Do you go to Google and see what doctors have the best ratings? Or do you go to your family and friends for recommendations? Or perhaps you visit your health plan’s website to see if they have a provider search tool?
What is steerage? Steerage, or healthcare navigation and guidance, is when a health plan directs a member to a better or more affordable provider – helping both the employer and employee save money, and the employee get better care overall.
When done correctly, steerage can save the employee money in the long run. For example, the same service can cost 10x more at a facility across the street. A health plan can guide members to facilities and providers that are more affordable.
For standard services, this guidance can especially come in handy. For items like surgeries and advanced imaging, providers need prior authorization from insurance in order to execute these services. Let’s say a prior authorization comes in and the member is expected to pay $1500 for basic imaging. Steerage can help guide members to a place that is lower cost.
At Poppins Health, it’s our goal that our members go to the best possible care, and not just rely on word-of-mouth for recommendations but actual objective data. Enter our Member Navigation team.
The Member Navigation team’s number one goal is to make sure members understand what their plan is and what it can do for them.
“A lot of times in the past, members had to go with their gut on who they felt was a good quality doctor, or go to a neighbor because they had a good outcome. Objective data is not easily accessible,” says Member Navigation Lead Beth Anne Doner. “Our version of steerage is providing our members with all the information they need to make an educated decision on where they’re going for their healthcare needs.”
For employees to be more informed consumers, the Member Navigation team helps them:
It’s also important to note that members don’t have to switch their doctors in a Poppins Health plan. If a member comes in with a doctor or facility in mind, member navigation will call to make sure that the provider knows who they are and to provide the copay level to the member – even offering alternatives if the copay is too high. In a lot of these cases, member navigation and the provider team can get contracts and single-use agreements in place to ensure continuity of care.
At the end of the day, the member navigation team wants to help members be healthy by providing them options for cost-effective high quality services for their healthcare needs. To them, it’s personal.
“I treat every case like I would if I was telling my mom or dad where to go,” Beth Anne says. “I want them to get the best possible care.”
This kind of attention also extends to helping members overcome any obstacles. Why are members not going to a doctor? Is it too far away? Are they scared? What obstacles can they remove in order to get them to an office and ensure they get care?
These high touch conversations are what makes the Poppins Health Member Navigation team so successful. As one member put it, “It's amazing that you are handling all of this and getting it taken care of because I know I would have probably just said ‘heck with it, I'll just deal with it.’ You did everything but book my hotel."