positive outcomes. On the other hand, unhappy staff or burnout issues can impact the value and performance. Supported benefits managers can also care for and guide their team well. So, benefits managers and providers need to look for solutions that not only focus on the holistic healthcare of their clients, but also of their own staff and organization.
With the COVID-19 outbreak and its impact on employee health and wellbeing, benefits managers are looking for more ways to support their members through these uncertain times. The pandemic has shown why it is important for the health plans and benefits managers to assess employee health with more than just simple initial diagnoses. To add value to the healthcare solutions and wellbeing programs, benefits managers must ensure that employers focus on the holistic wellbeing of the employees that can rise to their specific health needs.