By Bryon Bass

SVP, Disability and Absence Practice & Compliance
Sedgwick

Integrated benefits programs have long captured the imagination of employers. Some of the more progressive organizations have implemented some form of integrated solution in recent years but still come across traditional barriers to fully integrated programs in the form of incompatible technology platforms, political turf wars, or organizational resistance to change. However, the introduction of a health assistant as a conduit for many benefit plans and resources is expected to make long-awaited in-roads to program integration. It is believed a single resource for all questions related to medical treatment, workers’ compensation, and disability/leave concerns can deliver much needed simplicity in what have become highly complex and specialized areas.

A health assistant would serve as a single resource or concierge for employees for all benefits-related questions and needs. This would hold true for both occupational and non-occupational injuries and illnesses. This individual would also help employees navigate the maze of issues and concerns associated with time off work for any reason whether due to family medical leave, intermittent absences, or pregnancy-related matters. Because so many benefits are dependent upon one another, but not necessarily integrated, a designated health assistant would help eliminate the need for an employee to go to multiple resources to get their questions answered.

An employee’s health concerns, as well as the medical needs of family members, can impact productivity. Having a knowledgeable and trained medical assistant who can guide employees through the entire process for themselves and all family members can save time and improve employee satisfaction.

Employing this approach, a health assistant would function in a virtual world staffed with highly trained resources and specialists including medical doctors, behavioral specialists, pharmacists, rehabilitation experts, nutritionists, and many other clinical resources. Under this model, all team members can access necessary data, and services become integrated. This begins with capability to receive an electronic and verbal authorization to release medical information from the employee being served, a paperless process that moves services forward instantly.

Each health assistant ensures employees get the information they need and connects them with experts who can assist with a wide range of topics in specific areas such as mental health, chronic disease, or pregnancy. The health assistant will help the person with the topic about which they are calling and then look beyond the initial question to see if there are other areas where they can be of assistance. For example, a woman calling about her deductible may express concern about high blood pressure. The assistant will look into her question about the deductible and then mention that there is a clinical specialist on the team who is available to help with additional questions if needed.

This type of program is among the first to link health plans, workers’ compensation, disability and leave, and job accommodation offerings together. Data integration allows the team to provide proactive assistance to the employee. It also offers an opportunity to streamline enrollment and pay reimbursements through a holistic health and productivity approach.

A positive patient experience offers advantages to all parties. The health assistant ensures the employee receives the information for which he or she is calling about and helps from start to finish — no matter what the specified needs are. This new model is designed to streamline the process, reduce additional calls, and ultimately, save time.

Early adopters offering health assistants have consistently demonstrated healthcare spending reductions and improved employee satisfaction. With the integration of health and productivity solutions, not only is a reduction in healthcare spending expected, but a positive impact on days away from work and claim durations is also anticipated.