The smart ways CHROs are using healthcare navigation

Maintaining a high-performing workforce is the goal of every employer and HR leader. While CEOs and CFOs are currently focused on delivering the financial goals of the organization amid instability of the macro environment — including growing economic pressures from inflation, slow job growth and continually rising interest rates — CHROs face challenges that may not quantify as easily but also directly influence costs. From increasing employee retention and engagement in healthcare benefits to fostering workforce performance and productivity, CHROs must balance qualitative and quantitative factors that have far-reaching impacts on an organization and its employees.

For CHROs, these current and persistent macro trends, coupled with changing employee expectations, can make improving productivity and the bottom line a moving target. Case in point: By some estimates, workplace productivity has decreased 3%-6% in recent years due to decreases in employee engagement, inefficiencies and lackluster collaboration. Meanwhile, absenteeism and presenteeism continue to increase even beyond pandemic rates, ultimately costing employers an estimated $2,945 per employee, per year. 

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Healthy people mean healthy business 
CHROs understand that labor and employee benefits are among their organization's biggest expenses, and HR teams can and should help drive change in these areas. Unfortunately, a recent study revealed that 67% of employees say they navigate the healthcare journey without help from employers or health insurance. Flying solo on health benefits places an unnecessary burden on employees and can cause multiple problems, such as delays in securing appointments, paying more when they inadvertently go out of network for care, and missing out on opportunities to benefit from centers of excellence or specialty partners their company may offer.  

Enter healthcare navigation, a service designed to help employees understand and use their benefits. Specifically, a healthcare navigation provider delivering personalized support and using predictive analytics to engage employees in their benefits earlier ensures that employees get the care they need, when they need it. This service model can reduce claims costs, improve the employee experience and health outcomes, and ultimately increase productivity and employees' sentiments about their benefits plans. 

C-suite leaders increasingly realize that workforce productivity and corporate financial outcomes are inextricably linked to the health of their employee population, which is why improving the benefits journey is more important than ever. Surprisingly, the connection between the employee health benefits experience and productivity in organizations that offer personalized healthcare navigation compared with those that do not has never been formally studied. Until now.

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The VOI of healthcare navigation: Increasing value and optimizing human capital 
Recent findings from a study commissioned by Quantum Health reveal a direct connection between healthcare navigation, absenteeism and presenteeism, productivity, and HR efficiencies. Quantum Health's healthcare navigation approach enables personalized clinical and benefits support to guide employees along every step of their healthcare journey, and can produce significant improvements in productivity, absenteeism and HR efficiencies. More specifically, companies in this study saw the following outcomes:

• Annualized productivity gains of 1,379 hours per 1,000 employees (a PEPM impact of $3.53), representing gains in reduced absenteeism, presenteeism and HR burden. 
• 368 hours of increased productivity stemming from reduced health-related absenteeism, an expense driven by healthcare inefficiencies that cause employees to miss work. Moving to a healthcare navigation approach streamlines the member experience, reduces inefficiency and waste in the system, and contributes to more efficient healthcare utilization and a reduction in claims per 1,000 employees. Companies in this study also realized productivity gains resulting from shorter average length of hospital stays, fewer admissions, and increased utilization of preventive care as represented by higher flu vaccination rates.
• 803 hours of reduced presenteeism as measured by improved health status and a reduction in administrative distractions during work. Health status focused on three common chronic conditions: diabetes, high cholesterol and high blood pressure. Administrative time reductions highlight the work that navigators tackle on behalf of members. 
• Improved HR efficiencies as measured by a reduction in the amount of time HR teams spend helping employees with benefits and helping them process benefits forms as they seek care. The study revealed a positive impact on HR departments of 208 hours gained per 1,000 employees per year. This improvement allows HR leaders to refocus their team on larger workforce initiatives because employees gain direct access to navigation support. 

When assessing a current or prospective investment in healthcare navigation, CHROs should consider two things: the ROI that comes from significant and sustained claims savings achieved only through predictive analytics, and the total value on investment (VOI) that can be realized through reduced healthcare claims costs, coupled with improved workforce productivity management that enables a more healthy, present and productive workforce.
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Putting these findings to work 
The question coming out of any research is whether the findings have practical application. For CHROs, the practical application is realizing that personalized healthcare navigation gives them the ability to directly influence two of their biggest expenses while supporting productivity and reducing health-related absenteeism and presenteeism.

And reality matters when financial and workforce challenges are expected to persist in the year ahead. Results and outcomes, such as those documented in this study, can deliver a streamlined and efficient healthcare benefits journey for all employee health needs (no matter how big or small). Meanwhile, an empathy-based approach that meets employees where they are in their healthcare journey can add value by helping HR teams gain the trust of employees and delivering a more personally satisfying experience. The icing on the cake is the ability to apply powerful data analytics to identify and engage employees earlier in the process, establishing an ROI and VOI strategy that can directly and positively impact an organization's business priorities.