1. Using smart device

6. FRAGMENTATION – look at old slide - integrate

8. Add Best practice stat -90% -

10. Nation’s leader in healthcare advocacy and assistance
Distinguished roster of 11,500+ nationwide clients
Serving over 50 million eligible lives
Broad product spectrum
Outstanding, experienced management team
15 years of experience building an integrated service
Expert staff of healthcare and insurance professionals
Powerful and proprietary infrastructure
Strong brand recognized as objective and well-respected
A subsidiary of West Corporation

11. Fully integrated model
Holistic focus on members
Single, independent source for the coordination and/or delivery of benefit issue resolution, health and wellness and condition management services
Clinical and administrative expertise
Engages members at all levels of care
Leverages data to drive member behavior changes
Improves compliance with preventive and chronic care services
Comprehensive management reporting
Independent of health plans and providers; easy to establish members’ trust

12. 2001
Created to help people navigate the healthcare system to get to the right care at the right time
50 clients and 80,000 members
2003 – 2005
800 clients and 3.5 million members
2006 – 2010
Announced addition of 24/7 NurseLine, Benefits Gateway™, and Employee Assistance + Work/Life programs
Announced Health Proponent, Health Advocate’s consumer product
2011 – 2013
Acquired WellCall to develop our wellness program including biometric screenings, nurse coaching, tobacco cessation, and seasonal vaccinations
Launced e2H data analytics division giving us the power to support our value with data
Built Health Cost Estimator+ pricing transparency tool

13. 2014
Became a part of West, a global leader in communication technology
10,000 clients and 40 million members
2015 – Present
Integrated West communication technology
Expanded product portfolio: Predictive Modeling, Provider Performance Analytics, PreVent/Claim Overpayment Recovery
Fully-integrated, employee solutions program
11,500+ clients and 50 million+ members

16. Think of us as your Personal Health Concierge:
Only ONE number to call
Access to top health, benefits and wellness experts
Compassionate, personalized service
Every interaction is tailored to the specific employee’s needs
Customized engagement strategy
Unlimited support, 24/7

17. A relationship that produces results
Money saved/reduced medical costs
Improved quality of care and health outcomes
Insight in to what’s driving costs
Increased employee productivity and satisfaction
Engaged employees
A strengthened brand – We do all the work, you take all the credit!
Increased benefit utilization and efficacy
Ease burden on Human Resources staff

19. Provide Healthcare Help
Expert help with healthcare and insurance-related issues
Find the right providers
Schedule appointments and transfer medical records
Answer benefit questions
Research treatments
Secure second opinions
Resolve claims and billing issues
24/7 NurseLine
Access to medical providers online
Negotiate discounts on non-covered medical and dental bills

20. Engage in Health and Well-being
Help with setting health goals and tracking progress
Customizable incentive programs
Screenings to identify health risks and chronic conditions
Talk to a Wellness or Nurse Coach
Fun, interactive website and activities
Create a Personal Health Profile
Flu shots and immunizations
Discounts on gym memberships

21. Help with Personal Issues and Work/Life Balance
Access to a Licensed Professional Counselor – video, phone or in-person
Grief, loss, depression, relationship issues, divorce
Job stress, burnout, work/life balance
New baby, adoption, eldercare
Financial and legal issues, retirement, identity theft
Addiction, eating disorders, mental illness
Personal Concierge Service for travel time-saving help with travel and event bookings.

22. Estimate Healthcare Costs
Get detailed estimates for medical services and procedures
Comparison-shop for healthcare services
Estimate out-of-pocket costs
Get help budgeting for future medical expenses

23. Support for Chronic Conditions
Help managing chronic conditions
Unlimited access to a registered nurse
Educational materials and other resources
Test and screening reminders
Help following a treatment plan

24. Plus + Healthy Reminders Mailers, text, email and phone
Help remembering and scheduling preventive tests and screenings
Medical tests and treatments
Vaccinations and immunizations
Education about prescription drug options

25. Plus + Online Resources Engagement platform app
Secure, customized online health data
Real-time health and benefit information, 24/7
Health screening and important test reminders
Provider contact information

26. Added Expertise
Nation’s Leading Objective Advocacy and Assistance Company
Advanced Clinical Support + Education
Appeals Administration + Review
Direct-To-Consumer Product Support
Regulatory + Outreach Therapy Compliance
Expert Healthcare Partner for Carriers and Health Exchanges

27. Integration has power:
Saves on administrative and HR costs
Improves productivity
Lowers medical costs
Costs less than buying each component separately
Maximizes benefits utilization
Data analytics enables customized coaching and communications
Decreases absenteeism and presenteeism
Helps develop long-term strategies
One integrated report

28. Large, Nationwide Manufacturer
Single 800 # -- services are easier to access
Unlimited support, 24/7
Access to the top experts
Member-, not product-centric
Every interaction is tailored to members’ specific needs
Maximizes benefits utilization
Saves members money
Improved quality of care
Identifies/closes gaps in care
Targeted personalized health communications
Promotes preventive care—teachable moments
Helps members better manage chronic conditions
Integration and engagement can make the difference:
Add

29. Nationwide Manufacturer
Number of Employees:
2,000+
Products:
A fully-integrated, total solution with program offerings customized to salaried and union employees.
Challenge:
Multiple vendors providing different services, with unengaged employees who were unaware of available services. Also challenged by unions who dictate which programs can/cannot be offered.

30. Nationwide Manufacturer
How we helped:
We took a customized approach by implementing a comprehensive solution to increase employee awareness and streamline the experience, taking both union/non-union benefits into account.
Results:
Eliminated five vendors resulting in estimated annual savings of $180,000 ($7.50 PEPM), by moving all services to Health Advocate
Doubled employee engagement rates after just 1.5 months

34. Saves on administrative and HR costs Only one report to review
Helps develop long-term strategies
Improves employee engagement and productivity
Costs less than buying each component separately
Lowers medical claims costs
Data analytics allow us to provide customized coaching
Decreases absenteeism and presenteeism
Maximizes benefits utilization

35. One Collaborative Workspace MemPHIS CMS
Experts work together on cases
Hidden issues are uncovered
Multiple issues addressed at the same time
Faster response
MemPHIS CMS
Facilitates collaborative teamwork
Tracks all interactions
Uses powerful analytics based on claims data
Allows us to “Ask the Hidden Questions”
Spotlights gaps in care
Single reporting

36. Health Benefit Specialists Work/Life Specialists Claims Specialists
Chronic Care Coaches
Personal Health Advocates
Wellness Coaches/
Nutritionists
Medical Directors + Registered Nurses
Licensed Professional Counselors
Master Social Workers

38. We customize the strategy to your organization, so your members keep us top-of-mind:
Personalized home mailers
Posters, wallet cards, table tents, magnets
Newsletters
campaigns
Automated outbound texts and calls
Interactive website and app
Informational flyers
Digital TV/monitor screens
Videos
Intranet materials
Webinars and presentations

39. We use data to close gaps in care
We aggregate health information from claims data
Data is analyzed against clinical care guidelines
Employees who have or are at risk for high-cost medical conditions are identified
Gaps in care are identified
Targeted employees receive:
Ongoing, personalized health coaching
Health information and important reminders on a personalized website
Targeted communications related to their health risks

40. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key insights into behaviors
Member feedback

41. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

42. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

43. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

44. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

45. Michelle was recently diagnosed with asthma after a trip to the emergency room. She had many questions:
How do I find a specialist?
What hospitals and urgent care centers are in my network?
What are my medications going to cost?
My ER bill is being denied, what do I do?
How can I make sure I stay on top of my care?

46. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

47. Hello, my name is Jim, how can I help you?

48. Michelle: Hello, I was recently diagnosed with asthma and I need help finding a specialist in my network.
Jim: Not a problem. I just need to ask you a few questions…
Michelle: I also have these ER bills and I don’t know what I should pay?
Jim: I can also help you with that.

49. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

50. Jim: How are you feeling now?
Michelle: Well, to be honest, it’s been tough. I don’t want to end up in the ER again.
Jim: You know, we have fabulous nurses on staff who specialize in helping people with chronic conditions. They can help you manage your asthma so you can avoid the ER in the future. I can put you in touch.
Michelle: Really? That would be great!!

51. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback

52. One day, her phone buzzed. It was a text from Jim:
Jim’s Text: “Hi Michelle, give me a call. I have some information for you.”
When Michelle called back, Jim not only gave her the names of providers in her area, he also scheduled time for Michelle to speak to a nurse coach.

53. Since then, Michelle has called back often to get help with:
Finding a summer camp for the kids
Starting an exercise program
Getting a claim issue resolved
Locating an urgent care center

55. Large, Nationwide Manufacturer

56. One report where you can easily see:
Estimated ROI and savings
Number and types of interactions
Collaborative Case Factor
Engagement rates by issue type
Population risk
Key Insights into behaviors
Member feedback
Since then, Michelle has called back often to get help with:
Finding a summer camp for the kids
Starting an exercise program
Getting a claim issue resolved
Locating an urgent care center