Improving employee engagement and managing rising healthcare costs

Consumers will stop at any convenience store once. But they’ll embrace a store brand as their favorite for the experience. Given the critical brand-loyalty role played by store managers and associates, a large regional store chain focused on offering robust health benefits, including wellness and disease management support. When member experience, utilization and outcomes fell short, leadership decided their people — and their brand — deserved better. 

The client’s priorities included maximizing investment in a provider cost and quality point solution, plus gaining control over cost-driving chronic health conditions. Also, improving the member experience meant having more, higher-impact engagement with associates who work mostly without computers and email. 

Driving results with care coordination, cost transparency and employee advocacy

To address these challenges, the retailer partnered with Quantum Health to deliver a more personalized and proactive benefits experience.  

COST AND QUALITY WIN-WIN 

The client’s plan included select services with a maximum allowable benefit amount, making it critical to guide members to high-quality, cost-effective providers. Through consistent education on Quantum Health’s cost and quality transparency tool, utilization nearly doubled in year one. 

TARGETED ENGAGEMENT 
As with all new clients, Quantum Health analyzed claims data to identify high-risk members who would benefit from proactive care coordination services. Engagement with those individuals rose significantly, along with increased utilization of targeted diabetes and musculoskeletal solutions. 

More members also designated a primary care provider — a key step in promoting cost-effective future care.  

LIFTING THE BENEFITS LOAD 
At the same time, the company’s rapid growth was straining HR resources. Quantum Health’s healthcare navigation platform and team of employee advocates helped ease the administrative burden, delivering a better member experience while enabling HR to focus on hiring, training and strategic priorities. 

Improving member engagement and outcomes with our industry-leading healthcare navigation platform

Associates soon discovered that friendly experts who make benefits less confusing and scary were 

a quick call, text or app click away. Easy access to highly proactive healthcare navigation helped 

reduce inappropriate emergency room visits by 23% over a two-year period.  

During year one, members progressing from high to moderate or low risk increased 53%. For a fast-growing retail brand, group benefits became less of a challenge and more of a business advantage.