The Advocacy Approach – Improving Consumer Experience

12.14.2016


By: Kimberly George, SVP, Corporate Development, M&A, and Healthcare

Nearly all businesses have interest in consumer experience. Whether you fly an airline, shop at a retailer, visit a website, or frequent an eatery, businesses care about your perception of their services and the products you consume. Negative experiences result in loss of business, and potentially sales for a competitor. Designing protocol inclusive of user experience has advanced from the automotive and technology industries to a broad spectrum of business verticals, including healthcare and insurance. Never before in my 25-year healthcare background has patient experience and patient engagement been more prevalent in design discussions and outcome reviews. Without a positive experience, patients will not engage in their health by way of treatment adherence and compliance.

Approach

This shift in focus from simply delivering care to understanding how the patient consumes care and feels about their care has lead heath systems and payers to focus significant strategic and operational resources on experience. Patients are frequently referred to as consumers, given that they are actively researching health options and purchasing their care directly. Employers are especially focused on their employees’ experience, whether it is within an operational team, the company as a whole, or the organization’s employee benefit offerings. Companies understand employee experience translates to employee engagement and directly reflects satisfaction and retention.

Adoption

Early adopters of advocacy-based claims management in workers’ compensation have jumped on the consumer experience bandwagon. Employers and payers are creating claims models to improve the experience of the consumer – the injured worker. Workers’ comp is complex and often difficult for someone without much experience in the system to understand. Stakeholders often address regulation and follow a required process with injured workers rather than truly focusing their attention on the worker’s needs. The vernacular used in workers’ compensation can be intimidating and cause confusion and mistrust. Do we think about the injured worker as a consumer of the goods we are delivering? An injured worker’s experience will impact their level of engagement with medical treatment, their return to work, and the long-term ramifications for the employer.

Advancement

I am grateful for the opportunity to present at this week’s National Workers’ Compensation and Disability Conference with three employers focusing on advocacy-based claims management during our session titled “The Advocacy Approach: Helping Injured Workers for Successful Claims Results” on Wednesday, November 30 at 2:30 PM. Denise Algire of The Albertson’s Company, Scott Daniels of Comcast, Bill Wainscott of International Paper and I will explore advocacy in workers’ compensation and share real examples of how advocacy is front and center in their benefit programs. We will review factors to consider when designing a program, various advocacy claims models and measurement outcomes. We hope to see you there and look forward to your ideas to help us advance the advocacy conversation.

The foregoing was originally published on the Sedgwick Blog and is reproduced here with permission of the author. No further republication is permitted without the author’s consent.

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