Simplifying the Search: Streamlining Access to Quality Care for Employees

Navigating healthcare can be complex, time-consuming, and overwhelming. From understanding insurance coverage to finding an in-network provider and determining costs upfront, the process of choosing care can feel daunting.

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According to a KFF Survey of Consumer Experiences with Health Insurance, thirty percent of insured adults find it difficult to understand their out-of-pocket costs. While cost is a critical factor, it is just one of many challenges.

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‍Why Finding Quality Care Can Be So Difficult

There are several challenges employees face when navigating healthcare, including:

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• Lack of Transparency: The healthcare system is often opaque, making it difficult to access clear information on the quality and cost of services. Hidden fees and inconsistent pricing can lead to unexpected financial burdens, causing some patients to avoid care altogether—resulting in even higher costs down the line.

• Understanding Provider Networks: Determining which healthcare providers are in-network can be challenging. Information is often fragmented, inaccurate, and spread across various sources. According to the same KKF Survey referenced above, nearly one in four insured adults (23%) say it is at least somewhat difficult to understand where to find information about which doctors and hospitals are covered in their health plan network.

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• Barriers in Health Literacy: According to the CDC, 9 out of 10 adults struggle with health literacy. This includes understanding medical terminology and procedures. The absence of educational resources intensifies this issue, leaving patients feeling unsure about their decisions.

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Breaking Down Barriers with Effective Healthcare Search Navigation

Healthcare search navigation is designed to guide individuals through the complexities of the healthcare system. It helps individuals find and choose the best care options by providing tailored information on providers, quality metrics, treatment costs, and patient experience – empowering individuals to:

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• Make informed choices

• Reduce unnecessary expenses  

• Experience better health outcomes

• Enhance overall satisfaction

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‍Search Navigation in Action: How It Transforms the Typical Healthcare Experience

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Avoiding Unexpected Bills

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Without Effective Search Navigation

‍An expectant couple received an estimate for their upcoming delivery, which they meticulously budgeted for. The delivery went smoothly, and they welcomed a healthy baby girl. Six months later, they were shocked to receive an unexpected bill for their newborn's care. The initial cost estimate did not include the entire episode of care, only the mother's portion. This unexpected expense put a significant strain on their finances, not to mention caused a lot of stress.

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With Effective Search Navigation

With access to an effective search navigation platform, the couple could have viewed an accurate cost estimate for the entire episode of care. This includes items ranging from facility costs, prenatal care, labor and birth, pharmaceutical costs, and postpartum care. This comprehensive estimate would have allowed the couple to prepare and budget accordingly.  

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Utilizing the Appropriate Site of Care

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Without Effective Search Navigation

At one company, several employees frequently visited a newly marketed and trendy stand-alone ER for routine medical needs. This choice resulted in significant unnecessary costs for both the employees and their employer. What's more, these employees overlooked their telehealth benefit, which not only would have saved them time, but also eliminated the need for co-pays, ultimately reducing both personal and company healthcare expenses.

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With Effective Search Navigation

When equipped with effective search navigation, employees are enabled to make more informed decisions about where to seek care. The platform guides them to consider other benefits that might be more appropriate, such as telehealth options that are more efficient and cost-effective. Employees are also educated on selecting the best facility based on their specific needs and are reminded of the value of establishing and maintaining a relationship with a primary care provider. This approach optimizes care and contributes to significant cost savings for employees and employers, while boosting health literacy.  

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Choosing a High-Quality Provider

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Without Effective Search Navigation

A patient was referred to an orthopedic surgeon for a hip replacement by their primary care physician. The surgeon was within the same health system. The patient proceeded with the surgery and unfortunately experienced a lengthy recovery. When sharing their experience with friends, the patient learned of another surgeon, also in-network, who specialized in a minimally invasive technique with better outcomes and higher patient satisfaction. Unfortunately, without knowing about this option beforehand, the patient missed out on a faster recovery, a quicker return-to-work-time, and a better patient experience.

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With Effective Search Navigation

Before deciding, the patient used a search navigation tool to explore all available options. The tool highlighted in-network surgeons, their quality, cost for the entire episode of care, along with patient satisfaction. Equipped with this information, the patient easily compared options and chose a high-quality surgeon, resulting in a quicker recovery and a more positive experience.

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Conclusion

Employees with access to an effective and non-biased search navigation platform can positively transform their healthcare experience. Whether it’s avoiding unexpected costs, finding the right care facility, or choosing a high-quality specialist, this tool can play a crucial role in guiding individuals to the right care at the right time, leading to improved outcomes and lower costs for both employees and employers.  

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To learn more about Faros Health’s effective search navigation platform, ENLIGHT, schedule time to connect here.

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