According to the Commonwealth Fund 2024 Biennial Health Insurance Survey, a staggering 23% of working-age adults are underinsured, meaning they have no time lapses in coverage, but still don’t have affordable access to health care.

Additionally, a survey commissioned by Goodroot found that 43% of employees with employer-sponsored insurance have experienced medical debt. And the consequences extend beyond finances: 92% of those facing debt have delayed or skipped necessary medical care to avoid additional costs.

The untapped power of hospital financial assistance

At the same time, one of the strongest available defenses against high medical costs is also one of the most underutilized: hospital financial assistance.

The Affordable Care Act requires all nonprofit hospitals to offer financial assistance to patients. Eligibility thresholds vary across states and hospitals, but typically families earning up to 400% of the federal poverty level — even 600% in some metro areas — qualify for free or discounted care. For a family of four, that could mean a six-figure income still allows eligibility for help. Given the average cost of a hospital stay is around $3,000 per day, not taking advantage of these programs is a costly lost opportunity.

While some hospitals could do more to promote these programs and make them easier to apply for, employers also have a powerful opportunity to protect their people. By offering financial assistance and encouraging employees to explore these options, they can help reduce financial strain on employees and improve overall health outcomes.

Reducing costs and empowering employees with benefits navigation

Plenty of employers have rolled out new plans for 2025 that include high deductibles and HSAs, but that doesn’t mean mitigation has to wait until 2026. This is where benefits navigators come into play, helping employees make the most of their benefits and find cost-effective options for care.

Navigators can assist both employees and employers by clarifying plan details, locating lower-cost treatment alternatives and even securing discounts through hospital assistance programs. This guidance is invaluable for employees facing critical decisions — like whether to schedule surgery at a hospital versus a surgical center — that could dramatically affect their out-of-pocket costs.

With expertise in comparing prices, quality ratings and coverage, navigators empower employees to make informed decisions about tests, procedures and specialists. They can also connect employees with hospital financial assistance programs, sometimes covering up to 100% of expenses. Acting as personal health care guides, navigators reduce employee confusion and minimize time-consuming HR inquiries.

Every medical bill deserves scrutiny

Most people don’t realize that medical bills often contain errors that go unnoticed and unchallenged. Employers who help their team scrutinize and negotiate medical bills can greatly reduce out-of-pocket costs and prevent medical debt.

Some errors are easier to catch than others. For example, you’d be surprised how often an in-network provider is inadvertently billed at the out-of-network rate or for a deductible status to be misapplied. Simple errors like these can mean hundreds or thousands of dollars in extra charges. 

Because a vast majority of medical claims these days are auto-adjudicated, there is little to no human oversight before a patient sees a bill. As a result, employees might receive a bill without realizing it should be reprocessed — like when their deductible has already been met. In other cases, charges appear for services never rendered, making a comparison between the medical chart and itemized bill essential.

Related: HSAs & open enrollment: 3 ways to demonstrate value 

And even if a bill is correct, there may still be an opportunity for negotiation to lower the total amount paid out-of-pocket. Most health systems are prepared to offer a discount for prompt payment. You just have to know how to catch these errors and ask for these discounts, or engage a service that handles this. 

Expert negotiators, skilled at finding these opportunities, can reduce medical bills by 30%-50%, a potentially life-changing amount for employees with high deductibles or those relying on HSAs to cover their expenses. When employers help ensure billing accuracy and secure the best prices, it not only eases financial stress but also reinforces a sense of security and support, showing employees that their wellbeing truly matters.

It's time to stand up for your team’s health and financial security

As health care costs continue to climb, both employers and employees face mounting challenges. By providing proactive benefits support, employers empower their teams to make confident health and financial choices that actually reduce the cost of care — building a culture of trust, security, and resilience that lasts.

Nick McLaughlin is vice president of BillAssist at Emry Health, which was recognized by BenefitsPRO in the Humanizing Benefits category of its 2023 Luminaries Awards. Emry is part of Goodroot, a community of companies dedicated to improving access and affordability in health care.