Complex Health Care Benefits Can Have Negative Impact On Employee Wellbeing, Productivity

New research reveals that consumers encounter multiple challenges when accessing health care. In turn, that complexity has a compounding effect on wellbeing and work life.

Quantum Health, a leading health care navigation and care coordination company, announced the results of its latest survey by calling them “groundbreaking” and emphasizing that they illustrate how consumer knowledge gaps can influence utilization of benefits, patient engagement, and compliance with care plans.

“This research drives home the fact that health care complexity affects individuals and families in multiple and very significant ways,” Kara Trott, founder and CEO of Quantum Health, said in a statement. “It’s critical that employers, benefits professionals, and health care providers recognize and understand that dealing with this complexity is not only a disruption for individuals and families, but it can also have a negative impact on their physical and mental wellbeing, as well as influencing workplace productivity.”

The Quantum Health findings were based on a survey of the following groups:

  • * More than 1,000 individual consumers between the ages 18 and 64 who have employer-sponsored health insurance
  • * More than 250 employer organizations with at least 1,000 employees
  • * More than 150 employer benefits consultants and brokers

Employer organizations and benefits consultants represented companies in 11 different U.S. industry segments.

The data revealed that eight out of 10 people who received health care services in the past two years experienced an average of three challenges when doing so, including administrative challenges such as understanding coverage levels; making use of all available benefits; finding a provider; and understanding insurance claims or billing questions. Additionally, 90% of respondents with complex or ongoing clinical needs faced additional challenges related to tasks such as getting prior authorizations approved; understanding test results or diagnosis and treatment options; and developing a plan of care for more complex health issues.

Here are three other key findings of the survey:

  • * Physical and mental wellbeing suffers due to complexity. Among individuals who experienced challenges with health care (79% overall), 57% suffered a resulting negative impact, including a significant decline in mental wellbeing (19%), a significant decline in physical health (17%), or interference with a prescribed treatment plan (16%).
  • * Health care complexity drains workforce productivity. More than half (60%) of all respondents said they have had to spend time during their workday on health care-related tasks for themselves or a loved one in the past two years. When that occurred, the average time spent was 27 minutes. The average amount of time spent completing health care-related tasks at any time – whether at work or home – was 46 minutes.
  • * Consumers say health care navigation can make a difference. Of those surveyed, 39% of individuals overall and 56% of those with chronic conditions agree that they need professional health care navigation services to make their health care experience less stressful, to increase their confidence in understanding and using their benefits, and to save time.

“It’s clear from this research that finding the right navigation solution — one that helps employees break through challenges caused by increasing health care complexity — should be a priority for business leaders and benefits professionals,” Trott concluded.


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