Complex health care benefits can have negative impact on employee wellbeing, productivity

More than half of workers say they've had to spend time during their workday on health care-related tasks.

Common challenges consumers face in dealing with health care include understanding coverage levels; making use of all available benefits; finding a provider; and understanding insurance claims. (Photo: Shutterstock)

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.

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“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:

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:

“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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