Setting the stage (and writing the script) for interconnectedness within benefits ecosystems

At Evive Health, we recognize the potential for the positive changes that can occur when benefits ecosystems are interconnected and integrated. Like Amazon, Evive uses purchasing data (such as healthcare claims, program enrollment data, program participation, customer service encounters, balances, and contributions, etc.) to predict what benefits an individual will likely need next. Then, like Google, Evive makes information about these benefits easy to find and access—including incorporating single sign-on capabilities so that users can access their account on a benefit vendor’s website with just one click.

Leading the field in interconnectedness, Evive Health (as of September 2016) is connected to 30 health plans, seven eligibility administrators, four dental/vision providers, seven pharmacy benefit managers, and 54 benefits service providers (FSA, HSA, employee discounts and 401(k) vendors, second opinion, wellness, telehealth, and disease management programs, among others). And new ones are being added daily.

Here’s just one illustration of how interconnectedness and prioritization pays off. Take, for example, an individual who sees a doctor for nonspecific back pain. Evive receives data from the health plan and first calculates a propensity score for back surgery. Following an imaging test (like an MRI) and the filling of a prescription medication (a claim from the pharmacy benefits manager), the score is refined and, in this example, exceeds the intervention threshold. In other words, the propensity model predicts that the person is headed down the path of surgery (known in this case to be an unnecessary or unproven form of treatment), and knows that it’s time to nudge the individual to consider a second opinion from an Expert Medical Opinion (EMO) service within their employer’s ecosystem.

By getting a prompt to seek a second opinion for back pain arriving at just the right time and in the preferred medium, the individual takes action and is able to schedule a consultation with a second-opinion service. With single sign-on, the individual’s information has already been passed onto the vendor, so the member does not have to create a new profile.

The result? An individual who took advantage of a second opinion benefit before getting a costly and potentially unhelpful treatment. Interconnectedness within the ecosystem helped one benefit supplement another at just the right time.

It’s time to prioritize ‘prioritization’: How interconnectedness improves benefits usage and value.

As an HR leader, you put considerable effort into selecting which benefits you offer your employees, and put just as much care into selecting the vendors that provide those benefits. The vendors you’ve chosen offer high quality services, but when they operate in a vacuum—that is, without linking to or communicating with the other vendors in your benefits ecosystem—employees could miss out on opportunities to engage with important benefits. Your team spends a lot of time coordinating vendors, creating communication campaigns, facilitating warm hand offs and referral workflows, yet the results are often sub-optimal. And when vendors act in their own self-interest, rather than working toward the greater goals of the company, to the employee, it sounds like noise from an uncoordinated orchestra.

The solution is not necessarily to add, remove, or change benefits or vendors themselves. Rather, focus on optimizing the benefits you currently offer in order to maximize their value. As health benefits and benefits ecosystems grow in complexity, the risk of lost savings opportunities grows, and the need to connect and prioritize them becomes crucial to realizing their worth.

Benefits vendors must be linked and integrated with one another. Then, recommendations can be prioritized and targeted across benefits for each individual. When this occurs, the employees who can benefit the most from a given service or product can get the right message, in the right way, at the right time.

Here’s what an interconnected benefits ecosystem looks like in action. Take the case of 35-year-old Donna. After a doctor’s visit confirming she is pregnant, she receives a recommendation to check out your company’s maternity program. After the pregnancy, when she adds her child to her health insurance, a recommendation about her life insurance benefit enrollment is triggered. Soon thereafter, she will begin seeing recommendations educating and reminding her about her child’s well-baby visit and vaccinations, and later, to let her know about free telemedicine resources, since, as a first time parent, she is more likely to use the ER than the average person.

A central “brain” that takes the whole employee picture into consideration and recommends the right benefit to each individual is key. Predictive analytics, big data, and behavioral science are key components in facilitating interconnectedness, and delivering measurable results.

What if your benefits “home” came with recommendations for every employee, similar to Amazon’s personalized recommendations, along with one-click ordering?

Is your benefits ecosystem interconnected? It should be (and what happens if it’s not).

Think about this: When is the last time you heard of a company offering all employment benefits from a single vendor? These days, it just doesn’t happen. Most companies, knowing how important benefits are to employees, provide multiple benefits offered by several different vendors. This is the benefits ecosystem. And in order to maximize gains, reduce waste, and make benefits as valuable as possible for employees, interconnectedness within the ecosystem is critical. 

Per recent Forrester research, 66 percent of employees interviewed said that benefits programs were a differentiating factor when deciding to join a given company. Further, the iCIMS Hire Expectations Institute found that 66 percent of people who are currently employed are open to new job opportunities with better salaries and benefits. If someone else’s benefits ecosystem is functioning better than yours, your organization could be at a hiring and retention disadvantage.

Benefits offerings at a given company can include everything from health, life, and disability insurance to retirement savings and transportation benefits to HRAs, telemedicine, transparency tools, employee wellness programs, child, elder, and even pet care—and more. In fact, most Fortune 500 companies have between 10 and 30 vendors providing these important services and products. 

When these vendors function as silos—when there is no real link or connection between them—at best, there are missed value opportunities, and at worst, there is the risk of confusion, redundancy, and wasted opportunities.

Without interconnectedness, benefits may go unnoticed or unused by employees who could use them most. Small missed opportunities add up to big losses in satisfaction and retention as people fail to see value provided by their employer.

A platform that can recommend specific benefits to specific employees, like the “customers like you also bought…” functionality seen on shopping sites like Amazon, can unlock this value by interconnecting the ecosystem and directing users with individualized prompts at highly specified moments in their lives. What do you think? Is your ecosystem interconnected?

 

 

[1] ″Employees Don't Know What Benefits They Are Missing, But Predictive Analytics Can Help″ Forrester Consulting, 2016.

[2] Braunsdorf, G. (2015, December 22). The Correlation Between Benefits and Employee Retention.