Narrow provider networks are becoming more prevalent with health insurance providers. If this is a new element of your company’s medical plan offering, it’s important that you educate employees on how narrow networks work—and the pros and cons they’ll need to consider.

Cost is not everything.

With narrow networks, you are limited to a select group of physicians, specialists and hospitals. In return, you pay less for services—that’s true for employees and generally true for employers, too. And given the high cost of healthcare today, it would be easy to think that lower costs are enough of an incentive for employees to use the narrow network. But that’s not true for everyone. While cost is an important driver, it is only one of a handful that are considered—and for many, it’s not the first consideration.

A major Midwest employer conducted a series of focus groups with their employees to gauge perception, interest and understanding of their new narrow network. To their surprise, they learned cost was not as high on the list as they thought when employees were deciding where to seek care. Focus group participants put cost in the middle of the list. They ranked considerations as follows:

  • Provider qualifications: Reputation/referral, certifications, quality rankings
  • Relationship: Comfort with and trust in provider; established health history
  • In-network: Benefit of lower cost
  • Location: Convenience and accessibility
  • Care coordination: Ease of records all being within same system
  • Administrative ease: Stay with provider because changing is cumbersome and/or inconvenient

This feedback is further supported by a Zocdoc survey that found that when searching for a provider, people care about:

  • Provider education
  • Communication
  • Trustworthiness
  • Location
  • Congeniality

What does this mean for benefits communicators?

Understandably, cost may be a main driver for employers—no one will disagree that the cost of providing medical benefits to employees has skyrocketed over the last decade and especially in the last few years. That said, it’s not always the main driver for employees, so how you present information matters. It can help or hamper how employees perceive the benefits of a narrow network.

If you’re introducing or encouraging use of a narrow provider network, avoid these three missteps as you talk about it with employees:

Don’t make it all about cost; do highlight other advantages as well.

Cost is in the mix of considerations, but it may not be #1 for everyone. Highlight the other advantages of narrow networks, like coordinated care, convenient access and no need for referrals. You may find these are equally important to them and will help employees feel like you’re not solely focused on cost.

Don’t avoid talking about the cons; do present the whole picture.

This means being upfront about what they may not like as much, including fewer providers or less convenient locations, for example. Employees will figure out the cons anyway, so if you’re upfront about them, they’ll respect that and possibly give the network more consideration because you’re not trying to hide anything.

Don’t send the same message to everyone; do segment your employee populations by what they care about most.

Certain employee groups may care more about cost than others, so segment groups and send targeted messages to those who may be more interested in saving costs through a narrow network. The focus groups for the large Midwest employer found that the narrow network is more likely to be utilized by younger employees who don’t have as many health issues yet—and, as a result, don’t have established relationships with providers that they are unwilling to give up. And because younger employees are in the early stages of their careers, they may have tighter budgets and be more concerned about cost. Targeting messages to certain age or demographic groups may help move the needle more than disseminating the same message to everyone.

Talk about what makes your narrow network stand out.

In the end, make sure you help employees understand that your plan still offers the same services. For example, although employees may have fewer physicians and location options, the network only chooses the best of the best. High quality healthcare is the bottom line; and while the narrow network is a way to contain costs, no sacrifices in care are needed.

Reach out below or at helloindy@westcomm.com, or follow us @westcomm on LinkedIn for more insights.

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