Advocacy for Personalized Care

The Issue

A large client had historically used a variety of health care strategies to provide for the well-being of their employees. Three years ago, however, the HR department was reporting an increasing number of employees frustrated with their efforts navigating the complexities of the company’s benefit plan requirements, knowing the best providers for their medical issues and determining the best care treatment options.

Our Solution

Although the company had a fairly comprehensive employee benefit portfolio, the component that would help the most here was not a part of their package…a patient advocacy program. Advocacy provides employees and their families with a dedicated team of doctors, nurses and clinical specialists to help them maneuver through the health care system, providing needs based guidance, answering questions and helping to facilitate their care. A successful advocacy program will provide the help needed to prevent health events from ever becoming a crisis.

The Result

Employee usage of the program increased throughout the first year of the program and has continued to increase each year since. In addition to a difficult to measure savings from increased employee productivity, the advocates were able to correct three patient billing issues resulting in over $30,000 in savings to the employees affected. Finally, a decrease in claim utilization during the second year offset our client’s cost for the program and a third year savings in excess of $115,000 has been attributed to the program through a reduction in duplicate testing, unnecessary diagnostic procedures and wasted medications.