The COVID-19 pandemic brought about significant disruptions in healthcare access, leaving many individuals grappling with postponed preventive care and elective procedures. Factors contributing to this trend may have included patient concerns about virus transmission, healthcare professional shortages, and reduced healthcare capacity. These challenges have exacerbated longstanding barriers to care. As we move beyond the pandemic, employers’ concerns are rising about employees delaying healthcare.

Unraveling care delay trends

Employers are understandably worried about the consequences of postponed care, especially for employees with chronic conditions left untreated for the past three years. To gain insights into the demographics and reasons behind care delays, the Integrated Benefits Institute (IBI), a non-profit focused on health and productivity research, conducted a survey involving 5,003 employed individuals in the United States.

The study utilized the Behavioral Model of Health Services Use, originally designed to comprehensively examine how and why people use healthcare services, address disparities in access, and inform equitable policy development. Within this model, healthcare utilization is influenced by predisposing factors (e.g., age, gender, education), enabling factors (e.g., income, health insurance), and need (i.e., illness level).

The survey’s primary objectives sought to uncover whether individuals in the United States were delaying medical care and the reasons behind such delays. The survey also investigated whether respondents and their children were keeping up with essential preventive check-ups and vaccinations.

Understanding the reasons behind delayed care

According to IBI’s analysis, more than half of employees, specifically 58%, have postponed necessary medical care due to cost or insurance barriers. An additional 42% reported delays because of unavailability of appointments, while 35% chose to delay or avoid care due to lingering COVID-19 concerns. These statistics are a clear indication of the hurdles employees face in accessing timely healthcare.

Furthermore, the research revealed that fewer than three-fourths of employees are up to date on preventive screenings and immunizations. Among those not up to date on preventive screenings, 17% believe it’s unnecessary because they consider themselves young and healthy, while 14% cite financial constraints as the primary reason. Similarly, for immunizations, 37% express reluctance or distrust, while 15% believe they have a robust immune system.

Chronic conditions compound the issues

What’s even more concerning is that individuals with chronic conditions tend to postpone care, especially when it comes to cost and insurance barriers. The number of chronic conditions emerged as a significant predictor of delayed care for various reasons regardless of sociodemographic. In the context of the Behavioral Model of Health Services Use, each chronic condition represents a need. With each additional illness, the likelihood of delaying care rises. A staggering 69% of individuals with three or more chronic conditions postpone care due to cost and insurance obstacles, in contrast to 51% of those without chronic conditions. Paradoxically, the individuals who require medical care the most are the ones most likely to delay or avoid it. Nevertheless, when adjusting for demographics, these same individuals remain up to date with preventive screenings and immunizations.

Implications and costs of delayed care

While respondents weren’t specifically questioned about cost barriers like co-pays and premiums, IBI discovered a correlation between lower-income individuals and higher instances of deferring healthcare due to costs. This suggests that limited resources may pose an issue. Besides copays and deductibles, other costs like travel expenses and time off work can also deter people from seeking medical care. Additionally, some individuals may not fully understand their available benefits or the exact cost of services.

The delay in accessing necessary healthcare services has far-reaching consequences, impacting both employee health and productivity. Kelly McDevitt, President of IBI, emphasized the gravity of these findings when speaking to SHRM Online, calling for action among organizations. She stated, “Delaying care significantly affects employee health, leading to decreased presenteeism and productivity. A healthy employee is a productive one.” For employers, delayed care translates into reduced output and potentially higher healthcare costs, especially further down the road.

Strategies for employers

Delayed care is a unique issue for employers but as pivotal stakeholders, they hold the means to address this challenge effectively. IBI has some suggestions for employers:

1. Proactively identify reasons for delayed care: Employers should engage employees in candid discussions to uncover the underlying reasons behind delayed care. Tracking these rates is pivotal in encouraging timely treatment and effective budgeting for healthcare costs. Especially when treatment delays could make later treatments more costly and extensive.
2. Ensure Consistent Communication: Employers should prioritize transparent communication about employee benefits. Information should be uniform across all channels, including email, print, and in-person interactions. Managers should be well-prepared to address staff health concerns and benefit-related questions.
3. Acknowledge mental health’s role: Mental health conditions often co-occur with chronic illnesses, adding additional barriers to seeking physical healthcare. In fact, according to the survey, individuals with co-morbid anxiety and depression are least likely to be up to date on preventive screenings or adult immunizations. Employers should recognize this and provide comprehensive support.
4. Enhance access to care: Cost remains a substantial barrier, especially as rising inflation is affecting everyone. Employers can alleviate this burden by contributing to health savings accounts, maintaining lower deductibles, or postponing premium increases. Additionally, exploring solutions such as workplace sponsored physicals and immunizations can help keep employees on schedule while keeping costs low.
5. Cultivate a caring culture: Employers can nurture a culture that actively encourages healthful behaviors by appointing employee champions for benefit programs and training managers to initiate healthcare and well-being discussions.
6. Tackle appointment availability: The scarcity of appointments, particularly for specialists, continues to be a widespread issue especially in more rural areas. Employers can explore alternative solutions, such as working with outside companies to schedule services in these areas, and offering time-off to travel and complete screenings to ensure employees receive timely care.

The COVID-19 pandemic has underscored the importance of timely healthcare access and the potential consequences of delayed care. Employers play a pivotal role in mitigating these issues. The insights from the Integrated Benefits Institute’s survey provide valuable guidance on how to address this challenge effectively. By understanding the reasons for delayed care, acknowledging mental health’s impact, improving access, and creating a culture that prioritizes well-being, employers can ensure the health and productivity of their workforce.

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For further insights into IBI’s survey, please visit: Webinar: Effects of Delayed Care on the Workforce.

IBI Director of Research Dr. Candace Nelson presented IBI’s survey findings. IBI President Kelly McDevitt moderated a Q&A with Matt Ponicall, Senior Director of Global Benefits at Honeywell offering perspectives on how employers can address delayed care.