3 reasons bundled surgical benefits are a win with employees

bundled surgical benefits

The disruption caused by COVID-19 shifted people’s priorities, especially in the workplace. Rather than chasing the highest-paying positions, employees are now assessing compensation packages more holistically.

People now want to work for companies that support their overall health and well-being and that provide better healthcare benefits. In fact, 37% of employees in North America would rather receive more generous benefits than additional salary/wages or bonuses, according to a 2020 report from Willis Towers Watson.

“Employees of all ages want more security—and getting benefits through their employer is an important way to obtain it,” Steve Nyce, senior economist at Willis Towers Watson, told SHRM. “They also want choice and personalization and are looking to their employers to provide tools to ensure they make good decisions on issues that are often quite complex.”

And decisions about surgeries and other high-priced procedures are some of the most complicated healthcare decisions people can make. To offer more personalized guidance and higher-quality healthcare benefits—without increasing costs for the business or employees—many companies are turning to surgical Centers of Excellence (COEs).

More than half (53%) of employers now offer access to COEs, according to another 2020 survey from Willis Towers Watson. More than 80% of these employers believe COEs will effectively reduce annual healthcare costs per employee, while 92% say COEs will effectively improve the quality of the healthcare they receive.

COEs help companies achieve these dual goals by building a network of skilled, pre-screened healthcare providers—but all COEs are not created equal. The best programs use their buying power to negotiate lower, more predictable rates with bundled surgical payments. They ask providers to commit to affordable, flat rates for end-to-end care associated with specific high-cost procedures—and then pass those savings on to businesses. And employees reap the rewards.

Here are three ways bundled surgical benefits can boost employee loyalty for the long term.

1. No surprise bills

For many employees, unexpected medical bills can break the bank. With traditional insurance, big-ticket surgeries often come with high deductibles and out-of-pocket costs that may discourage people from seeking much-needed care.

Employers that use bundled programs typically save so much money that they’re able to waive all employee costs related to specific procedures—and even sponsor any travel needed to get patients to a COE. Plus, the best programs restrict COEs from issuing any patient bills for specific services, which reassures employees that they will get the care they need without going into debt.

A recent RAND study of bundled payments for commercially insured populations, for example, found that companies using Carrum Health’s digital COE platform saw an average savings of $16,144 per surgical procedure. And while patients were paying between $998 and $2,387 in out-of-pocket costs, copays, and deductibles before, most paid nothing under Carrum’s program.

2. Patient-centric healthcare

Surgical bundles increase cost transparency and predictability for employers, which helps them offer higher-quality benefits to their employees. Knowing what they will pay upfront lets companies plan better and deliver more value to employees with every dollar they spend.

The best COE benefits adopt a value-based model, which rewards doctors for prioritizing appropriateness of care. These programs pay providers for consultations and evaluate their performance based on patient outcomes. Conversely, the fee-for-service pricing model pays providers based solely on the number of procedures they complete, which unintentionally incentivizes excessive and unnecessary medical care—even when it may not be the most appropriate course of treatment for the patient.

Traditional insurers and COEs are too invested in the fee-for-service model to change, even though it often leads to painful complications and readmissions for patients. The RAND study of Carrum’s value-based program found that 30% of members who were initially recommended surgery were redirected to less-invasive treatment options—and the program reduced readmissions overall by 74% to 86% relative to the national average.

3. Guaranteed surgical outcomes

When providers are incentivized to produce the best possible patient outcomes, everyone wins. True surgical bundles ask providers to guarantee their work. This comes in the form of a warranty that covers all related care for at least 30 days following a procedure.

Because most complications, such as readmissions, happen within the first month after surgery, these warranties encourage doctors to deliver the best possible results every time, which means lower costs for employers and shorter recovery times for patients.

Empowering employees to pursue the proper medical care, without the stress of anticipating surprise bills or worrying about unexpected challenges in the process, is a powerful way for any company to boost its benefits package. Supporting employee health and wellness goes a long way toward keeping your workforce engaged and productive—because people are more willing to go the extra mile for an employer that cares.