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First Match

Vision Benefit Breaks Out of Silo

Friday, March 7, 2014
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Every once in a while, I like to revisit a basic employee benefit to consider whether anything has changed.

This year, it's vision benefits. To be honest, vision benefits came to mind as reading menus in poorly lit restaurants became an increasing challenge for me.

I will spare you the analysis I could provide on the prevalence of vision impairment, problems and disorders (more than 150 million Americans alone use corrective eyewear), or the estimated impact on productivity ($48.4 billion). The reality is that many employers offer vision benefits (82 percent, according to the Society for Human Resource Management's 2013 Employee Benefits research report) and their workers appreciate it.

According to Jeff Spahr, president of WellPoint's vision, voluntary, life and disability business, the core vision-insurance benefit hasn't changed over time. Spahr must be right about that. I put out multiple requests on Twitter, LinkedIn and Facebook to speak with vendors and employers about innovation in vision benefits. WellPoint was the only company to respond.

What allowed vendors such as WellPoint to "fundamentally make giant leaps forward," according to Spahr, is its ability to move the vision benefit out of its "disconnected product silo" and cross it over to the larger body of health benefits and its associated data.

Employers, meanwhile, have nothing to do with the release of information or the authorization of the release of medical information. The insurance company can share information among medical practitioners as part of the provision of patient care.

Spahr believes sharing data makes the difference, and "the two-way sharing of information improves care at > both ends."

In other words, in a perfect world, the eye-health provider receives the patient's larger medical history and then shares the results of the eye examination back into the system. From there it goes into the member's clinical profile, where it is subject to a monthly risk-stratification algorithm. This triggers an appropriate response, which can range from something as innocuous as a postcard to the employee to a call from a health coach to an alert to the primary-care physician.

Spahr essentially believes this system is "leveraging every encounter in healthcare," which will ultimately lead to a total-healthcare-cost model.

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Now, I have no vested interest in WellPoint (although they hired me in the past to speak < at > a conference). But, here's what captured my attention.

I worked for a stand-alone ancillary line carrier. One of our differentiators was that we partnered with an array of health-insurance carriers to share data and occasionally case and claim management.

We were not, however, able to feed data to the healthcare practitioners, particularly on a proactive basis before they saw their patients. And the practitioners were not able to feed their data back to us, or the larger medical history.

As HR executives, the ability to provide your employees with complete clinical profiles, which includes them as well as their healthcare providers and health coaches is, < at > a minimum, a concept worth keeping your eyes on.

Carol Harnett, an expert in the field of employee benefits, can be emailed < at caharnett@aol.com.

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