Solving the Point Solution Challenge: A Conversation with HealthJoy

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Many employees today have more healthcare tools at their fingertips than ever—but don’t know it.

That’s where HealthJoy comes in. The app-first platform brings together all an employee’s benefits into one place and uses digital personalization and real-person concierge support to guide them to the right place.

We talked with three members of the HealthJoy team about the problems they’re solving for customers, how they deliver a 2-3x increase in point solution utilization and why they’re excited to partner with Employer Direct Healthcare (EDH).

EDH: What do you hear from your customers about what problems they’re trying to solve by working with HealthJoy?

David Lawrence, VP, Clinical Product at HealthJoy: Our employer partners spend a ton of time and effort working to build out a comprehensive set of benefits to attract employees, retain employees and solve a lot of the complex healthcare challenges that are out there, especially around cost. We’ve seen a huge explosion of healthcare point solutions over the past decade. On the one hand, that’s great because they have very talented teams, and their technologies are solving condition-specific issues. On the other hand, I think we all know employee awareness of these point solutions, and ultimately utilization, is a huge challenge.

We see HealthJoy fitting in a couple of different areas. One is taking all the benefits an employee has access to and bundling them together. The other area, which is related to this broader utilization question, is looking to HealthJoy as a cost containment partner. What set of capabilities are going to be required in order to address healthcare spend over the long term? Part of that’s bringing in great ecosystem partners like EDH, and part of that is making sure that people are using in-network services and are fully engaged in their own healthcare journeys.

Why is reaching small and mid-market employers important to HealthJoy?

Jeff Graton, Vice President, Member Services: It’s an area of the market that honestly represents the largest population of employees in America but is truly underrepresented in the healthcare industry like this, which a lot of decisions are dominated at the enterprise level. We feel like we’re really advocating for that little guy or that individual with everything we do. That’s fundamentally who we are.

Can you share an example of how someone would find SurgeryPlus within the HealthJoy app?

Vinson Tanner, Service Implementation Manager, HealthJoy: A member can come to us and say, I’m looking for a doctor for an ACL surgery. Can you find me a provider who can do that surgery for me? They know we already do that kind of in-network searches. But now we know this member also has the EDH SurgeryPlus program available to them. So, we’ll explain how SurgeryPlus works and highlight the benefits of being enrolled in that program, like that they’re going to get access to the highest quality providers. Then, they get a recommendation in their inbox showing them all the program details, benefits, why we’re recommending this program and how to contact EDH. We’re also sending a daily file over to EDH with that members’ information so they can do additional outreach.

What kind of support team do you have at HealthJoy to help guide members to the right resources?

Vinson: We have a team of around 200 of what we call our Healthcare Concierge, who are helping members on live calls, live chats and 24/7 in our app. That team is then doing that work on behalf of the member to find providers, set appointments and complete medical bill reviews. Members can also search on a map for providers in their network or see providers that they have available. So, for a member whose employer is partnered with EDH, if they went searching for an orthopedic surgeon, the first thing that’s going to pop up is, “You have access to SurgeryPlus. Instead of searching for a provider, here’s information on how to get in contact with them.”

Jeff: It’s less about directing members to call or chat with our concierge. Instead, we frame it as, what are you trying to solve? About 90% of our logins result in a purely self-service experience from what our technology is able to serve up. Roughly 10% of those logins result in a concierge guided experience where we pick up from the technology and continue that discussion or a handoff to one of our clinical partners.

Something we talk about at EDH is the way people generally choose a provider—word of mouth, primary care referrals—doesn’t necessarily lead them to quality care. How do you think about behavior change from how people normally access their benefits?

Jeff: Foundationally, we play on the learned behavior of when our little phone dings, it catches our eyes right? And that’s the backbone of everything we do. We also have regular reoccurring communication and awareness campaigns that we do outbound to our members and some proactive and data-driven outreach to a member.

What are other mechanisms you use to drive members to use the benefits they have access to?

David: Personalization is fundamental to making this happen. People respond to a survey as they’re being onboarded and tell us, “I have diabetes,” or “I’m adding to my family this year”—any number of questions that help us paint a picture of them. The second part of that survey is people telling us their goals. So, it’s a goal of mine to lose weight. It’s a goal of mine to improve my diet or fitness or complete my annual physical. And it’s through all this data that we’re putting together that we’re able to build out this profile and point people towards relevant solutions that they have access to.

EDH: Are there questions specific to surgery care you’d like to add to direct people to EDH/SurgeryPlus?

David: People generally know if they’re going to need surgery, so we’d like to add questions around, “Would you anticipate requiring surgery over the next six to 12 months” for some of the top five procedures. We want to get as targeted as possible to get someone onto our radar as quickly as possible through those questions with a direct tie over to EDH.

Why did HealthJoy choose to partner with EDH?

David: Cost and quality are two themes that I think come up routinely in healthcare that are extremely difficult to solve. I think EDH’s ability to drive hard dollar savings is extremely valuable to us and our clients, while maintaining a high-quality network along the way. Finding that balance between cost and quality is hugely important.

And then, as we think through how we actually get people to use resources that are available to them, that member experience is really important. Proximity is a huge piece of patient adherence. Our ability to drive people locally is hugely valuable given our national footprint. The local center of excellence model that EDH has is very well aligned with our own business, and where our clients are.

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