Through employee health navigation, your team can be empowered to work with referral experts to find the best care at the best cost, whether that’s seeing a specialist to getting an MRI.

Consider this scenario.

Employee #1 needs an MRI and decides to schedule it at the hospital’s preferred imaging center located 30 minutes across town. Price: $3,000.

Employee #2 also needs an MRI but chooses to call other imaging sites to seek more information. After comparing options, Employee #2 schedules an MRI at the independent imaging center located five minutes from home. Cost: $900 — for the same service!

Your first employee probably wasn’t too happy to learn they could’ve saved $2,100 and a few hours of time, simply by shopping around. Unfortunately, in some instances, employees likely decided to skip the imaging appointment altogether.

“I’ve had patients who needed a CAT scan or MRI, but the sticker shock prevented them from following through,” says William Klein, MD, Regional Medical Director at Marathon Health. “That’s a huge impediment to their care. Not only is it a lot of money out of the pocket, but it also puts up an unnecessary barrier.”

More often than not, your employees fail to realize they can evaluate options for specialty care and diagnostic testing. It’s often due to large hospital groups steering patients toward their network providers, with little regard to the patient’s personal needs.

“Referrals are made by network stance, so it doesn’t necessarily make it the best provider or the most affordable option,” says Becky Guanajuato, Family Nurse Practitioner at Marathon Health. “It’s based on who you’re affiliated with, not on your own narrative or your own capabilities.”

Instead of the traditional care navigation model, what if your employees had a team of referral experts performing the legwork on their behalf, who only presents options based on price, proximity to their home or office, patient satisfaction, and of course — covered by your insurance? Even better, what if the referral team scheduled the appointment for you, then communicated the results back to your primary care team?

Enter personalized employee healthcare navigation.

Empowering Employees with Best Healthcare Navigation Experts

At Marathon Health, we take a fundamentally different approach to care navigation, one defined by putting employees in control of their healthcare, while we maintain complete independence from traditional hospital systems or networks. It allows our referral coordinators to truly select a specialist or diagnostic center that works best for each patient – free of influence.

“Once one of our providers decides a patient needs to see a specialist, we send the information to our referral team and they take over from there,” Guanajuato says. “Within 24 hours, they’ll locate the provider and make the initial outreach.”

Before the referral coordinator makes contact, the provider initiates a conversation to determine how to best serve the patient’s needs. Do they possess barriers to travel? Is there a specific day and time that works best? Do they prefer a virtual visit? Would they consider an out-of-network option? Knowing the answers to these questions empowers the referral coordinator on the front-end to provide the patient with options tailored to their needs, and at the lowest cost.

“I help them understand the referral team is there to help find the best option, in terms of their insurance, their location and price,” Dr. Klein says.

Patient Navigators Help Employees Experience the Best Care at the Best Cost

With over 16 years of institutional knowledge, our referral team picks from a deep bench of high-quality specialists, who prioritize high-value care and an exceptional patient experience

“We’re more aware of what’s the better option insurance-wise, which reduces call-backs and lessens the burden on the patient,” Dr. Klein says. “We also track these specialists over time. The referral team will follow up with the patient and collect feedback on their experience, which allows us to isolate the specialists that will best serve our patients in the long run.”

The referral coordinators go above and beyond simply scheduling the appointment and communicating with the patient, they also share notes and other data with the specialists or diagnostic center, then communicate the results back to the Marathon Health care team.

“In the old days, I would give a referral to the patient, and I wouldn’t necessarily know whether or not they went to the specialist until my next visit,” Dr. Klein says. “Our referral team stays on top of it, and it really helps with patient follow-up.”

If a patient doesn’t follow through on a scheduled referral, the coordinator reaches back out to the provider, who makes contact with the patient. “A lot of times when we make referrals, the patient may be hesitant or they’re too busy. Whatever the reason, the referral team works with the patient to figure out their barriers,” Dr. Klein says. “And it gives me the opportunity to talk more about what their hesitancy is, whereas before the referral would just disappear.”

At the end of the day, we help patients experience the best care at the best cost, and that doesn’t change once they leave our center. We strive to be the trusted partner in their care journey, guiding them to higher-value care with better outcomes. 

About the Author: Kristy Esch

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