Complexities in the Healthcare System Create Opportunities for Brokers

Take a look at clinical advocacy programs

After what she thought was a routine mammogram, Wanda Jones (pseudonym) got the call women dread. She had a spot on her right breast, and it was cancer. She got the news while at work and immediately told a colleague and her manager. She and her colleagues spent the next several hours crying and trying to figure out what to do, from how to tell her family, to what this would mean for her job.

The following day, reassured her employer would support her, while at work, Wanda went online researching her diagnosis and treatment. Her health plan called and said they could get her in to see a cancer specialist, in four weeks. What was she to do before then? She didn’t have an established relationship with a primary care provider. She didn’t know whom to call, what to expect, or what to do. The confusion and lack of support led to considerable anxiety and, understandably, impacted her productivity at work.

Employers are Demanding a Better Way

Unfortunately, Wanda’s experience is all too familiar for employers and employees in California. However, to better support workers facing chronic or serious conditions, increasingly, employers are turning to independent outside resources. Partnerships with clinical advocacy firms are of interest to both fully and self-insured populations. The primary goal of these programs is to help employees get optimal care, and the most from their benefits, by helping the member navigate their medical needs and the healthcare system.

Read the full article on California Broker Magazine.