Compass professional health servicesnbiandassociates.com/pdf/compass.pdf · 01/09/2018 ·...
Transcript of Compass professional health servicesnbiandassociates.com/pdf/compass.pdf · 01/09/2018 ·...
HEALTHCARE NAVIGATION
Healthcare Navigation Redefined
COMPASS SNAPSHOT
HQ: Dallas, Texas
Founded: 2005
Employees: 258
Clients: ~2,000
Fee Model: Subscription (PEPM)
Implementation: < 2 months
Total Member Solutions: 1.35 million
Utilization: 25%+ (5x industry avg.)
1 The Wall Street Journal2 Harris Poll (www.insurancebusinessmag.com/us/news/
breaking-news/americas-leastrespected-industries.aspx)3 Global Brand Simplicity Index 2017
(http://simplicityindex.com/wp-
content/uploads/2017/01/SG_GBSI_2017.pdf)
Administrative Headaches
30% of medical bills are incorrect. 1
Lack of Transparency
The average employee overpays for prescriptions by 50% and in-network healthcare prices can vary by 300% or more.
Low TrustOnly 7% of Americans trust healthinsurance companies. 2
Overly Complex
The healthcare insurance industry rankslast in simplicity across 25 differentindustries – and the large healthinsurance companies hold 3 ofthe bottom 5 spots. 3
CHALLENGE THE STATUS QUO
Employees Have a Healthcare Hassle Problem
CHALLENGE THE STATUS QUO
Difference
Employers Are Overpaying for In-Network Care
In-Network
Prices for GI
Endoscopy
5x$527
$2,850$527
$1,240
Facility 2Facility 1 Difference
In-Network
Prices for MRI
2.4x
CHALLENGE THE STATUS QUO
Employers Are Wasting Money on Unnecessary CareTHE ”SNOWBALL” EFFECT OF GOING TO THE WRONG DOCTOR
• Orthopedist refers to
expensive imaging that is 2x
more expensive than area
average
• Orthopedist pursues surgery instead of
more conservative therapy
• Surgery performed at a facility that is 3x
more expensive than area average• Brand name meds
prescribed instead of
lower-cost alternatives
CHALLENGE THE STATUS QUO
Other Factors Driving the Employer Cost Problem
and Increased Renewal Rates
Rx Spend is
Out of ControlPlan members can save 1/3 on prescriptions by switching to more cost-
effective options like generics.
Specialty vs.
PCP Care37% of plan members
do not have an established relationship with a PCP, leading to initial overly expensive care with a specialist.
Healthcare Navigation
A DIFFERENT APPROACH
Healthcare Navigation helps employees make
simpler, smarter healthcare decisions.
Eliminate the healthcare hassle and optimize your network
with high quality, cost-effective care.
COMPASS NAVIGATOR
Complete Support Throughout Your Entire Journey
Understand Health
Benefits and Plans
Guide to the Right Programs
at the Right Time
Coordinate
Care
Compare Costs for
Procedures and Care
Drive Lower Cost
Rx Options
Get Help with
Medical Bills
Find Highly-Rated,
Cost-Effective Providers
The Glue That Makes Healthcare Navigation Work
COMPASS HEALTH PROS
The Compass Health Pro Difference
COMPASS HEALTH PRO
HIRING
• 4 year college degree
• Only 4% of applicants
accepted
TRAINING
• 6 months training
before interacting
with members
HEALTH PRO TOOLS
• 4.2 Billion price points
across 66 payer networks
for over 13,000 procedures
Higher Ranked PCPs Minimize Patients’ Average Total
Healthcare Costs & Ensure Better Care Experiences
THE RIGHT DOCTORS REDUCE HEALTH PLAN RISKS
Compass-Recommended PhysiciansNPS = +77
Bottom 50%in ranking
$6,698*Market PhysiciansNPS = +3
* Total Healthcare Costs
per Patient Per Year
Top 50%
$3,875*
Top 25%
$2,752*
Top 10%
$1,795*
• Clean State Licensing and Litigation History
• Current, not lapsed Board Certification
• Cost-Efficient
• Practice Patterns consistent with Clinical Guidelines/Evidence-Based
• Proactive “Medical Home” Multi-Provider, Multidisciplinary Practice
MEMBER ENGAGEMENT
Getting the Most Out of Your Compass Partnership
Making It Easy to Connect with Compass
MEMBER ENGAGEMENT
• 61% of members submit
a request via email
PHONE
• 46% of members
engage with their
Health Pro via phone
MOBILE APP
• 30% of app users are first
time Compass users
• 17% increase in overall
utilization with app
WEB
• 31% of members
engaged through Get
Connected platform
Creating Smarter Healthcare Decision-Makers
with Our 12-Month Member Curriculum
MEMBER ENGAGEMENT
Health Pro Cloud Gives Members 24/7 Access
to Compass Insights & Data
MEMBER ENGAGEMENT
TRUSTED
Helps employees make decisions
that take into account both
quality AND cost through a
trusted, independent 3rd party.
SIMPLE
Removes the
administrative
burden of
healthcare.
IN-THE-MOMENT
Helps employees understand
and use their health benefits
“in-the-moment” when they
actually need them.
PERSONAL
Meets the unique, personal
and emotional needs of
each employee.
Incentivize Good Consumer Behavior
for Higher Levels of Engagement
MEMBER ENGAGEMENT
GET CONNECTED
Download the Compass Health Pro Cloud app
to complete the Get Connected process.
ESTABLISH A RELATIONSHIP WITH
A PRIMARY CARE PHYSICIAN
Obtain a PCP Recommendation from
Compass or certify that you have one.
RESULTS
Proven Results for the Past Decade
Proven Results Across Our Book of Business
2017 RESULTS
Do Employees Use It? Do They Like It? Does It Save Money?
4Avg. No. of Solutions
Per Return User
+84Industry Leading
Net Promoter Score
$1,158Avg. Savings
Per User Per Year
3:1 ROI
21% 27%
Where Does The Savings Come From?
RESULTS
RO
I
Utilization
Every 7% to 9% of Utilization Produces on Average a 1x ROI
Healthcare Navigation Solutions for Any Budget
COMPASS SOLUTIONS
COMPASS NAVIGATOR
Give employees
comprehensive healthcare
navigation
COMPASS ADVOCATE
Eliminate the healthcare
hassle
COMPASS CONSUMER
Optimize your network with high
quality, cost-effective care
NEW – Available Now NEW – Available 9/1/2018
* With Compass Advocate, employees will be referred to third-party transparency tools, when available.
Healthcare Navigation Solutions for Any Budget
SOLUTION COMPARISON
Compass
Navigator
Compass
Advocate
Compass
Consumer
Eliminate the hassles of health insurance and healthcare
• Assistance Choosing the Right Health Plan ✔ ✔
• Help with Medical Bills and Resolving Billing Errors ✔ ✔
• Connect to Other Health Benefits Programs* ✔ ✔
• Help with Coordinating Care ✔ ✔
• Assistance with Understanding Health Benefits ✔ ✔ ✔
• Help with Scheduling Appointments ✔ ✔ ✔
• Personal Compass Health Pro® Support ✔ ✔ ✔
Optimize your network with high quality, cost-effective healthcare
• Find Highly-Rated, Cost-Effective Providers and Care ✔ ✔
• Compare Costs for Procedures and Care* ✔ ✔
• Find Lower Cost Alternatives for Prescriptions ✔ ✔
• 24/7 Access to Health Pro Cloud App and Member Portal ✔ ✔
Problems Solved
Ideal Client Profile
1. Employers that want a strategic central benefits
hub that their employees can use to navigate and
integrate all of their diverse health-related benefits
—medical, dental, vision, Rx, wellness, disease
management, telemedicine, etc.
2. Employers that do NOT want to use their medical
carrier as that navigator either because they know
their employees do not trust and will not talk to an
insurance company and/or because they want
the flexibility to change their carriers overtime while
keeping their same employee-facing service (i.e.,
Compass) consistent.
3. Employers that address healthcare costs with a
consumer directed health plan.
4. Employers that want to give their employees tools
to be better healthcare consumers in those plan
designs via both high-touch concierge service and
technology.
COMPASS NAVIGATOR
Ideal Client Profile1. Employers who do not need or have the budget for a full
navigation solution.
2. Employers that offer low-deductible PPO Plans (<$500
individual) and that want an easier experience with their
health benefits, but not much cost-share in the plan design.
3. Employers that offer HMO Plans where members have low-
dollar copays and a PCP gatekeeper who directs their care,
but also need an easier health benefits experience.
COMPASS ADVOCATE
4. Employers that are unhappy with their current advocacy
service where their current vendor does not have a personal,
assigned Health Pro for employees and their families and has
slow or poor service.
5. Employers that want to use their free insurance carrier online
tools for price-transparency, doctor search and prescription
assistance, but need advocacy support to help employees
with all the healthcare “paperwork.”
Ideal Client Profile
1. Employers that address healthcare costs with a CDHP and want to steer employees to more cost-effective providers.
2. Employers that have another outside advocacy vendor but are looking to steer employees to more cost-effective providers with a transparency solution.
3. Employers that are dissatisfied with their insurance carrier price-transparency tools because they are underutilized
and too confusing for employees to use.
4. Employers that have a particular problem with high prescription costs and are looking for a specific tool to address this problem.
COMPASS CONSUMER
2. 25x BETTER CARE
The satisfaction rates for Compass-
recommended providers have an average Net
Promoter Score of +77 – more than 25 times
higher than those employees find on their own.1
3. GUIDANCE WHEN NEEDED MOST
Help employees understand and use health
benefits programs “in-the-moment” when
they actually need them.
4. 7x BETTER BENEFITS EXPERIENCE
Simplify the healthcare experience for your
employees so they can focus on their jobs and
families.
1. $1,158 SAVINGS PER USER
Empower employees to make smarter
healthcare decisions that lower
healthcare costs.
Why Compass?Eliminate the healthcare hassle and optimize your network with high quality, cost-effective care.
1 The Advisory Board Company