By Steven Knight, Chief Operating Officer, Quantum Health Most executives and human resources leaders agree that employee engagement with health benefits is important. Deciding what “engagement” means, how best to pursue it and how it advances an organization’s strategic goals can be challenging.   When HR managers sit across from their C-suite partners and make the case for enhancements to the health benefits plan, the conversation invariably comes around to two topics: ROI and engagement. CFO: “What value will we get from this additional benefit?” Benefits leader: “We believe these investments will drive more engagement.” CFO: “Remind me: What do we mean by ‘engagement’?” If that conversation sounds a bit too familiar, it’s probably time to step back and take a fresh look at engagement. Specifically, to see whether everyone can align on a clear definition, along with a strategy best suited for your organization and its objectives. According to Mercer’s 2019 survey of employer-sponsored health plans, 69% of senior leaders believe engagement with health programs is “very important” to their business and human resources objectives. Yet, many CFOs and benefits managers will concede there’s a lack of clarity and alignment in their organizations around engagement. At Quantum Health, we provide healthcare navigation and care coordination solutions to more than 350 self-insured employers. That puts us in frequent and ongoing collaboration with HR leaders and their benefits consultants. This unique vantage point helps us recognize when organizations are having strategically aligned and productive dialogue about engagement. As you anticipate your next round of benefits planning discussions, here are some takeaways we’ve drawn from organizations striving for greater alignment on engagement: Clarify how your organization defines engagement. The word “engagement” can mean different things. For some, it means how employees are participating in their benefits and might best be defined as usage. For others, it means creating an optimal member experience. Some organizations define it, very simply, as communications, such as email or direct mail sent to employees, or website logins or downloads. Although definitions vary, what matters most is that you and your stakeholders are aligned on what engagement means and the value it delivers to your organization. At Quantum Health, we define engagement as interaction: a meaningful exchange of information between two people that helps members understand and navigate their benefits and healthcare. The mode of interaction can vary — whether it’s via phone call, email, secure message, chat or text message — but it means there has been a human interaction that delivers a result. Experience tells us that these very interactive and personalized engagements are the most effective in guiding members along consistently satisfying, less costly healthcare journeys.
  • Recognize that the most effective engagement extends beyond employees. If the engagement occurring within your benefits ecosystem is only with members, then you are leaving value and impact on the table. More than half of Quantum Health’s engagements supporting our members are with providers, who are critical stakeholders in any healthcare journey. Providers connect with us to confirm patients’ eligibility and benefits, or to submit precertification and authorization requests, and the interactions we have with them often give us more than 100 days’ head start helping members with their healthcare journeys. This Real-Time Intercept® model inserts us early ¾ long before a claim would be filed in a more limited service model ¾ to educate members on their array of benefits and steer them toward high-quality in-network providers, before decisions are made and costs are incurred.
  • Optimize member engagement by streamlining the entry points. Employers offer an array of benefits to their employees, and each new solution creates another entry point for members. Healthcare is already complex, so it’s easy for employees to struggle when faced with too many options or a confusing set of choices. They can’t engage with benefits they don’t know about or don’t understand. The right navigation partner serves as members’ single point of access, informing and matching members with the right solution at the right time, resulting in an easier, more satisfying experience. The right navigation partner will integrate with an organization’s total benefits ecosystem, helping curate members’ choices in real time. This interactive and streamlined engagement that connects the dots for members also helps employers get a greater return on their benefits investments.
Create an engagement strategy with clear priorities and goals — then keep going. As employers become more clearly aligned on engagement, they can take it to the next level. Once they’ve mastered how they are engaging members in the aggregate, they can develop more tailored engagement strategies — and realize greater returns — by segmenting behaviors and conditions within the member population. It’s valuable to establish metrics that show more members accessing their benefits tools and resources efficiently and effectively. It’s even more valuable to ensure that members living with chronic conditions, like diabetes, or those overusing emergency room services, get the targeted education and follow-up they need to support therapy adherence, lifestyle changes and more judicious healthcare choices. There is no one-size-fits-all, plug-and-play approach to engagement. But when HR and C-suite leaders align on terminology and set strategic goals and priorities, engagement can truly begin. Steven Knight Chief Operating Officer, Quantum Health