Provider searches, member ratings among new wave of solutions
Private health insurance providers are going digital in a bid to empower employees — a move that simultaneously benefits employers, according to industry experts at Sun Life, League and Canadian Benefit Providers.
In an effort to promote healthier lives alongside financial security, Sun Life unveiled a provider search function on its website in June that has been available on a mobile app since November 2016.
The service allows users to search for a range of health-care providers from a database of 90,000 nationwide, including physiotherapists, chiropractors, massage therapists, psychologists, naturopaths, osteopaths, acupuncturists, podiatrists and chiropodists.
The search function also includes an average rating for providers, as given by participating plan members.
Like other providers, Sun Life is looking for ways to expand its services beyond simple reimbursement, said Chris Denys, senior vice-president of possibilities and leader of the digital team at Sun Life in Toronto.
Consumers don’t often think of their insurance company as a provider of such support, he said.
“We’re almost like a TripAdvisor of health. It gives you that little extra boost. Sometimes, it’s just that extra mental barrier to get things taken care of. We’re trying to remove that.”
While Sun Life is not the first to unveil a provider search, the ratings system is cutting-edge, said Denys.
“The real value of the ratings is it’s clients helping other clients,” he said. “That community wisdom takes over.”
“It’s meeting a client need, basically. One of the first things we did upon getting set up is a lot of insight work with customers: ‘What are your pain points? What are your needs?’ And this is one of the areas they (identified),” said Denys.
Sun Life will be looking to add more features going forward in an effort to make digital benefits even easier, said Denys.
“How do you book appointments online? How do you pay? How do you make it kind of an Uber-type experience? That’s in the works. We’re basically trying to find the best solutions that are emerging and connect them to people.”
Marketplace of providers
League, a digital alternative to traditional health insurance, has been providing clients with a marketplace of paramedical providers for three years via its app, according to the Toronto company’s chief health officer, Lori Casselman.
“Our marketplace, and that access to chat with, find and book practitioners, is always on, so there’s a great aspect of that on-demand element within our offering,” she said. “We’re also providing a tremendous amount of flexibility.”
“Having provider networks is not new, but having these types of facilities to get into location and rating and on-demand booking and payment — those are all new features and functionalities,” said Casselman.
“We’re not necessarily recommending those practitioners, but those are practitioners we have done due diligence with and curated them to include them in our marketplace,” she said.
“It’s about making it really flexible and convenient for those members, and providing that always-on access.”
Through a mobile location or manually entered preferred address, clients can easily locate service providers, with the highest-ranked ones coming up first in the search function, said Casselman.
“It’s a tremendous, organic quality control measure,” she said. “(Providers) know that it’s very transparent in terms of the feedback that members are providing. It’s real-time, immediately following your appointment or experience. It inherently creates a higher level of customer service and it’s a great quality measure.”
The millennial worker population makes up the lion’s share of the early adopters of the digital technology space insurance carriers are now promoting, said Casselman.
“The industry as a whole is evolving to bring health and health care into the health benefits equation,” she said.
League also provides proactive messaging prompting a reconnection to service providers, as well as discounts and offers on services as negotiated with providers, said Casselman.
The company is looking to introduce a health concierge service, with a health professional taking real-time questions on health or lifestyle concerns, then aiding navigation of the digital marketplace.
Improving experience
Canadian Benefit Providers — an Edmonton-based company with brokers in Alberta, British Columbia, Ontario and Nova Scotia — is designing its own digital service with hopes of going live by year-end, according to COO Cathy Chouinard.
The company intends to provide members with a better overall experience, such as identifying which service providers complete direct billing as opposed to requiring clients to pay upfront, she said.
“When it comes to chiro, massage and physio, people want to know before they start the services if they can direct bill, because they don’t have a relationship yet,” said Chouinard.
Another option will see the company track different providers’ services, then leverage their relationship to push for more significant discounts or better pricing for clients, she said.
“Everybody wants the member to have a great experience.”
Changes benefit employers
With a plethora of digital offerings now available at employees’ fingertips, employers will also reap benefits, said Denys.
“The reason why they put benefits programs in place is to have healthier, happier, more productive employees that value their employment,” he said.
“This is another dimension to that. It’s removing barriers so that people will appreciate their plan.”
“It allows them to get after health issues that, if left unchecked, could be bigger and more problematic for the employer,” said Denys.
“Employees today look to their employer to be a partner on health way more than they have in the past. So anything that helps them live healthier lives is a plus for the employer as well.”
Provider searches also help with worker productivity, said Casselman.
“You certainly don’t want employees to be distracted doing searches, trying to find the right treatment, support, providers, etcetera. So I think it saves time for employees and employers.”
Digital services also promote ongoing health and well-being for employees, which drives lower health-risk levels and absenteeism, she said.
Proactive benefits usage also means less utilization and cost for the company benefits plan overall thanks to early intervention and treatment “by getting those services front and centre and easily accessible,” said Casselman.
Further, employers will experience less fraudulent transactions as service providers go through a much more thorough vetting process in order to receive direct billing, said Chouinard.
“The relationship between the supplier and the carriers, or the people adjudicating the claims, will become much closer and we’ll be able to zero in on, for instance, regional averages for reasonable and customary charges,” she said.
Benefits companies will have much richer levels of data and the ability to control suppliers in terms of labelling preferred or non-preferred service providers or driving down prices for members, said Chouinard.
“The future will be catering more to the employee,” she said. “The employers want to make sure that their employees are using the benefit plan, but they’re all about cost-containment.”
