Integrating preventative care into your post-COVID benefits experience

The COVID pandemic has made the importance of preventative wellness too clear both in terms of health and economics.

People with poor overall health risk suboptimal outcomes if infected — and higher costs down the road. And it’s not just COVID that attacks chronic, underlying, and undiagnosed medical conditions; from heart disease and diabetes to untreated mental illnesses, a lack of timely preventative care can increase the likelihood of more serious problems over time. Today, as self-funded employers seek to soar controlled health expenditure in a post-COVID world, ensuring their employees can access the right benefits at the right time is essential.

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Effective preventive care begins with an understanding of what is needed, when. For a busy employee, the first signs of a developing problem can be easy to miss or ignore. For employers, however, data captured in consumer-focused health plans such as FSAs, HSAs, and HRAs can provide a 360-degree view of an individual’s health. Complemented by the information available to them as payers, this helps guide the individual towards more effective care. For example, an employee living with diabetes can be offered help connecting with the right healthcare providers and specialists, the right benefits plan to cover their insulin costs, programs to improve their diet and fitness, and other resources. Driven to take a more proactive approach to managing their condition, the employee can improve their overall well-being and potentially avoid costly complications and co-morbidities.

To take this approach, however, self-funded employers will need to reassess the systems through which their CDH plans are delivered. Today, these systems are typically siled and disjointed, with multiple providers connected only through a webpage without the back-end data exchange or cohesive front-end experience necessary for a truly 360-degree approach to wellness. Employees struggle to use their consumer-focused benefits, so they are less likely to use them, forgoing the ability to access services and resources that can improve their physical and mental health. To deliver a better benefits experience, self-funded employers need a more interconnected benefits stack, and CDH providers need a way to deliver it.

Take an API-centric approach to benefits
Traditionally, CDH plans have been thought of and created as standalone products, rather than parts of a larger ecosystem. For employees, this means a different sign-in and user experience for each of these plans, making it difficult to fully understand their benefits or use them effectively – for example, directing funds from an HSA to pay for health insurance. . -Payment. The health plans and third-party administrators (TPAs) that bundle and deliver these benefits to employers would like nothing better than to remove this friction, but the difficulty of creating and maintaining integrations between systems makes this impractical.

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To enable real-time data exchange on the back-end and a seamless experience for employees on the front-end, CDH vendors need to move from traditional monolithic development to a modern, API-centric approach where the products are designed to be easily integrated. with each other. Just as the API mindset has transformed software development across industries, from e-commerce to travel to telecommunications over the past decade, an API-centric approach to CDH systems will enable vendors to health plans and TPAs ​​to easily assemble benefits into any stack an employer wants, integrated from the user interface to the back-end.

For TPA, API-driven development means being able to offer a unified platform and user experience rather than a portal to disparate and disjointed systems. For employers, the seamless two-way data exchange between CDH plans enables the 360-degree visibility and information needed to understand employees’ preventative health needs, guide them to the right resources, and reduce overall costs. And for employees, a better experience enables access to the right benefits at the right time to improve well-being and quality of life.

Today’s benefits can help employees manage their wellbeing more successfully while reducing out-of-pocket expenses, but only if they’re delivered in a way that’s easy to understand, navigate, and use. In the same way, a better integrated and more flexible benefits stack can help employees achieve a healthier workforce while reining in rampant healthcare costs. An API-driven approach to CDH plan software development will enable the modern benefits experience we need for the post-COVID world.


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Richard V. Johnson