By: John Sunde, MHA
VP, Payor Strategies at SoNE HEALTH
When you are looking for a home for you and your family to provide them with safety and comfort you want it to be designed and constructed by a skilled team of architects, carpenters, electricians and plumbers. Check!
When you are looking for an automobile for safe and reliable personal or family transportation you want it to be designed and assembled by an experienced team of safety, mechanical and design engineers. Check!
When you are looking to select health benefit programs to meet the needs of your employees and their families you want them to be designed and coordinated by a visionary team of providers, health plan leaders, brokers and consultants. What?
This last scenario may sound like a mythical unicorn, but more and more across the country disparate segments of the healthcare system are working together as a team to help employers find solutions to the difficult challenges they face when seeking to arrange high-quality, accessible and affordable health care for employees and their dependents.
The traditional approach to arranging health benefit programs, which lacks collaboration across the aforementioned segments, continues to dominate the industry. However, alternatives to this approach can be found where a team of providers, health plans, brokers and consultants recognize the need for change and have both the desire and the ability to make change happen.
For more than four years SoNE HEALTH has been working collaboratively with health plans, employers, brokers and consultants to understand the needs/concerns of healthcare consumers and how employers go about arranging to address them. Drawing on the unique perspectives of these different segments it has become clear that consumers and employers can easily be overwhelmed by the complex and ever-changing healthcare environment when trying to address a wide range of priorities that may include:
- Maintaining access to providers (especially PCPs and mental health providers)
- Considering focused and tiered provider network products
- Using transparency data to identify what services cost
- Engaging employees in disease prevention and screening services
- Figuring out how to use claims data
- Understanding social determinants of health
- Managing specialty pharmacy costs
- Minimizing out-of-pocket costs
As a result, understandably frustrated by the lack of options and, on the other hand, daunted by the thought of making significant and disruptive changes, employers will often take the path of least resistance and maintain the status quo. At best they may be able to partially mitigate cost increases by making modifications to benefits and contribution levels.
A Proven Alternative: A team of passionate providers, creative health plans and engaged brokers/consultants working together and directly with employers to tailor existing solutions or develop programs and services to address their priorities and unique needs is not a mythical unicorn. At SoNE HEALTH it is happening, it works, and it has resulted in significant financial savings and other benefits for small and large businesses alike. Understanding that change is not easy, solutions can be scaled from the implementation of individual programs to address specific needs (e.g. MSK, diabetes, cancer screening) to a full-scale benefit plan utilizing focused, tiered and traditional broad networks.
SoNE HEALTH isn’t just a network of outstanding providers…we are an employer too, with more than 100 dedicated healthcare professionals. We know health care isn’t easy, but it is easier when we work together to find solutions.