HR Benefits Mgrs Guide to Patient Advocates

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

Current state of the

healthcare system

January 2016 © by MedSavvy Health Advocates LLC 2015 2

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


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


•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


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


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……………………


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


Employee Benefits


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

[email protected]

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.


http://www.medsavvyhealthadvocates.com/

HR Benefits Mgrs Guide to Patient Advocates

Leadership & Management

Transcript of HR Benefits Mgrs Guide to Patient Advocates