How to Enhance Care Coordination & Navigation

April 23, 2024

First Stop Health

Healthcare has an engagement problem. About 92% of adults do not receive recommended preventive services and 44% have skipped or delayed care altogether.1,2  The reason? Overall, healthcare has become inaccessible and inadequate. In a recent survey, 70% said the healthcare system had failed them, 42% delayed care due to provider availability and 61% delayed care due to costs.3,4  

So how can employers help their employees engage in their health? Implementing a highly utilized, hands-on virtual care program removes care barriers, provides low-to-no cost care for employees and dependents, encourages preventive care and overall offers more convenient care. To prevent gaps in care, keep employees engaged in their healthcare journey and aid in benefits education, they must have access to a full suite of providers who can help with care coordination and navigation. Here’s how a virtual care solution can do just that:  

A Fully Integrated Solution 

A virtual care solution may have many offerings and it’s important that they are integrated for patient and provider convenience. This may include smart steerage within the virtual care solution (i.e., to health coaches, dieticians, diabetes educators, mental health providers, etc.) and integrations with employer-sponsored wellness incentives. Integrations with national lab and imaging vendors for real time result return and partnerships with prescription vendors also ease the healthcare experiences. A fully integrated solution engages employees in their health and removes barriers of seeking providers from various vendors or in-person care.  

Advanced Benefit & Clinical Navigation 

Understanding the benefits ecosystem can be burdensome. Just 20% of employees feel their employers do a good job with benefits education and 1 in 3 chose a 7 or lower (scale of 0-10) when asked how confident they are in their understanding of the benefits offered.5,6 But with guidance and education from a hands-on virtual care team, employees can harness the full power of their benefits.  

Virtual care solutions must guide employees to other clinically relevant solutions that are part of the total benefit package, as well as support any external navigation. This includes thoroughly researched specialist referrals that consider in-network status, cost, quality, location, soonest appointment availability and patient preference. Steerage does not stop there. To provide a holistic experience and act as a virtual medical home, virtual care solutions must reengage with employees and perform appropriate follow-ups. 

Wrap-Around Network of Providers 

As mentioned above, steerage within a virtual care solution limits employee efforts to seek care. As they’re already familiar with the services, movement between offerings is easy and convenient. A wrap-around network of providers takes care one step further. Whether an employee is looking for a bit of guidance on how to improve diet or care coordination for a high acuity condition, offering a full suite of support engages employees in their health no matter the complexity of need. Health coaches, case managers, mental health providers, nurses, and primary care physicians can provide a holistic care experience and get employees engaged in their health.  

 

About First Stop Health Virtual Care 

FSH Enhanced Primary Care, Virtual Urgent Care and Whole Person Mental Health solutions deliver patient-first, $0 care to members where and when they need it. As FSH runs independently from carriers, virtual visits do not incur claims, all members are pre-registered for easy access to their accounts and implementation is turnkey. FSH puts its fees at risk and offers performance guarantees on utilization or return on investment to ensure solution efficacy.  

Enhanced Primary Care: A Virtual Home Designed for Everyone. We aim to be a virtual medical home for patients and to meaningfully change the way they think about a primary care relationship. Scheduling is available as soon as next day with a Virtual Primary Care physician. Members have access to urgent care plus a wrap network of health coaches, dieticians and onsite biometrics starting 8/1/2024. Case management, advocacy and steerage from registered nurses that goes beyond care coordination will also be available 8/1/2024.  Coming 1/1/2025 is Whole Person Mental Health, which includes scheduled visits with therapists for long-term therapy and behavioral coaches for guidance on finance, tobacco cessation and personal goals.     

 

  1. Preventive care falls short: Only 8% of U.S. adults receive all appropriate services | Fierce Healthcare 
  2. Nearly 40% of Americans skipped medical care in 2022 because of cost concerns, poll finds - CBS News 
  3. New Data from Harvard Business Review Analytic Services Reveals Employer Investment in Health Benefits has Minimal Impact on Employee Health (prnewswire.com) 
  4. More than Half of Employees Delayed Necessary Medical Care due to Cost, 42% Delayed due to No Appointments Available, According to Integrated Benefits Institute Analysis (ibiweb.org) 
  5. Benefits Optimization 2023 | Guardian 
  6. Why It’s Critical for Employees to Understand Their Benefits Packages | National Association of Plan Advisors 

Originally published Apr 23, 2024 8:33:50 PM.