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Think of a health condition or concern 鈥� from cancer to anxiety 鈥� and there are companies that promise to help health plan members through the appropriate virtual treatment, coaching, tools, and supplies. Benefits plan point solutions have proliferated over the past decade, nurtured by billions of dollars in venture capital and private equity investment.

By 2023, 64% of large employers offered to manage a specific disease, and 80% provided at least one lifestyle management program to address issues like smoking, weight management, and behavioral health. Many employers also hire vendors to support members with broader issues such as care navigation and financial management.

At Alliant, we鈥檙e increasingly hearing from employers concerned about having too many disconnected programs that don鈥檛 really provide the benefits they promise. Some of these organizations allocate as much as 10% of their benefits spending to as many as half a dozen vendors. Yet, often, member participation is far lower than expected.

In our rigorous monitoring of the point solution market, we鈥檝e been crunching the numbers and examining feedback from employers to understand when point solutions can be effective and when money can be better spent elsewhere. The correct answer, of course, depends both on the specifics of the program and the needs of the employer and its members. But there are two overarching conclusions that suggest that it鈥檚 a mistake to think of all these vendors as 鈥減oint solutions鈥�:

• There鈥檚 a difference between tools and solutions. Employers can鈥檛 solely rely on a vendor to handle everything from engaging employees to coordinating care. They must stay involved to ensure the vendor (and solution) integrates well into their overall benefits program.
  
  
• Too fine a point won鈥檛 provide the care that鈥檚 needed. Focusing on a specific disease more often than not misses the connections between conditions and lifestyle behaviors. The more effective strategy? Treating people, not diseases.
  
  
• Engagement alone does not equal results. Look beyond the vendor story to determine if an intervention is working. At Alliant, we use our own data analytics platform to evaluate the impact of a specific solution. We do this by analyzing participation and engagement patterns as well as medical and pharmacy data to determine how the solution is affecting the population. While return on investment reports are considered the gold standard for evaluation, they are often expensive, burdensome, and may not be statistically accurate.

Here are six lessons for employers:

1. Behavioral health and care navigation are the clear wins.

With mental health issues afflicting a rapidly growing portion of the population, especially young people, programs that offer an expanded range of behavioral health treatment options have proven to be very valuable for most employers. In particular, programs that combine digital tools with a broad network of therapists and psychiatrists can help members get the care they need without the wait associated with the in-network providers of many insurance companies.

2. For chronic disease management, turn to an integrated provider.

Some of the first point solution vendors focused on managing specific conditions like diabetes. Over time, we鈥檝e learned that members often have a multitude of related conditions that are best addressed holistically. A person with diabetes, for example, may also need treatment for hypertension and coaching on nutrition. The best results are from programs that take a whole-person approach to care.

We鈥檝e also seen improved results from vendors who go beyond coaching and digital tools, offering virtual access to doctors or other clinicians. This makes it easier to adjust a member鈥檚 medication or therapy without an often difficult-to-schedule in-person appointment.

To be clear, even the most effective of these programs do not dramatically reverse the effects of chronic diseases. But we do see that people with multiple conditions are often stabilized 鈥� and thus less likely to progress to more severe conditions that require more expensive care.

3. VOI (Value on Investment) can be as important as ROI (Return on Investment).

It鈥檚 important for companies to be clear about their goals for each point solution program they add. Some will improve outcomes, some will cut costs, and some will help attract and retain employees. Rarely can you count on one accomplishing all three, but some can do one quite effectively.

Exhibit A: family planning programs, which help couples with fertility issues and sometimes arrange for adoption or surrogacy. More often than not, they increase employers鈥� costs by expanding coverage. However, these programs have become very popular, especially in industries like technology, where there is high competition for skilled workers. And they can help manage the costs of fertility treatments, mainly by dispensing drugs in small batches to avoid waste.

4. For maximum engagement, employers must take the lead on communication.

In our experience, participation in point solution programs is often very low when companies mainly rely on their vendors to reach out to members eligible for their services. People today are often wary about unsolicited calls and emails, especially from companies they don鈥檛 know. Moreover, members may associate these services with bad experiences they鈥檝e had with utilization management programs that made it difficult to get the care they felt they needed and interfered with their doctor relationships.

Instead of relying on vendors for outreach, employers should build information about specialized programs into all communication about company benefits. A care navigation service can also help send members in the right direction. Every employer should consider creating messages that focus on common conditions among members, highlighting the company鈥檚 commitment to helping them, and detailing the services offered. Finally, employers need to clearly communicate how the program benefits its members. That includes explaining how it can help avoid copays for supplies or in-person doctor or therapy appointments, and showing how the services can work with, not against, their existing providers.

5. When evaluating potential vendors, look closely at the stability of their financing.

Investors鈥� previous enthusiasm for 鈥渉ealth tech鈥� has waned, leading to a decline in the sector鈥檚 popularity. That means many of the companies won鈥檛 be able to raise the money they鈥檇 been counting on. To compensate, they may cut back on services, seek out a buyer, or simply close up shop.

Any of those outcomes is likely to disrupt your benefits program, leaving members without the care they were promised. In this environment, it鈥檚 more important than ever to understand the cash position and ownership structure of any potential vendors. If they haven鈥檛 raised new capital recently and aren鈥檛 profitable, you鈥檒l be safer with a more well-established partner.

6. Confirm that the vendor can support a plan sponsor鈥檚 compliance obligations.

To make plan-related decisions effectively and comply with their ERISA fiduciary duties, plan sponsors must understand the risks of engaging a vendor that does not understand these compliance obligations.

As our clients take stock of the point solution programs they鈥檝e worked with, many realize they were relying on vendors to deliver more than they realistically could. While innovative technologies and treatment approaches can improve outcomes for many members, many solution providers have oversold the ease of integrating their offerings into employer benefit programs.

Today, employers are becoming more strategic in thinking about how to incorporate specialized capabilities from vendors, thereby developing a more comprehensive and integrated plan. Sometimes, in fact, they decide that rather than bringing on a new vendor, their money is better spent on additional HR resources to help members utilize the services they already offer.

We鈥檙e ready to help

At Alliant, we鈥檝e built a robust strategy around helping our clients evaluate their existing programs, investigate potential vendors, and monitor results to ensure the best possible outcomes. Reach out to start a conversation today.