A long-time client based in Cleveland, Ohio with 110 employees.
This client, which has enjoyed strong growth through an increasingly diverse employee demographic profile, alerted us two years ago to a growing concern among their employees. It seemed that a number of their staff members had experienced challenges with understanding the intricacies of the company’s robust benefit plan, including pre-authorization necessities, navigating provider networks and determining the best treatment options for certain conditions.
MBA Solution Presented
Our team suggested the implementation of a patient advocacy program. Through advocacy, employees and their families would have access to 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.
Employee usage of the program has seen a sharp rise each month that has passed since the program inception. The company has reported a substantial savings through increased employee productivity, while patient advocates were able to save employees over $25,000 by correcting erroneous billing issues. Additionally, a general decrease in claim utilization during the second year offset our client’s cost for the program and a third-year savings in excess of $74,000 has been attributed to the program through a reduction in duplicate testing, unnecessary diagnostic procedures and wasted medications.