Playing catch-up: How employers can lessen the impact of delayed medical care

The COVID-19 Public Health Emergency officially ended last month. However, employers will continue to deal with the repercussions of the pandemic, including delayed medical care.

Although emergency medicine endured the brunt of the pandemic, elective surgeries and non-emergent medical care were suspended for months. Employees often were isolated at home, and preventive care, regular check-ups and dental appointments were delayed indefinitely. Although the backlog is easing, challenges remain.

“We certainly are trending in a positive direction,” said Mandy Stogner, director of health and productivity for Unum. “We had some very tough years, especially early on in COVID as people worked through what it meant in the medical system and their comfort level in seeking treatment.”

Stogner and other panelists discussed COVID and the Impacts of Delayed Medical Care during a May 25 webinar sponsored by the Disability Management Employer Coalition. Severe COVID cases, especially during a time of uncertainty early in the pandemic, created a domino effect that resulted in a lack of resources for important but less-essential procedures.

“ICU demand went up throughout COVID surges, and this affected access to routine procedures across the pandemic,” she said. “Access to surgical procedures was affected throughout the pandemic and throughout surges in infection rates. When the need for ICU beds went up, access to elective surgical procedures went down.”

Insurance claims increased across the board but especially in two areas, said Derek Stern, director of health and productivity for Unum: “We saw increases in respiratory claims, which is where COVID-19 claims were held within Unum data,” he said. “That number continues to be a bit above where it was in 2019. The other area where we saw an increase was in behavioral health claims. We saw a pretty stark increase from 2019 to 2020 and another increase from 2020 to 2021. That increase appears to have stabilized from 2021 to 2022 at 8.6%, so hopefully it will not be as large as it has been in the past.”

The waiting time for surgery, which increased by two days during the pandemic, still has not receded to previous levels.

“We have dropped from the height of nine days in 2020 to 8.5 days in 2021 and eight days in 2022, but we definitely are not back to where we were in that pre-pandemic timeframe,” he said. “I am a little concerned that we continue to experience delays with individuals getting the surgeries they need as quickly as they might need them. That may be due to the beds that are available and care within the health care system as well.”

Although some employees may have talked themselves out of elective surgery, most are likely to reschedule needed procedures.

Related: Consumers taking more control over health care decisions following pandemic, research finds

“I believe that many of those elective surgeries were delayed but not completely put off,” Stern said. “There is a subset of employees who may have found alternative treatments and learned to live with a certain situation, realizing that they did not want to go through with surgery. But based on the data we have seen, I would say the majority delayed their care and went forward with it as the medical establishment was able to reopen or as they regained their comfort level.”

Panelists offered a couple of suggestions to employers as they help workers catch up on delayed care.

Enhance support. “We have continued to expand our offerings to be able to continue to support our employee base with multiple sessions of free counseling, and not just giving them a list of providers but helping them secure a visit,” said Anthony Stover, director of integrated leave for Costco. “Help them make those connections. A lot of employees have a fear about what the next step is and how they will get through it. Our attitude is, `whatever you need, we are here to help you.’”

This support is especially critical to lower-salaried employees, who are more likely to delay or forgo care.

“Those with lower salaries, in this case under $30,000 a year, were experiencing the longest delays in getting surgical intervention,” Stern said. “That was true in the pre-pandemic world as well, but it increased during the pandemic. At the height of the pandemic, it was taking an average of 11 days for an employee to receive surgery if they were in that $30,000 or below salary range. When you look at that $75,000-plus salary range, it drops to seven days, so there is a stark difference in access to care.“

Embrace telehealth. “Something that was mainstream even before COVID-19 was the idea of telehealth and the ability to access care online or via phone,” Stern said. “When COVID-19 hit, it really thrust telehealth into the limelight. I believe that going forward, a really key component of any employer’s ability to provide care for their employees is to make sure they have access to some component of telehealth. There are a number of telehealth opportunities that exist out there, but making sure you have that as part of your overall health care package is going to be really important.”

The pandemic was a dark time that employers would just as soon forget. However, it also taught valuable lessons about how to better meet employee needs moving forward.

“Did we do everything perfectly?” Stover asked. “No. But we took anything that didn’t work well as a learning opportunity.”