Originally Posted September 1, 2006

What is a medical advocate, you ask… A medical advocate is a person who helps patients navigate our complex, fragmented healthcare system. With last week’s announcement by Wellpoint about their widespread launch of consumer driven health plans (Read my thoughts here), it is likely that this service industry is on the edge of becoming really huge. Just this week, The Philadelphia Inquirer ran an article that highlighted the growing medical advocate industry.  According to the article, more and more employers are adding this service to their benefit menus.  According to the article:

Health Advocate, which is contracted by employers nationwide, has increased its client list from 10 businesses in 2002 to 1,700 today, the Inquirer reports. Large corporations pay a $1.25 monthly fee per employee, and small businesses pay $4.95 per employee.

Typically being highly trained nurses, medical or patient advocates assist patients by finding and getting appointments with the best doctors for certain diseases/illnesses, translating complex doctor speak so that patients are empowered to make good health decisions, working with the patient to complete complex insurance certification processes, promoting healthy lifestyle changes, and handling claims and billing problems– just to name a few things.

The benefits to employers likely are worth the small monthly cost as they enable the worker to focus on his or her job. So in essence, the productivity of the employee is preserved.  Additionally, patient advocates also create the potential of saving the company hard healthcare dollars by reducing the risk of misdiagnosis, unnecessary procedures, office visits, and duplicated services.

With the patient empowerment and self-education requirements of consumer-driven health plans, patient advocates do fill a very real need.  They will also likely help physicians and facilities bridge the gap that will occur as patients begin to switch to these plans. With their ability to really recommend facilities and providers, facilities and medical practices would be wise to be proactive in developing plans to coordinate and collaborate with patient advocates.  Afterall, they will likely help in reducing some of the obstacles of care and reimbursement, as well as, encourage patients to follow treatment plans and take action to improve their health.

Tags: patient advocates, healthcare, consumer-driven health plans, patient empowerment