Employer Benefits News (EBN), a primary media resource for decision-makers in the world of employee benefits, human resources and workplace culture, announced the findings of its State of Healthcare 2023 study, sponsored by Quantum Health, the industry-leading healthcare navigation and care coordination company. The study reveals that more than two-thirds of all employees are currently navigating their healthcare journey alone, without enough support from their employers or health insurance to help understand the options available to them, including how to access leading care providers in their networks and the associated costs.
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“Quantum Health is pleased to partner with EBN on this important national study that highlights some of the core challenges employees and their employers experience navigating the healthcare system”
The study, conducted by Arizent, the parent company of EBN, sought to understand both the employee and the employer perspectives not only surrounding the cost of healthcare, but what navigating the benefits process is like. The study sampled more than 500 employees and 165 benefits decision-makers at employers. Employees were balanced to the U.S. employed population (based on gender, age and race) and employers included organizations with at least 10 employees and from a wide range of industries and job levels/roles.
“The study found that cost is a major healthcare challenge that employees face. Sixty-six percent of employees say the cost of care is too expensive and 51% encountered a healthcare bill that was higher than expected in the past year. In addition to cost, employees face challenges throughout their healthcare experience — from making decisions during enrollment to navigating insurance and the healthcare system. Although many employers provide active support during the enrollment process, most employers are largely absent during the rest of the healthcare journey,” said Kerry Gross, Director of Research Intelligence at Arizent Research.
These results suggest that employees are not getting access to the resources and expert guidance that could help them be more cost-aware and cost-conscious to make better healthcare decisions. Access to high-quality, affordable healthcare has never been more critical in helping prevent disease and improve quality of life. But healthcare is complex, burdensome and expensive, and can be stressful for employees to navigate alone.
In contrast, companies have recently built up their employee benefits offerings to include a variety of healthcare point solutions. These are typically focused on chronic conditions in an effort to offer the right care and wellness solutions for employees, while also incenting retention and recruiting during times of workforce and labor shortages.
Despite the focus on supplementing benefits, this has resulted in point solution fatigue and confusion for both the employee and the employer. And because healthcare benefits are some of the costliest operational costs for a self-insured organization, employers are now pressured to demonstrate return on investment of their employee benefits programs. With employers working with four to nine point solutions in their benefits portfolios, HR benefits administrators must assess the time and management required to coordinate multiple partners, as well as demonstrate impact through employee utilization and cost optimization. The study revealed that 51% of employers do not feel that managing point solution/digital health tools and vendor relationships is easy.
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The study also found that just about 20% of employers feel it is difficult to drive employee awareness, engagement and utilization of health benefits and don’t feel they have adequate time to dedicate to the administration of their benefits programs. With 67% of employees having to navigate their healthcare journey alone, employers may underestimate the poor experience and outcomes employees have when trying to utilize their healthcare benefits.
For employees, navigating insurance and understanding the costs of healthcare can be the hardest part of their healthcare journey. Only 20% of employees say they feel “very confident” they understand and know how to use their health benefits. The study revealed that while employees cited feeling most supported at open enrollment when they are choosing a healthcare plan, when the plan becomes “real” and they must navigate and make decisions, they feel the support is not there.
“Quantum Health is pleased to partner with EBN on this important national study that highlights some of the core challenges employees and their employers experience navigating the healthcare system,” said Shannon Skaggs, President of Quantum Health. “Employers have a real opportunity to address the struggle their employees have with the complexity of healthcare. By providing navigation support, employers can ensure their people receive the care and guidance they need to make the best healthcare decisions throughout every step of their healthcare journey.”
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