Despite continued work to simplify the system, health care can be complicated — and some employees still have difficulty taking full advantage of their benefits. In fact, in one survey, about 60% of members said they didn’t have a good understanding of their new health plan.1
UnitedHealthcare is working to change that with a multi-layered advocacy program designed to avoid a member having to go at it alone.
Part of this advocacy work includes increasingly personalized digital tools, backed by comprehensive data, that can become a resource for a member who’s trying to find network providers, program recommendations, claims information and more.
If they hit a roadblock, there’s Advocate4Me. Employees can pick up the phone to be directed to an expert advocate who can guide them to answers — all with an eye toward better health and affordability.
“We define advocacy as knowing that someone is looking out for you,” said Nia’Be Mitchell, vice president of member experience at UnitedHealthcare. “With Advocate4Me, we help members navigate the system to get to resources.”
Advocates have a wide range of their own qualifications and the support of a full team of clinicians, pharmacists and other specialists for finding answers to questions.
When they’re on a call with a member, advocates can see a comprehensive health profile — including how a member has used the health system in the past — to assist in offering guidance. Additionally, when an employer integrates medical coverage with pharmacy, behavioral and specialty benefits, advocates can go beyond basic benefit and claims questions. They may be able to help an employee enroll in clinical programs or access other helpful tools, including ones that address mental health.
“We help our members connect the dots,” Nia’Be said. “We answer their specific questions and listen for ideas in the conversation about how we can highlight other services.”
Calls that connect dots
Case in point: a mom who called in for help finding a pediatrician in her new town.
“She was really far away from her family for the first time in her life,” said Liz Durkin, the UnitedHealthcare Advocate4Me specialist who took the call. “I could hear her very small, very energetic kids in the background.”
Liz, a mom herself, also sensed stress in the woman’s voice and knew she may be able to help with more than just the name of a pediatrician.
“I understand being stressed out but not being really sure where to go, because it doesn’t seem like a crisis or an emergency,” said Liz, who specializes in behavioral health support.
In addition to helping with a list of network pediatricians, Liz told the woman about the Sanvello emotional-support app, which she could use at no cost to help reduce stress and anxiety. They also went over ways the busy mom could access medical or mental health services virtually, including through the Employee Assistance Program, another support service already included in her family’s health plan.
“I can really listen to what they are saying — or how they are saying it — to be able to take a look at their whole benefits package and recommend services or benefits,” Liz said. “Then, I can explain how things work.”
“We want to make the most of each touchpoint to help members find that care that is convenient, cost-effective and meets all their needs,” Nia’Be said. “Advocate4Me helps make that happen.”
More on UnitedHealthcare advocacy
Advocate4Me is part of the broader UnitedHealthcare advocacy work that focuses on creating solutions to common stress points for employees, including:
- Understanding coverage
- Reducing costs
- Accessing quality care
- Managing complex conditions
For more information about advocacy resources, visit uhc.com.
1 UnitedHealthcare new member tracking survey, 2019.