hr benefits mgrs guide to patient advocates
TRANSCRIPT
Human Resource
Professional’s Guide to
Independent Patient
Advocates
January 2016 © by MedSavvy Health Advocates LLC 2015
Michele Hanley, BS, MPA
MedSavvy Health Advocates LLC
1
Medical Costs
Employer Cont.
Employee out of pocket
Employee Contribution
59%
25%
16%
© by MedSavvy Health Advocates LLC 2015 3 January 2016
The healthcare and insurance industry answer:
More Services ** Fewer Primary Care Docs **
** Less time/patient ** New Treatments
** Confusing Technology ** More Drugs **
** Less Communication ** Insurance Choices
** Electronic Medical Records ** More Specialists
Too many CHOICES and Confusing DECISIONS!
Tool & Info
Overload
© by MedSavvy Health Advocates LLC 2015 4 January 2016
Information + Tools Knowledge
© by MedSavvy Health Advocates LLC 2015
•86% of a representative sample of 24-65 year olds with
healthcare insurance DID NOT understand traditional health
insurance concepts — deductible, copay, co-insurance and
out-of-pocket maximum
• 89% of people were NOT able to compute the cost of a four day
hospital stay when given the information that should have
enabled them to do so.
-Journal of Health Economics, Volume 32, Issue 5, September 2013, Pages 850–862
5 January 2016
Human Resource Efforts
© by MedSavvy Health Advocates LLC 2015
•Employee assistance programs
•Wellness programs
•Flex time and flex accounts
•Health savings accounts
Great innovations but ………………
illnesses still occur, accidents and trauma still happen, many
families facing almost insurmountable medical bills.
And all these can lead to employees missing work, being
distracted, quitting to care for family members, declaring
bankruptcy.
6 January 2016
Traditional Help
We have relied on:
Family and friends
Emotional baggage, family dynamics,
Limited knowledge of healthcare industry
Employed patient reps and nurse navigators
Mixed loyalties (who pays them?)
Limited service range
© by MedSavvy Health Advocates LLC 2015 7 January 2016
A Better Solution -
Independent Patient Advocate
Someone who:
Supports and promotes patient’s rights.
Guides and helps them navigate the
healthcare system.
Ensures a patient’s voice is heard and respected.
Guarantees patients get the care they need
Resolves conflicts
Works synergistically with your current program
© by MedSavvy Health Advocates LLC 2015 8 January 2016
Services Might Include
Care coordination and navigation
Accompanying to appointments
Liaison between patient and doctor or other provider
Diagnosis and treatment option research and explanations
Coordinating medical records and medications
Help preparing advanced directives
Auditing bills and negotiating denied claims
Help in choosing best insurance coverage
…………and much more……………………
© by MedSavvy Health Advocates LLC 2015 9 January 2016
Employer Benefits
Presenteeism and productivity
Negotiating power with insurer
Recruiting and retention of valuable employees
Absenteeism
Turnover
Denied medical claims
Confidentiality liability
Cost
Bottom Line = Better Business
© by MedSavvy Health Advocates LLC 2015 10 January 2016
Employee Benefits
© by MedSavvy Health Advocates LLC 2015
Personal responsibility
Problem resolution
Understanding and knowledge
Quicker return to full attention and attendance
Out–of-pocket costs
Stress and distraction
Bottom Line = Peace of mind
11 January 2016
Website: www.medsavvyhealthadvocates.com
Blog: Better Savvy Than Sorry
(719) 481-6440
Michele Hanley, BS, MPA
Contact me today to find out
how we can help your business
decrease medical costs and
increase employee loyalty and
productivity.
© by MedSavvy Health Advocates LLC 2015 12 January 2016