Delayed care continues after the pandemic, report reviews issues and possible solutions

A new report from the Integrated Benefits Institute (IBI) takes on the difficult problem of delayed care — and offers suggestions to companies on how to address this problem with their employees.

The report, “Effects of Delayed Care on the Workforce,” noted that many Americans were asked to delay care during the first months of the pandemic, in order to limit the transmission of the disease. But even before COVID-19, delayed care was a problem, and now that the pandemic has been declared over, health experts say delayed care remains a problem. The main barrier today seems to be cost — many feel they can’t afford treatment or medications, and so delay care.

One finding of the IBI study is that individuals with more chronic conditions are more likely to delay care. The data showed that 69% of individuals with 3 or more chronic conditions delayed care due to cost/insurance barriers, compared with 51% of those with no chronic conditions. However, the researchers added, those with chronic conditions are also more likely to be up to date on preventive care.

The survey for the report was conducted in January of this year, with more than 5,000 people from around the country participating.

Cost is an impediment for some

As noted in other studies, cost is a major barrier for Americans when it comes to health care treatment and medications. This study found that 58% of those surveyed delayed or avoided necessary medical care due to cost or insurance barriers, 35% delayed or avoided care due to fear of getting or spreading COVID, and 42% reported delays/avoidance because there wasn’t an appointment available when they needed it.

In the area of preventive care, Americans are doing somewhat better, possibly because current rules from the Affordable Care Act require insurers to cover preventive services without deductibles or copays. The report found that: 60% of respondents were up to date on recommended preventive screenings, 68% were up to date on adult immunizations, and, of those who had children under 18 in their household, 92% reported that their children are up to date on childhood immunizations.

Other findings were that rural areas had lower rates of preventive care, individuals with co-morbid anxiety and depression were the last likely to be up to date on preventive screenings or adult immunizations, and older respondents were less likely to delay or avoid medical care for any reason.

The IBI study also noted that staffing issues are a concern for health care delivery. Although clinic staffing has largely rebounded since the pandemic, hospital staffing is still down 2% and residential care staffing down 12% since January 2020. Other areas that were cut back during the pandemic included termination of quality initiatives, reduced services, and decreased staff training.

Recommendations for employers In the second part of its report, IBI included feedback from human resource executives from national and global companies regarding the effects of delayed care on their employees. The report outlined five areas that employers should keep in mind as they try to address the problem of delayed care.

First, the report urged employers to track rates of delayed care among employees. This includes looking for employees who haven’t received health care over long periods of time, noting when employees don’t have a primary care provider listed, looking at chronic conditions, and comparing health care utilization year-to-year.

Recognizing the problem of mental health is also a key component in this area. “Mental health

conditions often occur with other chronic conditions such as diabetes, obesity, and asthma, and can impact patients’ ability to adhere to treatment recommendations for other physical health conditions,” the report said. Further, these physical health conditions can make depression and anxiety symptoms more likely due to the burden they place on everyday activities.

The report also notes that cost can be a problem, especially for those with high-deductible health plans. “High-deductible health plans are usually set up so that preventive care is provided at no cost, but everything else, including care needed by those with chronic conditions, is paid for by the insurance only after the deductible is met by the individual,” the report said. “Looking at equity in plan design that encourages those who need care to be able to access that care is very important.”

Improving access to care may take some new approaches and creativity, the report said. It noted that some employers use mobile clinics and have instituted biometric screening at worksites. One employer is considering in-home visits with nurse practitioners for employees with limited access to care.

Related: How employers can lessen the impact of delayed medical care

Finally, the report encourages creating a culture that encourages employees to seek care. Training employees to be “wellness champions,” and training managers to be better equipped to talk to employees about health care concerns are two approaches that companies are experimenting with. “Depending on the employee population, initiatives to address cultural barriers and social determinants of health may need to happen either onsite at work or in the home,” the report said.