While healthcare complexity is nothing new, a 2021 study from Quantum Health underscores the significant, negative effects on program participants and the employers who fund these complex group medical employee benefit programs.
One of the clearest takeaways from the research is that consumers continue to struggle with healthcare complexity. The key challenges consumers face revolve around understanding their coverage levels, making use of their benefits, finding providers, and understanding their insurance claims or bills.
Furthermore, healthcare literacy has been shown to directly correlate with health status, where states with higher rates of health literacy typically have lower rates of chronic conditions and lower overall healthcare costs.
These health literacy challenges can result in uninformed decisions and low participation and engagement in employer-sponsored offerings, hampering the desired effect of keeping employees healthy and productive.
These challenges are amplified when companies constantly change their benefits program, medical carrier, and/or the structure of the medical plans (jumping from PPOs to HMOs, from Copays to HDHPs, and from HRAs to HSAs, for example). These changes cause an increased amount of angst and confusion among employees.
Because change is often inevitable, it’s important that employers consider the findings of this research to reevaluate their employee benefits programs and communication plans, all in an effort to help facilitate employee adoption, productivity, and well-being.
Employee Healthcare Literacy is Dangerously Low
According to the study, the majority of employees reported facing challenges in understanding coverage levels, locating providers, and navigating the insurance claims process. In addition, 90 percent of those with chronic conditions faced additional challenges with understanding diagnoses and test results.
A low understanding of healthcare benefits can lead to low participation and engagement in employer-sponsored benefits.
Healthcare Challenges Cause Declines in Well-being
Of those who experienced healthcare challenges, more than half reported associated declines in well-being, 19 percent reported declined mental well-being, and 17 percent reported declined physical well-being.
Challenges faced from healthcare complexities can compromise physical and mental health. Ultimately, this can hinder an employer's ability to enable employees to perform at their highest abilities.
Healthcare Complexity Drains Workforce Productivity
60 percent of the consumers surveyed reported taking work time to manage an average of 3 healthcare-related tasks for themselves or a loved one. On average, they would spend 27 minutes dealing with these tasks. Alternatively, if employees reported taking time out of work to handle the healthcare tasks, they reported having even more stress and anxiety.
It is easy to see the broader financial and productivity effect on employers when you consider these findings across a larger organization.
Low Confidence in Health Benefits
As the survey demonstrated, most employers (88 percent) believe their employees are confident in understanding their health benefits. But in fact, only 52 percent of individuals surveyed actually say they feel confident, and 78 percent shared that they did not see it getting any simpler to navigate in the future.
With only half of employees effectively using benefits - let alone understanding them - it is clear that many employers need to refocus their efforts. Since a lot of time and money is invested in tailoring health benefits to ensure they meet the needs of employees, companies must ensure they're focused on educating employees to maximize the value of their benefits program.
Education must be executed in a consistent, multichannel approach including comprehensive benefits guides, instructional and educational videos, onsite marketing, in-home communications, and one-on-one and/or interactive group presentations.
As the study illuminated, bypassing this step can result in declined employee well-being, productivity, and morale.