How to Choose Health Benefit Decision Support: 10 Questions to Ask

Benefit decision support helps more consumers choose a health plan that best fits their needs. With added support and education, individuals get more from their benefits and end up happier at work, happier with their carrier, and living healthier in life.

 Those are some powerful reasons for adding decision support, but you might be overwhelmed by the options if you’re considering adding it this year. After all, sifting through the different platforms can be confusing, not to mention time-consuming. That’s why we’re here to help.

We’ve put together a list of key questions to ask when choosing health benefit decision support software. Our list includes the key features to evaluate when looking at what’s on the market. If you ask these questions when evaluating solutions, we’re confident you’ll choose the one that best supports your people.

How to Choose Health Benefit Decision Support: Questions to Ask

1. Does it have a simple setup process?

 Benefit professionals know that open enrollment (and the months leading up to it) are incredibly busy. Adding a new solution is often only feasible if the install process is easy. Be wary of decision support offers that don’t tell you exactly what you’ll need to do to get started. A good solution will:

1. Build out your specific benefit offerings in their system—you’ll just need to send them your health plan documents and contribution structure.
2. Develop a custom communications plan for sharing the solution with employees. This should include custom emails, posters, and videos—everything you need to get the word out, without adding more work to your plate.

2. Does it include live customer support?

 There’s a reason that more than 90 percent of employees roll over their health plan choice every year: choosing the right plan is too complicated. Decision support won’t make a big impact unless it comes with live support. Along with a robust online support system (e.g., email support, resources, and FAQ), employees should have the option to talk to a real person at any point during their experience, whether when sharing their medical use or reviewing their recommendation.

 The tool should be available for employees to use at any time from any device, whether their phone or computer.

3. Are recommendations based on each employee’s self-reported predicted medical usage?

 Decision support is only useful if consumers trust it. Otherwise, they’ll dismiss the recommendation and just stick with their same plan—and you’ll have wasted money on a platform that might look nice but doesn’t get you results. That’s why it’s important to pick a platform that provides personalized recommendations that people trust.

Look for platforms that have consumers walk through a series of questions about their specific medical usage, instead of giving them a generalized recommendation based on the healthcare usage of similar people. Individuals are more likely to trust recommendations that they know are about them, not people like them.

4. Is education provided at every step, especially around HSAs?

Words like “deductible” and “out-of-pocket maximum” are still a mystery to a lot of people. Only four percent of Americans know all the terms needed to understand their healthcare costs. That’s why it’s important to choose a platform that offers multiple educational resources, like videos and infographics and defines complicated terms for employees as they go through the platform.

Education on health savings accounts (HSAs) is particularly important, given that HSA-eligible plans are historically underutilized. Be sure to choose a platform that embeds education about HSAs throughout the employee experience and calls out the employer HSA contribution, when applicable.

5. Can employees easily understand why the recommended plan came out on top?

 Most platforms offer a results page that shows employees which health plan is best and why. This is a make-it or break-it part of the experience. After all, employees won’t choose a plan based on a recommendation that they don’t believe.

 Here are some things to consider when comparing the results page for different solutions:

1. Is the information easy to understand? Ideally, it should include simple graphs that outline the total healthcare costs employees can expect under each plan option.
2. Can the employee easily see what went into the report? Many employees won’t trust a recommendation unless they can see what it’s based on. The best solutions will show employees how their specific medical usage impacts their healthcare costs for each of their health plan options.

6.  Can employees can make real-time edits?

Make sure that employees can go back and edit a response to a question without restarting the whole experience. Similarly, choose a platform that allows employees to add or remove medical services and see the real-time impact on their expected healthcare costs. This is not only simple; it’s also interactive and fun, which can increase overall participation.

7. Is it specific and accurate?

 Many solutions on the market don’t account for specific variables that have a big impact on costs. These solutions seem adequate at-a-glance, but end up with major inaccuracies that employees see right through (again, remember that trust matters). Save your money and invest in a platform that accounts for things like:

• Embedded deductibles and out-of-pocket limits
• Tiered provider networks
• Prescription pricing based on brand vs. generic, mail vs. retail, and 30- vs. 90-day supplies
• Early intervention services
• Specific specialists and mental health services 

8. Does it include a claims integration?

A claims-based analysis shows employees which health plan will save them the most money based on their past medical use. For employees whose medical needs aren’t changing, this report provides an incredibly, accurate, personalized cost comparison—and one that they can see in seconds. It can also be a real wake-up call for employees who might have dismissed decision support. Seeing that they have a big potential to overspend encourages employees to use the platform and make a change.

9. Does it show ROI and plan selection trends?

 Don’t pay for something unless you’ll be able to prove it made an impact. Good decision support platforms collect pre-and post-enrollment data, so employers can see how many people used the tool, which plans that platform recommended, and how recommendations affected employee plan choice. This not only provides an ROI but also gives employers insight into how well their benefits packages serve their employee populations.

10. Can it predict which plan employees will choose?  

 A good decision support tool can cause a 3-4X increase in employee plan migration, often moving employees to lower-premium plans. That’s great news for employees and fully-insured employers—everyone will save on premiums. But that unexpected movement could lead to unintended consequences for self-insured employers and their predicted costs. If your decision support platform doesn’t mention this potential impact, they’re doing you a disservice. Look for platforms that:

1. Acknowledge their impact on migration, and,
2. Have software that predicts how decision support will impact employee plan choice.

With this comprehensive solution, benefit consultants can factor in decision support when setting plan pricing, and ultimately ensure a setup where the employer and their employees save.

With MyHealthMath, every answer is Yes.

MyHealthMath’s decision support answers yes to every question on the list. Our personalized decision support goes above and beyond other solutions on the market, providing individual support, an engaging experience, and incredibly accurate recommendations. People trust our product, which inspires them to make a change. With MyHealthMath:

• 95% of employees are satisfied
• Employees save over $1,300 annually on healthcare costs
• Employees are 3-4x more likely to choose a more cost-effective plan