• Results indicate more than 50% of employees feel that their employers are providing little to no care coordination support, and only 20% feel very confident they understand and know how to use their health benefits. 

Employer Benefits News (EBN), a primary media resource for decision-makers in the world of employee benefits, human resources and workplace culture, announced today 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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The side effects of healthcare (Graphic: Business Wire)

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.

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.”

See the results of the full study at EBN’s The State of Healthcare 2023: Is your benefits game plan working and designed to endure?

About Employee Benefits News

Employee Benefit News (EBN) is the primary media resource for decision makers in the world of employee benefits, human resources and workplace culture. As the dynamics of these spaces continue to shift and become increasingly complex, EBN delivers expert insights to allow business leaders to navigate their industries with agility. From helping benefits managers meet the challenges of reducing care costs and improving retirement plans to providing HR leaders with guidance on building a talented and diverse workforce, EBN drives the conversation and delivers the research and analysis to help readers support their companies’ objectives. For more information, please visit www.benefitnews.com

About Arizent Research

Arizent delivers actionable insights through full-service research solutions that tap into its first-party data, industry SMEs and highly engaged communities across banking, payments, mortgage, insurance, municipal finance, accounting, HR/employee benefits and wealth management. Arizent has leading brands in financial services, including American Banker, The Bond Buyer, Financial Planning and National Mortgage News, and in professional services, such as Accounting Today, Employee Benefits News and Digital Insurance. Interested in learning more about how to put Arizent’s full-service research capabilities to work for your company? For more information, please visit www.arizent.com.

About Quantum Health

Quantum Health is the industry-leading consumer healthcare navigation and care coordination company that delivers an unparalleled consumer experience to its members, as well as validated claims savings and high satisfaction rates for its self-insured employer clients. Quantum Health's proprietary Real-Time Intercept^® model identifies opportunities for early intervention in a member's healthcare journey, resulting in better engagement, outcomes and cost efficiencies.

The company was founded in 1999 and is based in Dublin, Ohio. Since its inception, Quantum Health has earned numerous awards and honors, including being named among the Fastest-Growing Private Companies by Inc. 5000, and a Great Place to Work by FORTUNE Magazine and Entrepreneur Magazine. Quantum Health has consistently been named one of the 50 Fastest-Growing Women-Owned/Led Companies by the Women Presidents Organization, and Columbus Business First has consecutively honored Quantum Health as a Best Place to Work.

To learn more about these results and the company, visit Quantum-Health.com, and connect with us on LinkedIn and Twitter.

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