Apps Can Help Employees with Health Care

Employees want their employers to provide digital health apps that help them get full value from their health and wellness benefits, a new survey reveals. Meanwhile, proposed regulations would require employers to make a cost-transparency tool available to health plan participants, although questions remain about how practical price-revealing apps are or can be.

There's an App for That

Nearly half of U.S. workers (48 percent) surveyed said they would have more confidence in digital health tools, such as apps to locate a doctor, if they were offered by their employer. Twenty-six percent said they would be more likely to stay with an employer that offered digital health tools.

These findings are from the inaugural Health on Demand survey by HR consultancy Mercer and management consultancy Oliver Wyman, which surveyed workers and employers in August 2019 and analyzed responses from more than 2,000 employees and 100 employers in the U.S.

The wider the range of health and well-being resources an employer offers—from insurance coverage to subsidized nutrition or exercise programs—the more likely workers are to feel supported and energized, and the less likely they are to leave their employer, the survey showed.

Among U.S. workers who are offered 10 or more health and well-being benefits, 68 percent believe their employer cares about them, compared to just 44 percent of those offered five or fewer.

Most U.S. workers polled said they would most value an app that "helps find the right doctor or medical care when and where needed."

"Employers looking to build a workplace culture of well-being and to improve talent retention should consider digital health investments," said Hervé Balzano, Mercer's president for health.

Source: Mercer's Health on Demand survey.

More than 7 in 10 benefit decision-makers at U.S. companies believe digital health solutions can improve staff energy levels, and 4 out of 10 believe they can help them retain staff.

Reminding Employees to File Claims

Another way technology is helping employees make the most of their health benefits is claim integration, a process by which insurance companies use medical data or other information to identify when employees don't make a claim they are entitled to file on services received, and then notify them about their ability to file a claim for these services.

Mona Zielke, senior vice president of employee benefits claims and operations at Voya Financial, a provider of life insurance and supplemental insurance products, gave these examples:

• "A customer taking maternity leave filed a short-term disability claim. We realized she also had a hospital indemnity product. We notified her, she submitted a hospital claim, and we paid her an additional $1,300 in benefits."
  

• "A customer had a snowmobile accident and filed a short-term disability claim. We paid it and notified him that he had accident coverage. He submitted an accident claim, and we paid him another $2,795."

Tim O'Connor, director of partner integration at Voya, explained, "If we can leverage technology to help people get the benefits of the coverage they've paid for and enrolled in, then that … offers huge value to the employer."

Zielke added, "They're paying for this coverage. It's important that they understand what it is they've purchased."

Preparing for the Price-Transparency Rule

A proposed regulation published last November by the departments of Labor, Treasury, and Health and Human Services would require employer-sponsored group health plans to provide plan enrollees with estimates of their out-of-pocket expenses for services from different health care providers. Plans would make this information available through an online self-service tool so enrollees could shop and compare costs for services before receiving care.

The Transparency in Coverage proposed rule aims to make employees fully aware of their insurance carrier's negotiated prices before they receive care, allowing consumers to compare provider costs, the agencies explained. This, in turn, could promote more competition in the health care industry, pushing prices lower.

"This rule would finally put an end to the secret pricing in health care and create a fair marketplace for consumers," said Mark Galvin, president and CEO of MMS Analytics Inc., which markets MyMedicalShopper, a tool that analyzes claims data to help employers identify health care savings opportunities. Using data for this or similar apps, employers can build targeted campaigns to encourage employees to consider costs when selecting health providers and services.

Critics of the proposal say that the limits of existing technology and the complexity of health care pricing would make it difficult to deliver on the promise of health care transparency.

"The proposed rules would [require] individually tailored cost estimates prior to the receipt of services," noted Susan Nash, a partner at law firm Winston & Strawn in Chicago. While transparency in health care pricing is generally welcomed by employers, she observed, "employers may balk at the cost of preparing the online or mobile app-based cost-estimator tools or purchasing such tools from vendors."

Because much of the information required to be disclosed is specific to the participant and the health plan in which the participant is enrolled, the disclosures "will require greater coordination among employers and third-party administrators, pharmacy benefit managers, [and] disease management, behavioral health, utilization review and other specialty vendors and will require amendments to existing agreements," Nash explained.

In written comments on the proposal, Ilyse Schuman, senior vice president of health policy at the American Benefits Council, an employers group, supported "taking steps intended to increase price transparency in order to reduce health care costs" but encouraged the federal agencies that issued the proposal to consider the increased obligations it would impose on employer plans.

"Notwithstanding its benefits, the cost-sharing estimate tool ... will impose substantial burdens on plans," Schuman wrote. She encouraged the federal agencies to "develop rules that would require increased pre-service disclosures by [health care] providers to participants of the services," and called for "increased transparency… with respect to a plan's and employer's access to and use of the plan's own pricing data, including claims data and provider-specific negotiated rates" to make pricing information available to employees.

"The council is deeply concerned that even with good-faith efforts, plans may be unable to obtain some of the information needed to complete the required disclosures," Schuman stated, and she urged that final regulations include a safe harbor to address this issue.

Lin Grensing-Pophal, a freelance writer in Chippewa Falls, Wis., contributed to this article.

Related SHRM Articles:

Proposed Rule Would Require Health Plans to Disclose Out-of-Pocket Costs by Providers, SHRM Online, November 2019

Is There a Future for Price Transparency in Health Care?, SHRM Online, November 2019

Wellness Platforms Provide Flexibility, Raise Data-Privacy Concerns, SHRM Online, July 2019

Amazon Alexa Now Helps Employees Manage Health Care, SHRM Online, May 2019