Approximately 70 percent of the U.S. workforce are frontline employees. They’re essential to critical functions of our nation’s economy working in industries like healthcare, retail, production and food processing, trucking, maintenance and agriculture.
These individuals are the backbone of our society. Many endure physically and mentally challenging work environments, which can make taking good care of themselves (and their families) difficult. This, along with changing healthcare benefits and a myriad of complex socioeconomic factors, contributes to a greater likelihood of certain medical conditions, a lower likelihood of receiving routine care and a high rate of workforce turnover.
These intensifying issues mean benefits managers at companies that employ frontline workers face a hard question: How can we improve the health outcomes of our workforce and provide benefits that have staying power?
Skai Blue Cross Blue Shield has decades of expertise supporting the complex health needs of high-turnover populations. Let’s take a look at how our approach supports frontline workers’ health.
1. Leveraging data in new ways to intervene sooner
Most health plans and health navigation companies use medical claims history to identify members in need of intervention. However, high employee turnover, coupled with a lower likelihood to seek preventive care means that claims history data can be sparse or even nonexistent.
To give members a chance at better health, we leverage more than just claims data. Socioeconomic, environmental, occupational, demographic, attribution, verification of benefits, pharmacy, engageability, biometrics, language and channel preference data all provide a rich context for populations and employees lacking claims history.
At the population level, our health economics practice utilizes this information to uncover important findings like:
- Truck drivers with certain social determinants of health are more likely to have diabetes and to benefit from a specific type of drug.
- Certain characteristics are tied to an increased likelihood of a member being identified as pregnant in the ER two months into their pregnancy.
- Low-income, single-person households are at higher risk for end-stage renal disease.
Findings like these and many others are being used to predictively identify at-risk populations. In fact, our AI predictive models can find members an average of 6 months before becoming a high-cost claimant. This translates to $37.5 million in savings for members engaged in our care management prior to becoming a high-cost claimant.
At the member level, our health solution Celeste uses unconventional data to uncover valuable findings like whether a member has a primary care doctor and the strength of their relationship.
2. Making engagement easy and repeatable
Sixty-five percent of Americans say coordinating and managing their health and the healthcare system is overwhelming and time-consuming. Our health solution Celeste helps take the burden off managing the minutiae within the healthcare system—like understanding confusing billing, finding a doctor in-network or knowing what is and isn’t covered—so people can focus on what’s most important: their health.
How are we able to do this? Celeste Care Advocates leverage the robust data collected to proactively reach out to members and provide them with personalized and comprehensive support. Based on a member’s data and benefits, an algorithm scores the value of each potential solution (e.g., a behavioral health program, virtual diabetes coach, telehealth specialist visit, etc.) and that score gets paired with the likelihood of the member engaging with a potential solution to determine what option is best to recommend and in what order. This helps members focus on one change at a time instead of overwhelming them with making multiple changes at once.
Once a member gets engaged in their health, the challenge of keeping them engaged begins. Celeste helps with this by using integration to simplify members’ healthcare experience. Celeste connects multiple healthcare components, which are typically siloed, into a single platform that’s easily accessible for members via an all-in-one digital app.
These integrated components include:
- Navigation and patient advocacy
- Benefits and claims management
- Health decision support
- Data-driven, proactive outreach
- High-quality care
- Point solutions programs
- Complex care management
At any point while they are in the app, members can message or call a Care Advocate.
Together, integration and guidance result in a seamless experience for the member. And when members experience healthcare in this way, they are more likely to stay engaged not only with the app, but most importantly, their health.
3. Making it easier for members to get the care they need
Sixty-one percent of adults seek care only when they are sick. For those skipping or delaying care, 30 percent say it’s the inability to take time away from other responsibilities, while 25 percent cite long wait times to book appointments. Deprioritizing healthcare is something that can happen when life gets in the way. And it has negative consequences for frontline workers and the general population.
Virtual care shows promise in making it easier for frontline employees to access care and is an important component of any integrated solution. However not all virtual care is created equal. Celeste’s model incorporates the following elements:
- Robust primary care that prioritizes a virtual-first, comprehensive spectrum of services that includes same-day appointments, a board-certified physician panel and 24/7 access to a care team.
- Empowering Care Advocates with data on whether a member has a relationship with a PCP, the strength of that relationship and how long it’s been since they’ve seen one so they can proactively contact members who look like they may benefit from our virtual solution.
- Giving PCPs full view of a member’s complete data set, including employer benefits, so that they can recommend point solutions that complement a patient’s care needs.
- A collaborative model that integrates physical and mental health to make it easier for providers to be connected and deliver whole-person care.
- Continuity of care, prioritizing data sharing with in-person specialists for a seamless healthcare journey.
Beyond virtual care, Celeste provides a best-in-class virtual medical opinion service—with 700+ specialists to help members make the right decision about their health—and a range of point solutions, both of which are beneficial for populations that lack access to traditional healthcare options.
In practice, the three strategies laid out in this report have the potential to improve health outcomes for frontline workers—as well as the general population. In doing so, they also have the potential to improve retention rates by offering employees something they highly value—better benefits.
You can provide your employees with healthcare that meets them where they’re at. Reach out to a Skai representative to learn more today.