Employees Are the First Line of Defense
This past month I was double billed for tickets to a sporting event and charged for services at a health club that I did not receive. My credit card company did not “catch” this activity (nor did they have the information to know that the charges were incorrect – and perhaps fraudulent). I was able to reverse the charges because I understand how to read my credit card statement and can monitor it for inappropriate charges. Imagine if we empowered employees to look at healthcare the same way.
By recognizing how and when employees can add value, organizations can learn useful ways to influence their growth. With the challenge of increasing healthcare costs, employees can also help their organizations reduce their healthcare costs – and even prevent their organizations from being victims of healthcare fraud.
Knowledge Lowers Healthcare Costs
People are good consumers – of automobiles, home appliances, engagement rings and just about any other purchase that deeply affects their own “bottom lines”. Now that payors are shifting more expense to patients through co-payments, out-of-pocket expenses, deductibles, etc. and patients have greater access to healthcare information then ever before, it is the right time to get employees engaged in their healthcare expenditures. Clearly when an employee makes a better financial healthcare decision, their employer also benefits.
Because of the complexity of our healthcare system, it is important to teach employees how to be effective healthcare consumers and arm them with accurate information to make optimal decisions about their care. Patient Advocates help patients navigate our healthcare system – and can train employees to gather, assemble and use information to mange, control and reduce their medical expenses. Critical information that employees need to understand to make informed healthcare decisions include, but are not limited to:
1. Medical records
2. Beneficiary rules
3. Healthcare bills
4. Explanation of Benefits (EOBs)
5. Clinical quality outcome measures
The key is for organizations to explain to employees the incentives of being a conscientious healthcare consumer, including but not limited to:
1. Preventing costly clinically adverse outcomes
2. Preventing inappropriate payments for healthcare services and products
3. Safeguarding personal healthcare information from Medical Identity Theft
People know how to be conscientious consumers – we just need to teach them how to be conscientious healthcare consumers.