Benefits managers have to weigh many factors when it comes to employee health. The advantages of integrated healthcare offered by a sole carrier is one of those factors. In some cases, healthcare from a sole carrier can lower costs, improve health outcomes, and simplify the experience.
A sole carrier is a medical insurance provider that offers pharmacy coverage and other health insurance products like dental, vision, disability, absence management, Employee Assistance Program (EAP), and supplemental health.
This approach to healthcare is becoming more common. One reason is it allows doctors and other health providers to seamlessly share data. This helps them consider a complete view of a person’s whole health. When they are able to look at all factors, they can better diagnose and treat patients, detect coverage gaps, and guide employees toward prevention and care management.
According to a recent study, 56% of employers are already integrating benefits. This integration can happen between separate insurance carriers with partnership agreements. But 71% of employers who are integrating benefits are doing so with a sole carrier.
Integration provides a better healthcare experience for both employers and employees. Potential benefits include:
- Increased employee engagement in well-being programs.
- Lower healthcare costs.
- Improved health outcomes thanks to the whole-health approach.
- A simplified benefits portfolio.
Products offered by sole carriers
While these products can change by carrier, there are many benefits a sole carrier can provide. Some examples are:
- Pharmacy – Pharmacy is the most used benefit among medical and pharmacy plans. So, it makes a lot of sense to provide connected pharmacy and medical benefits through a sole carrier. Not only can be more convenient, it can also promote better communication and connectivity between doctors and pharmacists. It gives your medical professionals a more complete view.
- Vision – Employers can integrate vision to keep eye-related illnesses from limiting employee productivity.
- Dental – Many health issues, including chronic conditions like heart disease and diabetes, have connections to oral health. A sole carrier connecting dental and medical benefits can help detect these issues early before they become more serious and more costly.
- Disability – Nine out of 10 disabilities are caused by illness, not accidents. And many disability claims require a visit with a doctor. Providing both benefits under a sole carrier makes it easier to connect plans and improve outcomes.
- Employee Assistance Program (EAP) – Increased demands at work and home can lead to added stress for employees. EAPs can give employees an easy and confidential way to receive help with managing personal or work issues.
- Supplemental health – This provides additional medical coverage and assists with costs not covered by traditional medical insurance. Supplemental health plans ease worries and protect your employees’ financial security.
Employers have different reasons for offering these products. But nearly all help improve employee health and offer the most convenient healthcare experience.
When to carve out benefits
While there are many benefits to the sole carrier approach, it is not right for every business. In the past, carving out ancillary benefits was an opportunity to lower costs. This was especially true with pharmacy benefits. Prescription drugs account for a growing share of healthcare spending each year. That number is expected to continue to grow.
In some cases, purchasing and managing your pharmacy plan separate from your medical plan can allow for increased customization and potential cost savings depending on the size and makeup of your employee population. But it is important to ensure that potential cost savings do not come at the expense of larger health goals. A disconnected approach to patient care could end up creating more costs as well as confusion.
While it may not be right for every business, the advantages of the sole carrier approach to healthcare are clear. Integrated healthcare can lead to lower costs, improved health outcomes, and a simplified experience. Talk with your broker or healthcare partner today to see if medical benefits provided by a sole carrier can work for you.