Group Captives: An Effective Vehicle for Point Solution Implementation

Employers have an abundance of choices in point solutions—specialized services that they can utilize as part of their employee benefits programs to address specific health issues (e.g., diabetes management). In fact, employers have so many choices that "point solution fatigue" has become common, resulting from the vast amount of solutions available, saturated markets, and the potential overlap in services these solutions offer (e.g., diabetes management solutions adding mental health services).

Fortunately, support is available to help employers implement point solutions effectively: self-funding their health benefits through group captive membership. Let’s look at how self-funding in a member-owned group captive can provide employers with valuable advantages to help them wisely evaluate and successfully implement the right point solutions for their employees.

Supporting Evaluation Strategies

Let's review three primary advantages of the group captive model that enable employers to develop successful strategies for evaluating point solutions and partners.

No. 1: Transparency into Claims Data

A significant benefit employers gain from self-funding their group medical insurance plans is greater access to employee health and claims data than in fully funded plans. By thoroughly examining claims, employers can identify cost drivers and determine how well their existing point solutions address those needs.

Typical employee health data and claims analyses might include the following.

• Use of annual preventive exams. By adding exam locations to the analysis, employers can assess potential gaps in access to care.
• Age- and gender-specific adherence to preventive exams, such as mammograms or prostate screenings.
• Cancer claims, including late- versus early-stage detection.
• Potential gaps in care for diabetes and other chronic conditions.
• Severity level and prevalence of behavioral health claims.

No. 2: Flexibility in Choosing Solution Partners

Group captive member-companies also have the ability to unbundle or carve out their point solution partners so they can choose them individually. Although the decision to self-fund gives an employer more flexibility when selecting point solution partners, it won't pay off if those choices aren't sound. This is where having the right partners comes into play. Seeking expertise from a captive or benefits consultant who can work with the company and its broker to help evaluate partners and provide sound recommendations is extremely valuable in selecting the right point solutions.

No. 3: Networking Insights from Fellow Members

Besides access to health data and consultant expertise, group captive members can take advantage of an even wider range of point solution expertise and experience from perhaps their most valuable resource—their fellow member-owners. During captive board meetings and other events, members can gain insights into various point solutions and providers from their fellow members.

Through networking, members can find out which point solutions and partners have given their peers commensurate value for the costs. They can also gain insight into emerging workplace health and cost containment trends to proactively address them and minimize potential costs.

Implementing Best Practices

Once a member-company selects the point solutions that best fit its individual needs, it's imperative to implement them the right way. Given the diversity of available point solutions, there isn't one uniform way for a company to do this; however, there are several best practices companies can follow to optimize the implementation process.

Understand Current Challenges

Start with a comprehensive assessment of your organization's current healthcare needs and challenges. If possible, you can conduct further analysis to understand the root cause(s) of the cost drivers. Examples of root causes include access to healthcare gaps, lack of preventive screenings, financial barriers, or mental health-related issues.

Define Success Metrics

Clearly define your objectives before implementing healthcare point solutions. Determine what success looks like for your organization and establish measurable metrics to track progress and impact. These metrics might include employee satisfaction, healthcare cost reductions, better health outcomes, and more.

Explore the Right Solutions

Evaluate point solutions that align with your organization's needs, goals, and budget. Consider solutions that offer comprehensive features, scalability, interoperability, and user-friendly interfaces. Many point solutions are now expanding their capabilities and/or partnering with other point solutions to solve more than one problem.

Ensure Integration

Seamless integration among point solutions and existing systems is crucial for optimizing efficiency and data accuracy. Consider solutions that can easily integrate with each other, your organization's human resources software, and other relevant platforms.

Communicate

Effective communication and incentivization strategies are essential. Overcommunicating is almost necessary to ensure employees know the solutions' benefits, hear the success stories, and understand how and when to access and utilize them.

Monitor and Adjust

Regularly monitor performance using predefined metrics. Analyze data to identify areas for improvement and opportunities to enhance the return on investment. Adjust strategies and configurations based on employee feedback and evolving organizational needs. Lastly, allow enough time for employees to engage with the solution and for outcomes and savings to develop.