Updated: Aug 16, 2022
Recently, I had the privilege to volunteer with the COVID-19 vaccine team at a federally qualified health center (FQHC). The moment I walked through the door, I felt valued and comfortable. It was airy, with a lot of light, and calming wall colors. My initial thought was that anyone who walks through these doors will be confident that the health care team at this facility cared about their well-being. As the day progressed, only a handful of those who passed by our booth spoke English as their first language. However, it was exciting to see that the facility was prepared to serve its diverse community. Most members of the care team were bilingual; they spoke the primary languages of those receiving care. Every time a nurse would come out to the waiting room to get a patient, they spoke in the patient’s primary language.
It dawned on me that the FQHC had taken steps to make sure that their patients felt safe and comfortable during their interactions with healthcare professionals here. This experience brings to life how I define humanizing healthcare. It’s taking the time to understand who the patient is, what their needs are, and what will make them feel comfortable and heard. Often, it has nothing to do with the actual medicine being given. For this FQHC, it involved recording primary languages spoken by patients in their EHR, hiring for those languages, and then matching those patients with healthcare staff at the time of their appointment. In my view, these are necessary steps to humanizing the way we deliver care.
This is all well and good for a team that sees patients every day, but for a healthcare actuary, how can we humanize healthcare? Is it about understanding the needs of those we’re designing benefits for? Do the needs go beyond the standard clinical issues and take into consideration their experience with the healthcare delivery system? Actuaries and other healthcare professionals have the special position to incentivize behavior through network, benefit designs, etc. For example, can a health carrier serving a community of hourly workers working 60+ hours per week incentivize providers in that community to be open during nonbusiness hours? This type of creative thinking further humanizes healthcare.
How are Actuaries and Human Resources consultants taking steps to humanize healthcare?
Benefits managers and Human Resource teams are not only responsible for making sure their benefit offerings are compliant; they are also tasked with providing a benefits package that supports the overall wellbeing of current employees and that attracts diverse talent. Consultants have helped their clients achieve this by:
1. Utilizing personas when designing a benefits program
Creating personas based on employee demographics can lead to more informed decisions when designing a benefits program. Rather than viewing the members of a plan as a single employee population, consultants and benefit managers may group the population into categories such as mid-career level employees, members approaching retirement, and soon-to-be parents. When these characteristics are considered and the most prominent personas are identified, it is easier to answer the question of what employees value most out of a benefits program. Mid-career level employees interested in updating their skills may appreciate a tuition reimbursement program while members approaching retirement could be more focused on maxing out their 401(k). Soon-to-be parents would be more likely to utilize parental leave, dependent care support, or lactation counseling. Taking the time to understand the needs of employees and incorporating them into the overall benefits strategy results in more satisfied employees and higher retention rates.
2. Incorporating clinical case management into cost-mitigating strategy
Designing a cost-effective benefits strategy is top priority for most employers. By working with carriers to understand the most prominent conditions that their employees are facing and identify opportunities to help them manage these conditions, employers can help members live healthier lives while also reducing morbidity rates and cost. In many cases, investing in vendor partnerships and implementing point solutions to support the wellbeing of the employee population can reduce the costs associated with high-cost clinical conditions and prevent future cases. For example, if a medical carrier’s annual review notes an uptick in behavioral health related claims, a strategic consideration could be to implement a mental health vendor that offers a program that intends to reduce the rates of depression and anxiety. Actuaries and HR consultants support the benefits team by reviewing the value propositions set forth by vendor partners to conduct a cost-benefit analysis and determining the cost-savings from reducing the prevalence of clinical conditions.
3. Providing an alternative perspective in a room full of decision makers
As consultants, it is our responsibility to provide recommendations based on trends in the marketplace and learned experiences from our clients. When it comes to making critical decisions for a company's benefits strategy, employers rely on consultants' expertise to guide them in the right direction. Traditionally, benefit programs often consist of access to health insurance, retirement planning support and paid time off. Companies hire consultants to provide a fresh point of view on their offerings and help modernize their benefits to remain competitive when trying to attract and retain top talent. By embracing this concept, consultants should feel empowered to make suggestions that challenge the status quo and put the employees' wellbeing at the forefront of the benefits strategy. Consultants should be prepared to ask how decisions will impact the overall employee experience and remind their clients to consider how experiences may differ based on demographic characteristics, whether they be race, ethnicity, gender, socioeconomic status, or other identifiers that may impact how they employees utilize or value benefits.
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