None of us likes paying for something we don’t use, or vice versa, skipping out on buying something you end up wishing you had in a time of need. For employees who elect to leverage claims-based data, they’re able to not just personalize their benefits based on what they didn’t need from the last year but also look towards what they will most likely need support for in the future.
Moreover, this data helps employees feel even more valued and supported. For instance, you may have an employee who is unaware that your organization offers support for their heart condition. Or maybe an employee who was recently in a car accident forgets they have accident coverage. But by leveraging their claims data, employees can not only increase awareness, but activation as well—leading to better health outcomes and happier employes.
With Claims-Based Activation Paths, claims data flows through our benefits administration platform, Benefitsolver, to promote a given benefit. Our proprietary technology has the ability to leverage eligibility data and in-platform behavior analytics in conjuncture with claims data. We call it “Activation Paths”, as this tool highlights available benefits throughout an employee’s benefits journey so that they can activate on the most appropriate options when a relevant health event arises.
For example, someone who has a claims indicator for hypertension is promoted to a hypertension program.
And for some, providing the opportunity to model last year’s benefits with their future expectations can bring a great level of awareness into how their benefits supported them over the last year. But take care! Last year’s benefits use is not always a reflection of what is to come, and providing choice for employees of how they use claims is paramount.
Some programs that can be tied to claim-based promotions are:
This tool promotes solutions that are tied to a specific condition or target preventative care opportunities using specific claims data to support. Furthermore, members who have had a recent hospital, critical illness, or accident claim can then be prompted to file for their benefits, ensuring they make the most of the voluntary coverages they have elected.
And once an employee has elected to leverage their claims-based data, they aren’t just going to get a single nudge that this could be something beneficial to their health and well-being. With Claims-Based Activation Paths, employees receive multiple preventative care reminders.
Some applicable reminders include:
And with more than half of employees wanting personalized benefits messaging, they’ll receive communication that is relevant to them, whether that’s text or email.
Take Matthew, an employee who has elected to let his employer use claims-based personalization through Benefitsolver.
Empty nesters, he and his wife spend a lot of time focusing on work and their success. But this has also led to some bad habits. Matthew tends to eat fast food after working late at the office.
During Annual Enrollment, Matthew chooses ‘below average health’ when running through decision support. Since Matthew consented to let his employer use claims-based personalization, claims indicators from his previous doctor visits are sent to Benefitsolver.
The claims indicator comes over showing Matthew has indicators for being pre-diabetic. An automated message goes out to his preferred email to look into the diabetes prevention program that is offered by his employer.
He logs into Benefitsolver and sees a call-out for the specific program and learns the evaluation is free and confidential.
Matthew takes the first step and logs into the program directly from Benefitsolver to complete the evaluation.
More employees are continuing to embrace AI and the use of their data to drive real saving for their families. In fact, 89% of employees are opting to use their claims data to help tailor their experience, and this number only continues to grow.
According to data from Airship, the personalization consumers find to be most useful is “recommendations and offers based on past behavior or purchases” (41%). Which is probably why it’s no surprise that employees are looking for ways to understand what their healthcare usage was in the past, to help guide choices for future coverage. So the question is no longer whether employees are ready to embrace advanced technology in their benefits experience—it’s whether employers are willing to catch up.
And it’s not just about saving your employees money, utilizing claims-based data and decision support impacts organizations’ bottom lines as well. Through the use of AI and automation, Businessolver’s proprietary benefits administration technology has helped organizations find millions of dollars in savings. And with medical and prescription spend eating up 95% of many organizations’ budgets, it’s important to help ensure employees are using, and activating the right benefits for their needs.
By leveraging empowering support such as claims-based data, employers can continue helping employees activate on the benefits they’ve invested in, while simultaneously elevating employee’s financial, physical, and emotional wellbeing.
Curious about how AI and decision support tools can transform your employees’ benefits experience? Grab a quick 20-minute live demo to see our industry-leading innovation in action!
