New data shows traditional health plans fail Texas employees

Curative recently published a study examining the state of employee healthcare across the four largest cities in Texas to assess how the current cost-sharing arrangements impact utilization, overall health and well-being, and identify the primary barriers to accessing necessary care and treatment. The study’s results are eye-opening: Texas employees struggle to afford health services and face confusion regarding their health insurance plans. This forces many to delay or forgo care altogether. Consequently, employees surveyed are left with worse health outcomes and poor work performance. If they choose to seek care, many employees are forced to take on medical debt, adding significant financial stress to everyday life.

The study demonstrates a clear need to improve the individual experience with employer-sponsored healthcare plans and to ensure employers have new, innovative options that meet the needs of working Texans and ultimately prove their value.

Lack of affordability

High deductibles, premiums, and out-of-pocket costs make receiving care under traditional healthcare plans seem like a luxury. New survey data reveals that 59% of the Texas employees surveyed have difficulty paying out-of-pocket healthcare expenses because their deductible is too high. In addition, nearly a third of these employees stated that their annual deductible is $3,000 or more.

Confusion surrounding coverage

Simplifying the member experience and improving customer service play an important role in coverage comprehension, yet, many health insurance companies fall short in educating and supporting their members. Survey results show that 42% of Texas employees don’t know what’s covered under their plan.

When employees are confused about their health plan, they have difficulty estimating the cost of care. Fifty-three percent of survey respondents couldn’t anticipate out-of-pocket expenses for healthcare services. As a result, they struggle to plan ahead for themselves or their families. Furthermore, one-third of respondents feel they have to fight with their health insurance company to get them to pay for healthcare, leaving them to handle future surprise medical bills that should be covered under their plan all on their own.

Delaying or forgoing care

The effects of medical financial stress and confusion regarding plan coverage lead many of these Texas employees to defer or forgo care altogether. Survey results illustrate that 57% of respondents deferred care or treatment in the past year, which could lead to higher levels of stress over their healthcare decision-making and lower their overall productivity. Of those who deferred care, 42% did so due to a high deductible, copay, coinsurance, or other out-of-pocket expense.

Alongside tertiary care, employees report delaying preventive care services that could actually help save them money and improve their overall long-term well-being. Twenty-nine percent of survey respondents said they skipped preventive health services, such as a yearly check-up or routine test, due to financial stress.

Poor health consequences

Deferring care for minor medical needs or preventive checks negatively impacts future health outcomes. Because many employees wait to seek initial treatment for seemingly minor symptoms, their conditions only worsen the longer care is delayed. By the time symptoms are severe enough to finally see a doctor, treatments are often more intense and costly than they would’ve been at first.

Survey data reveal many Texas employees opt out of preventive care: 44% have never had a mental health screening, 36% have never had a cancer screening, and 30% have never been screened for diabetes. Improving health literacy and selecting health plans that are transparent, comprehensive, and easy for employees to use encourages employees to seek preventive services.

Stress over medical debt

Unreasonably high healthcare costs can plunge employees into medical debt — and fast. Right now, 38% of Texas employees surveyed have outstanding medical debt, and the percentage among those with high deductibles is even higher.

Employees can accrue medical debt at any stage of the care-seeking process. Not only can minor conditions turn severe and thus more costly, but the cycle of stress continues even after care is sought due to costs: 39% of Texas employees surveyed felt anxious about delaying medical care because of financial concerns in the past three months, while 26% of respondents increased their credit card debt due to medical costs.

Financial stress related to medical debt directly impacts work performance, increasing rates of presenteeism and absenteeism. Fifty-four percent of Texas employees surveyed agree that their personal or family health affects their work performance, and a whopping 68% believe that their employer-sponsored health benefits impact their work satisfaction.

To view the full survey findings and gain a closer look at the ways healthcare can be improved for Texas employees, you can download the report here.

Curative, a Texas-based healthcare company, doesn’t force employees to choose between care and costs. No copays. No deductibles. Just one competitive monthly premium that encourages patients to seek care when they need it. Curative is redefining healthcare for Texans, with a focus on preventive health — leading to better health outcomes, less medical debt, and a more productive workforce.

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