Health benefits

Redefining the value of health benefits


One thing that is quite clear is that the cost of health care is increasingly a burden on individuals and their families which often outweighs the value they receive in return. This reality should lead us to ask ourselves critical questions, not only about the solutions we offer, but also about the experiences we create for individuals.

Here are three themes that continue to surface during our ongoing analysis of how to better understand the barriers people face when it comes to paying for health care. This information can be useful for brokers and consultants to review with employer clients, particularly around registration season.

1. Individuals need immediate value from their health plan

If we are to meet the changing needs of individuals and reduce the burden that healthcare spending places on them and their families, we must be innovative. Traditional health plans with high deductibles are increasingly designed to provide a safety net for those who are seriously ill, rather than making daily health care needs affordable for the majority of employees. These plans force people to pay a significant amount out of pocket before they get anything in return – premiums, then deductibles and coinsurance, and often a co-payment as well. It is not only a financial burden that often causes people to choose to postpone medical care or ignore it altogether, it is also confusing and unpredictable. Today’s smart consumers demand better – and they should.

Helping individuals manage their health care costs begins by introducing benefits that provide comprehensive, predictable coverage that allows them to get the care they need to stay healthy. This includes plans that reflect user-centric services, which are often delivered through a monthly subscription model that they have become accustomed to, and which offer clear value and an understanding of cost.

2. Costs prevent people from accessing the care they need

As mentioned, traditional health plans often make it prohibitive for people to get the care they need when they need it. And it will cause problems and increase costs down the road for individuals, employers, other stakeholders and our society as a whole.

Employers may not know that, regardless of an individual’s salary, 55% of Americans live paycheck after paycheck, leaving them unprepared to pay unforeseen medical expenses. It’s no wonder that many postpone care and wait for health issues to become an emergency before seeking care. About one in 10 adults said they delayed or did not receive medical care due to cost reasons in 2019, according to a 2020 study. Poor health adults are much more likely than others to delay or avoid care because of the cost.

It is not a “personal problem” for the employees. It’s an issue that affects everyone and one that employers should carefully consider when evaluating the health benefits and payment options they are making available to their employees over the coming year.

3. Individuals want flexibility when it comes to personal expenses

Even the richest health benefits may require a bit of skin in play on the part of individuals when certain health issues arise. We need to help employees reduce out-of-pocket costs for routine and daily health care services. And when more serious events do arise – surgery or emergency care, for example – our priority should be to help them manage those costs by providing them with tools to pay their expenses in a way that minimizes the burden on them. family budget.

Today, the options available to pay for direct medical expenses are cumbersome, impractical and often expensive. For example, with deductible health plans, it is up to the individual to negotiate each bill (and there can be a lot) with the respective provider, and hope to be able to come up with payment options that don’t push. not its finances beyond its limits. breaking point. Of course, the alternative is to pay with a credit card, a route that is not accessible to everyone and comes with high interest charges.

This is especially important, because outside of healthcare, consumers increasingly expect to be able to pay for almost everything with convenient payment plans thanks to the increasing availability of companies like Affirm, Sezgle or Afterpay, which offer interest-free payment plans with flexible terms. These payment methods are especially popular among the younger generations, especially Gen Z, who tend to be wary of credit cards but still prefer or should always spread payments.

An IBIS world report predicts that the Buy Now, Pay Later industry will continue to grow at 9.8% per year over the next five years, and will eventually exceed $ 1 billion. If we can meet this need of people who buy jeans or cellphones, we certainly need to find a way to make it work for people who have to pay for necessary and perhaps life-saving healthcare.

This registration season, as employers make decisions that will shape their team’s experiences over the coming year, we can help steer conversations toward consumer-centric health benefits and solutions that deliver the value and flexibility that individuals and their families desire. By viewing employees as consumers, we can help employers design a better benefit plan that achieves their ultimate goals of attracting, recruiting and retaining talent. As we hold meetings with employers, let’s talk about these very real issues and opportunities, and tackle them head-on to better meet clients’ needs.

Marek Ciolko is the CEO of Climbed.