Need to get a blood test? An MRI? A same-day medical procedure? A new medication? Most of us will either go where we've gone before or to where our doctors recommend, and whatever it costs, it costs, right? These are not the kinds of things that get shopped around for the best price.

But why not? Why are you -- and your employees -- sometimes paying two or three times the amount (or even more) for a test or medication than what you could be paying? Why can't we be better consumers about these kinds of things?  

That's the question being addressed by a Chicago startup called HealthJoy.  The company, which last spring added $12.5 million in financing to its total of $23 million raised so far, offers an app and service that helps employees find the most cost-effective options for medical procedures and pharmaceuticals -- and then gives the employer the opportunity to reward those employees when they make that choice.

The idea has worked so well that the approximately 125-person company (as of March) has grown its user base by 610 percent last year to 200,000 and expects to grow another 250 percent this year, according to a TechCrunch report. The company mostly focuses on customers with more than 100 employees.

How does this work?

After setting up your employees and your plan details in the system, participants are then asked to submit their medical issues via the app to HealthJoy's team of doctors and administrators, who will, along with the company's proprietary artificial intelligence technology, strategize and make recommendations for the most affordable treatment (including telemedicine providers), confirm availability under your company's health plan, help book appointments, estimate costs, and even resolve any billing issues. According to its website, the company also provides a "proprietary algorithm" to identify lower-cost medication alternatives. "Our staff is available as a personal resource for all aspects of benefits," the company says. "We can help you find a doctor, answer an insurance question, book an appointment, or more."

The company has recently introduced a rewards program where employers will be notified when an employee uses the HealthJoy recommendation, and it can then share its savings with the employee via contributions to a Health Savings Account or even a gift card.

The results are financially impactful for both employee and employer. The employee can cut back on out-of-pocket expenses and deductibles. Employers, particularly those that are offering self-insured plans, will be directed to lower-cost options for treatment, so their expenses are reduced. HealthJoy claims its customers save $6 for every $1 spent on administrative costs under its rewards program.

"There is a lack of transparency and wide variation in healthcare prices," Doug Morse-Schindler, president and co-founder of HealthJoy told Employee Benefit News. "Offering rewards to help people make better care decisions pays off for both the employer and employee."

So, no, you and your employees shouldn't be just doing the same as before. That's the easy way out. With some effort and investment, apps like HealthJoy are able to offer better, more affordable options.

Published on: Sep 26, 2019