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How to Choose a Benefits Decision-Support Tool

Ross Simons

Ross Simons

Director of Inbound Marketing
what makes a good benefits decision support tool v2

Decision-support tools are relatively new arrivals to the human resources world. So new, in fact, that as an HR professional, you may find yourself choosing a decision-support tool for the first time.

Your (completely understandable) lack of experience with decision-support tools may leave you wondering which features to prioritize when comparing tools.

Even if your company has experimented with a decision-support tool, you may not have seen the results you anticipated. Your employees may not be using the tool, and the expected healthcare savings may have failed to materialize.

This article is for HR professionals researching benefits decision-support tools for the first time or those seeking alternatives to their current tools.

We’ll explain the core guiding philosophies that should drive the development of a decision-support tool. 

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What Is a Decision-Support Tool?

In the HR realm, decision-support tools are apps or websites designed to help employees choose the best-fitting, most affordable health plans and other benefits based on their anticipated needs.

These tools generally ask users to answer questions about their health and expected usage. The tools then recommend benefit choices based on the information users provide. As you will see, the number and scope of these questions vary significantly between decision-support products, as do the algorithms used to match users with benefits.

For employees, decision-support tools are meant to remove the uncertainty from choosing benefits and simplify an often frustrating and time-consuming process. Employers offer decision-support tools to more effectively educate employees about their options and encourage the adoption of lower-cost but potentially confusing plans such as HDHPs.

Whether or not these objectives are achieved depends largely on the decision-support tool’s design. Tools built around the five following fundamental principles engender greater adoption rates, more satisfying user experiences, lower healthcare expenses, and higher ROI.

1. An Easy and Quick User Experience

To put it bluntly, most employees despise open enrollment. Most workers would rather do almost anything else than spend time researching and selecting benefits.

Decision-support tools exist to make choosing benefits less arduous and more pleasant than the typical open enrollment experience that fills employees with dread every year. If a decision-support tool can’t deliver in those areas, employees will give up in frustration.

Your decision-support tool should be speedy and intuitive. The data bears this out:

  • The PLANselect decision-support tool requires between four and five minutes to complete and sees typical engagement rates of 60% to 65% based on completion.
  • A competing decision-support tool requires 25 to 30 minutes to complete and sees engagement rates of only 10% to 20% based on completion.

2. A Focus on Privacy

Many employees are not willing to sacrifice the privacy of their personal health information (PHI) for benefits recommendations. In one survey, respondents ranked patient privacy and data security as more important than the cost of healthcare.

Moreover, HIPAA regulations prevent employers from asking for and storing personally identifiable health information.

Some decision-support tools can be quite intrusive in their questioning, asking not only for health information but about personal topics such as annual income, savings, and comfort with risk.

On the other hand, tools like PLANselect are deliberately designed to avoid asking for any personally identifiable information or PHI. All questions and responses are anonymous and are never stored within the system, eliminating risk and potential liability for the employer.

3. Responsive Design

Your employees may spend most of the workday in front of their computers, but in their personal time, they’re more likely to pick up their phones than a laptop. Well over half of U.S. website visits originate from mobile devices.

Responsive design means building apps or websites that render as well on mobile devices as they do on personal computers — for example, enlarging the text and decluttering the layout automatically for smaller screens.

Responsive design makes your decision-support tool accessible to your employees however and wherever they choose to use it, at home, at work, or on the go.

4. Data-Driven Accuracy

Perhaps the most crucial aspect of any decision-support tool is that the results are reliable. If your employees can’t count on the tool to recommend the most affordable plans for their needs, they will quickly lose faith in it.

Some decision-support tools use a “calculator” model to generate results. Under this model, employees must input detailed estimates of historical and anticipated medical services and prescription data for each family member. Employee costs are then calculated by multiplying units of services by applicable copay or average costs.

Calculator models tend to underestimate employee out-of-pocket costs and expenses for ancillary services such as diagnostics, anesthesia, therapy, and supplies.

PLANselect takes a different approach:

The tool maps users’ stated needs across 26 types of medical services (office visits, labs, testing, prescriptions, surgery, and so on) against actuarial data tables from the Federal Actuarial Value Calculator based on the Blue Health Intelligence database of about 250 million claimants. Then, the tool applies a regional geographic cost factor.

PLANselect predicts employee costs by running type-of-service data against the plan-design details to project premium and total expected out-of-pocket costs, less employer contributions. The upshot of this data-driven methodology is a faster experience, increased accuracy compared to the calculator model, and — most importantly — more satisfied users.

5. Employee-Focused Results

To trust the decision-support tool, employees need to feel like the tool is working for them, not solely your company or the benefit providers. A lack of bias in the results is essential.

Some decision-support tools integrate career or plan-sponsor interests into their recommendation results. Other tools, such as PLANselect, are 100% employee-centric. The results only consider healthcare costs and plan features relevant to the user.

Of course, employers save money when employees save money, so unbiased employee-focused results are in your organization’s best interest, as well.

Shopping for a Benefits Decision-Support Tool? Start Here

The best decision-support tools transform the benefits-enrollment experience from an intimidating chore to a quick, easy, and even fun task. The right decision-support tool can reduce your company’s healthcare spending, while making your employees happier with their benefits. But what is the right decision-support tool?

Learn how to find the best decision-support tool for your organization — including seven questions to ask yourself and prospective vendors — in our free and comprehensive guide to Decision Support: Your Secret Weapon for Reducing Healthcare Spending.

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