How hub and advocacy solutions work together to help employers

Across the benefits landscape, many vendors make it increasingly difficult for employers to evaluate, select and manage the right benefits solutions. According to a major survey of large employers, 43% of companies say there are too many health benefits solutions on the market — up substantially by 26% from the year before.¹

And for employees, the environment can seem even more overwhelming: The U.S. healthcare industry is so complex that adults spend the equivalent of an entire 8-hour workday every month coordinating care for themselves and their loved ones, according to a recent Harris Poll survey.² A better solution is desperately needed.

The employer’s perspective

To create a benefits ecosystem filled with targeted solutions, employers should consider a hub approach that offers a curated network of vendor solutions and tailored guidance around which solutions will be most meaningful for their employees.

A hub solution focuses on vendors that make sense for a company and its employees by reviewing the marketplace, assessing efficacy and identifying leading vendors across a wide array of benefits, from diabetes management and cancer care to women’s health and nutrition. It also helps secure competitive pricing, features a single contract with simple invoicing and conducts ongoing performance analyses to ensure that vendor partners continue meeting the employers’ needs.

The employee’s perspective

However, even the most optimized benefits package with products uniquely tailored for a company’s employee population will not be effective if employees do not use the benefits — whether they have difficulty accessing them, fear the associated costs or do not know how to navigate the options. According to recent data from the Kaiser Family Foundation, 1 in 4 adults have skipped or postponed necessary healthcare in the past 12 months.³

To ensure that members get the most out of their employee benefits, which leads to better health outcomes and lower costs, a patient-centered advocacy solution becomes critical. An employer-sponsored advocacy program that offers 24/7, proactive support can assist employees in accessing the right care at the right time and the right place.

An optimal advocacy solution also takes a whole-person approach, addressing an individual’s unique physical, behavioral and financial needs while placing a deep focus on prevention and authentic engagement. These solutions recognize that a person’s health is far more than the sum of their medical record.

In fact, non-medical factors such as education, socioeconomic status, housing, employment and social support networks — factors that are often referred to as social determinants of health — have a greater influence on health than either genetic factors or access to healthcare services.^4,5 As such, a personal approach that takes into account all of these considerations is critical to connecting individuals with the right support and interventions.

The following case study offers a closer look at what constitutes a robust advocacy program and how the right approach can ensure that a particular benefit meets the needs of employees.

Learning to live with a rare diagnosis: Andrea’s story

Andrea needed help determining a path forward after finding out she had a very rare lung disease. She had already spent weeks feeling ill and visiting multiple doctors before a specialist finally made the correct diagnosis and referred Andrea to a holistic support program.

Frustrated, exhausted and wondering if she would ever feel better, Andrea called and spoke to a nurse advisor. Hule, the nurse, spent 30 minutes on the phone listening to her story and the deep physical, financial and mental toll the illness had taken. It was clear that Andrea’s difficulty breathing and fatigue were keeping her from working and severely impacting her quality of life.

Hule immediately connected Andrea with a Optum Care Guide who helped her manage claims and a nurse who offered support for managing her symptoms, medication and pain and stress. Over the next 6 months, Andrea’s health stabilized and she was able to return to work on a part-time basis, with newfound knowledge and skills for managing stress that improved other areas of her life.

Many employees will face a serious health diagnosis, whether an acute illness like Andrea’s or a chronic condition such as diabetes or heart disease. Those suffering from chronic conditions are more likely to have a mental health issue, but many never get diagnosed or treated.⁶ That is why a holistic advocacy program that connects patients to an array of services is so important to employee health.

Addressing the frequently changing health needs of employees can seem like a complicated problem for large employers. By leveraging a hub approach that provides an integrated, trusted source to find and purchase available solutions, employers can meet employees’ needs across a range of issues, including nutrition, tobacco cessation, fertility and maternity support, cancer care, caregiving, behavioral therapy stress management and many others.

This curated hub approach allows employers to take an important step in raising benefits engagement and awareness by delivering coordinated care experiences across a variety of employee health needs. This is especially true when coupled with a one-on-one advocacy solution to help individuals make more informed healthcare decisions.

The needs of each employee vary immensely. Some individuals may benefit from connecting via chat to receive an at-home health kit to diagnose or manage a chronic condition, while others may prefer to enroll in a targeted virtual program for losing weight or adopting health habits.

An advocacy approach also works with employees over time. For example, an employee may first engage with fertility support services to help navigate the medical, emotional and financial impact of starting a family and then later begin virtual behavioral therapy sessions to manage postpartum anxiety.

Another employee may start a health journey by enrolling in a tobacco cessation program with one-on-one coaching and then sustain the positive momentum by starting a type 2 diabetes program that offers personalized recommendations on diet, activity and medication.

The right vendor solutions are aligned with employee health needs and offer thoughtful, compassionate support that can make a real difference in employees’ lives. By providing the right benefits package, assistance and education that meets each employee need, an employer-sponsored hub strategy and advocacy solution simplifies benefits, reduces confusion and improves health outcomes.

Learn more about Optum Hub and Optum Guide, a health advocacy solution for employers.