Facilitating Care Through Healthcare Advocacy

Company Overview

A long-time client based in Cleveland, Ohio with 110 employees.

Key Challenges

This client, which has enjoyed strong growth through an increasingly diverse employee demographic profile, alerted us two years ago to a growing concern among their employees. It seemed that a number of their staff members had experienced challenges with understanding the intricacies of the company’s robust benefit plan, including pre-authorization necessities, navigating provider networks and determining the best treatment options for certain conditions.

MBA Solution Presented

Our team suggested the implementation of a patient advocacy program. Through advocacy, employees and their families would have access to a dedicated team of doctors, nurses and clinical specialists to help them maneuver through the health care system, providing needs based guidance, answering questions and helping to facilitate their care. A successful advocacy program will provide the help needed to prevent health events from ever becoming a crisis.

Measurable Results

Employee usage of the program has seen a sharp rise each month that has passed since the program inception. The company has reported a substantial savings through increased employee productivity, while patient advocates were able to save employees over $25,000 by correcting erroneous billing issues. Additionally, a general decrease in claim utilization during the second year offset our client’s cost for the program and a third-year savings in excess of $74,000 has been attributed to the program through a reduction in duplicate testing, unnecessary diagnostic procedures and wasted medications.