By Raffi Terzian, M.D., M.P.H., FACEP
Senior Medical Director,
Senior Vice President of Clinical Operations
For many healthcare consumers, the complexity of the system is an unnecessary barrier to understanding their treatment options and receiving quality, affordable care.
The goal, then, is to help employees get to the right care at the right time, so they can return to a normal routine in a reasonable amount of time. It begins with having a clear support system in place to help employees navigate the healthcare system so they can make the right choices for themselves and their family members.
By providing ongoing access to someone with clinical expertise who can answer their questions and explain their options, through clinical decision support, employees can make care decisions with more confidence.
The discussion can also include a review of the impact their condition or treatment may have on recovery time or return to work, clarifying benefits and understanding out-of-pocket costs – considerations that may be overlooked when faced with a serious health issue.
Turning anxiety into action
Facing a complex diagnosis or circumstances where an employee is uncertain about their care plan or next steps can leave them feeling vulnerable. Coordinating care and making treatment decisions, including knowing the right questions to ask, can be challenging tasks.
Empowering employees and offering resources to help them get the answers they need before care decisions are made alleviates uncertainty and helps prevent concern about their (or a family member’s) health from affecting their productivity or disrupting their lives. Having an additional layer of support is key during these times of high stress and anxiety.
Expert support to find the right doctors
In addition to helping to coordinate care and providing decision support to assist with understanding treatment options, another key element of clinical advocacy is helping to locate high-quality providers, including specialists and facilities, to meet employees’ individual needs. The focus on quality (such as leading academic centers and Centers of Excellence), can result in better outcomes and lower costs.
The process begins with a thorough clinical intake, followed by a comprehensive search to identify leading in-network providers. Making proactive outreach to provider offices to assess experience, confirm availability and help with scheduling appointments and transferring medical records are also key elements of the process. These personalized services help ensure that employees get to the right care quickly and efficiently. All of these services are augmented by an ongoing relationship with an advocate who can assist with any additional needs that may arise.
Research shows that organizations who integrate clinical advocacy into their benefits offering experience improved health and productivity and lower medical costs. It’s a practical, winning solution for everyone involved.
Contact us to learn more about clinical advocacy and the many ways we can help your employees and organization.