Benefits

Employers Are Taking Cost Action With Healthcare Navigation

Only 22% of employers fully trust that digital health tool vendors are acting in the employer’s best interest

A new report from Quantum Health reveals 37% of employers are offering healthcare navigation platforms to address rising healthcare costs. View the complete study here.

DUBLIN, Ohio–(BUSINESS WIRE)–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 2024 study, sponsored by Quantum Health, the industry-leading healthcare navigation and care coordination company to over 500 self-insured employers and supporting over 3 million active members on their healthcare journeys.

The study, conducted by Arizent, EBN’s parent company, researched both employer and employee perspectives on healthcare costs and the benefits navigation process. The study sampled 501 employees and 181 employer benefits decision-makers. Employees were balanced to the U.S. employed population (in gender, age and race), and employers comprised of organizations with at least 10 employees and from a wide range of industries and job levels/roles.

For employers, 63% reported that cost is among the most important factors in building their benefits packages. 89% are taking one or more actions to lower their healthcare costs, and for 37% of respondents, one of those actions includes offering healthcare navigation services to make sure employees are accessing the right care. With more than half of employees feeling their total healthcare costs are too expensive, health-related benefits are often cited by employees as the most important benefits employers can offer.

With the demand from employees for new virtual care options and tools, employers have increasingly made digital health point solution tools (for management of chronic conditions) available for their employees (82%) to drive efficiency and cost reduction. However, EBN’s study found that, of employers using digital health tool providers/vendors as a source for benefits decisions, only 22% fully trust that these vendors are acting in the employer’s best interest. Instead, the study insights point to utilization data as the most trustworthy source: 90% of employers that use utilization data to make benefits decisions either fully or mostly, trust this resource to provide information that serves the best interest of the company.

With employees feeling the crunch of high healthcare costs, 42% reported that their medical expenses went up because their health plans got more expensive within the past year. Among the respondents who experienced a decrease in household medical expenses, 20% reported that their family sought out less specialist care and 18% less preventative care. For their part, employers don’t see the future of healthcare changing much, with 79% of companies expecting next year’s overall costs of healthcare benefits to be higher than this year, and 70% reporting being concerned about their company’s ability to afford health coverage.

Kerry Gross, director of Research Intelligence at EBN, notes, “Based on our findings, costs are a clear factor for both employers and employees, and costs will remain a critical issue that employers will need to manage as they look to continue to offer well-considered benefits plans.”

Managing Costs & Clinical Outcomes

To better manage costs and clinical outcomes, employers are taking action against higher benefits costs. They see healthcare navigation platforms as a means to support and drive employee engagement and manage digital health point solution utilization across their populations.

The study found that only 44% of employees are confident they understand how much healthcare will cost using their insurance. This gap points to a need for more clarity, education and guidance around healthcare. While employees feel relatively confident in their overall coverage and are most confident about finding a doctor in their network (67%), they are less confident about other aspects of insurance, including costs and coverage details.

Costs are a clear factor for both employers and employees, and costs will remain a critical issue that employers will need to manage as they look to continue to offer well-considered benefits plans...

“Going beyond just finding an in-network doctor and answering coverage questions, Quantum Health’s navigation platform intersects the member, the provider and the payer in the natural benefits flow to administer preauthorizations, provide claims support, and integrate member support with clinical care specialists and other care-specific point solutions offered through the member’s benefit plan,” says Veronica Knuth, chief people officer of Quantum Health. “Utilizing our proprietary Real-Time Intercept® model (initiated by a member’s first contact with us through their benefits card) our Healthcare Warriors® proactively and directly engage with members on their healthcare journey to get them on the right healthcare path, advocating for them and mitigating ineffective or costly claims. Overall, we help improve clinical outcomes and provide the support HR benefits teams need to take on the hard stuff of benefits management.”

The study revealed that even employees who know something about their health insurance or coverage still go to HR first with their questions. Even younger workers (Gen Z) report turning to HR first when they have questions about their health insurance. This need for “human” support can put an increased burden on HR and benefits teams, already in pressured roles handling significant and intensifying shifts in workplace operations and cost benefits management.

Learn more about EBN’s State of Healthcare 2024 study here.

 

 

 

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 celebrates its 25th year as 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.
Founded in 1999 and based in Dublin, Ohio, Quantum Health has earned numerous awards and honors, including being named among the Fastest-Growing Private Companies by Inc. 5000, a Great Place to Work by FORTUNE Magazine and Entrepreneur Magazine, and one of FORTUNE’S Best Workplaces in Healthcare. The Women Presidents’ Organization has also ranked Quantum Health as one of the 50 Fastest-Growing Women-Owned/Led Companies for over 15 years.
To learn more about the company, visit Quantum-Health.com, and connect with us on LinkedIn and Twitter.