Concierge Style Employee Customer Service

What Is Concierge-Style Employee Customer Service?

Concierge customer service addresses a substantial challenge that exists for health consumers today—namely that the benefit and health care ecosystems are enormously complex and costly to understand and navigate. Current trends toward high deductible plan design only amplify the time and money required by you and your employees to make more intelligent decisions.

Proliferation of solutions that address one or two discrete consumer needs (e.g., scheduling, price transparency, or finding a provider) still leave the individual to synthesize information across disparate sources, often during a serious health crisis. Concierge service is the conductor that harmonizes much of this discord and fragmentation, providing one point of interaction and distilling complex information down to actionable guidance.

The concierge processes all the critical dimensions to be considered as the health consumer is contemplating or accessing care. As a result, the health consumer has one point of interaction rather than many and is delighted with an experience that absorbs complexity and distills information down to understandable, actionable guidance.

How Does It Work?

Concierge services are available as a subscription benefit for employees in value-based reimbursement contexts. They come in different forms. At one extreme, there are progressive concierge services driven entirely by algorithms that offer guidance based on machine learning. At the other extreme, there are more traditional, high-touch one-on-one concierge services. In the middle, there are hybrid models built on “human-driven” technology, offering a balance between live support and technology-driven solutions. Members can speak with live support or, if they prefer, navigate through an intuitive mobile or web interface.

Members can access a broad spectrum of support services in a single interaction or series of interactions. Specifically, the concierge can provide:

  • Triage
  • Explanations of appropriate and available care
  • Selection of plan-approved locations
  • Help scheduling care
  • Cost estimates
  • Advocacy for claims and billing questions

The key to an effective concierge experience is integration of information so employees have hassle-free access to simple and actionable guidance on any issue when they need it. To make this work, concierge services are ingesting more and more data to improve the value of their support, tapping into information about plan design, provider networks, real-time benefit consumption (e.g., deductible and out-of-pocket status), individual preferences, and care costs and quality data.

Why Should You Support It?

Concierge services integrate and coordinate a vast array of fragmented solutions into one location, enhancing engagement and optimizing benefit use to lower costs.

Employees who understand the implications of their consumption decisions are empowered to more intelligently navigate the care system. This means they can avoid unnecessary expense. As consumers use concierge services frequently and stretch their health care dollars further, risk bearing employers, insurers, and providers can accrue savings as well.

Many programs that employers have invested significant dollars in, like value-based primary care or the small number of proper workplace wellness programs, require years to deliver return on investment. Concierge services can deliver savings in year one by guiding your employees away from unnecessary, high-cost care.

Concierge support at “critical moments” builds lasting affinity among employees. Helping individuals understand their benefits and access the optimal care in a time of need capitalizes on powerful teachable moments to build awareness of how individuals can be smarter health care consumers on an everyday basis.

Finally, concierge services can be implemented off cycle and introduced successfully in advance of open enrollment as a benefit that can help employees select the best plan for their circumstance. Many times, employees are more comfortable selecting higher deductible plans when they know they will have concierge support as they navigate the care system.

What are The Key Elements to Look for?

Understanding of the Individual Consumer

A hallmark of true concierge care is a deep understanding of the individual consumer—including preferences and health profiles—so that care itineraries are personalized and thus more likely to be followed.

A good concierge service considers the suite of benefits the member has access to, understands the individual’s plan design, and the individual’s current consumption of care (i.e. progress toward their deductible).

Network Directories

Robust concierge offerings integrate the appropriate provider directories to accommodate complex network designs, including centers of excellence, onsite care clinics, or narrow networks. The concierge directs members to the highest tier in-network providers for the highest-level of care at the lowest cost, avoiding network leakage and the costs incurred as a result.

Scheduling Capability

Exceptional concierge services go a step beyond and schedule care on the employee’s behalf.

Clinical support based upon triage protocols

Identifying the health consumer’s needs often begins with triage of an individual’s symptoms. A concierge service then guides the consumer to the appropriate level of care.

Price Transparency

Concierge services should help employees prepare both clinically and financially for appointments by explaining the cost of an encounter upfront.

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How Can You Ensure Quality?

While there aren’t reference resources that assess the quality of concierge services, there are key performance indicators that indicate the quality of a concierge service.

Member Engagement

What portion of a concierge service’s addressable population is using the service and how frequently?

User Satisfaction

What is the net promoter score associated with the concierge service? Would members recommend it to a friend or loved one?


What savings has the concierge service delivered for members to date?

Building initial awareness with healthcare points of entry

The concept of a concierge service in healthcare is still new. Most health consumers still receive benefits from their employer, who are typically reliant on benefits brokers or consultants for direction when selecting benefits. In other instances, consumers are purchasing healthcare on public or private exchanges and could benefit from a concierge service being bundled with medical coverage. Regardless of the distribution channel, upstream stakeholders need to be aware of and support concierge services so that the health consumer can access the service downstream.

Leave the annual subscription cycle

Employers and brokers/consultants consider benefits decisions annually in advance of open enrollment. However, concierge services can be implemented off cycle and can be introduced successfully in advance of open enrollment as a benefit that can help consumers select the best plan for their circumstance. Many times, consumers are comfortable selecting higher deductible plans when they know they will have concierge support as they navigate the care system and manage their care.

Remaining top of mind for health consumers

Concierge services need to maintain a high level of consumer awareness, so that consumers reach out in a time of need. Maintaining awareness requires commitment to frequent marketing campaigns, webinars, development of case studies and incentives that reinforce use of health concierge services when consumers need to access the care system. These activities require continued support from distributors after a concierge service is implemented.

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What Challenges Can You Expect?

Employee Education

Such models will require continuing messaging and clear, easy to understand action steps so that concierge services remain top-of-mind for employees when the need arises.

Data Sharing

It could be difficult for your concierge service to obtain pricing and quality information from local providers. Since it is your spend, you have a right to this information and experienced concierges can overcome this barrier.

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What Action Steps Can You Take?

Evaluate the return on your investment realized from current health benefit tools by assessing member utilization rates and savings delivered.

  • If employees, members or patients aren’t using the tools provided in their benefit toolkit, it may be that the health consumer finds them overly complex and fragmented.
  • Concierge services integrate and coordinate a vast array of fragmented solutions within the health benefits suite, enhances engagement, and optimizes benefit utilization to lower costs.

Survey your member population’s aptitude to understand and efficiently navigate the benefits landscape.

  • Do your members have an easily accessible resource to guide them through the lifecycle of a healthcare episode?
  • Are you confident in the ability of your members to utilize the appropriate resources at the appropriate time to make educated decisions while at the point of healthcare consumption?
  • Through the holistic understanding of a member’s physical and fiscal profile, concierge services can guide the member to the most efficient, effective, and satisfying method of care every time they purchase healthcare.

Ask your broker, consultant, insurer or TPA if they are familiar with concierge offerings and how they may benefit your health plan.


Compass Professional Health Services

Zest Health


Your benefits advisors or an Independent TPA may provide some or all of these services as well.

Many others...

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What's next?

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