How Americans’ Health Care Costs Affect Their Work and Savings

Two out of every five Americans are postponing health care needs due to cost concerns, according to a survey commissioned by Paytient Technologies.

A new study confirms that many Americans are struggling to pay for even basic health care, and the cost of saving is taking a variety of tolls, including heightened health problems.

In a study released Wednesday by Paytient Technologies Inc., a health care payment provider, 40% of respondents admitted to delaying health care due to cost. The top types of care this subset delayed were:

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Regular visits / checkups

32%

Follow-up visits for a specific symptom / condition

30%

Tests (blood, biopsies, etc.)

28%

Imaging (X-rays, mammograms, etc.)

27%

Specialist referrals

27%

Regular treatment for chronic conditions or recovery

24%

Prescription medication

23%

Emergency visits / urgent care

23%

Outpatient surgeries

20%

Inpatient surgeries

9%

Medical devices (wheelchairs, asthma pumps, etc.)

5%

The delay in these preventative measures and, at times, direct care, is adding additional problems and costs in the future. Of the 40% of people who delayed care due to cost, 23% said they developed new symptoms or conditions, and 38% reported that their health got worse. Moreover, 19% resorted to working a second job during work hours to pay for health care, and 31% felt compelled to lie to their bosses about their activities while dealing with the consequences of deferred medical attention.

Concerns about paying for health care are already a drag on many American’s retirement hopes. More than half (59%) of respondents in a separate annual survey done by Nationwide lack confidence in their ability to pay for health care costs as they age. Another 57% worry about their ability to pay for caregiving for their partner or spouse, according to Nationwide’s Health Care Cost in Retirement Survey, released in October 2023.

Work Reduction

Paytient, in its survey, examined the repercussions of delayed care on the workforce, revealing that one in six respondents’ work was directly affected by health issues they could not afford to treat. Among this group, 69% admitted to being distracted by pain at work, and 31% experienced panic attacks on the job.

Meanwhile, paying for insurance that might help offset health care costs is difficult in and of itself, according to the findings. The study found that 69 million workplace-insured Americans failed to meet their deductibles in the prior year. Almost half of respondents with insurance (45%) did not meet their single coverage deductibles in 2023, by an average of $1,482.

Some workers even moved with their feet to find better health care options: 17% of workplace-insured Americans made the decision to leave their jobs in pursuit of better health care.

Help Wanted

The need for medical attention comes as employers are placing a greater emphasis on wholistic financial wellness, which includes addressing health care costs.

“The results of this study spotlight the invisible insecurity of insured Americans as health insurance alone no longer guarantees access to care,” said Brian Whorley, founder and CEO of Paytient, in a statement. “Bringing this narrative into the national dialogue on healthcare highlights an opportunity for employers to affordably ensure employees have the security and certainty that they will be able to access and pay for care when they need it.”

The study included a diverse cross section of employed Americans with respect to gender, ethnicity/race, region, occupation, income level, seniority level, family type and health conditions. Respondents were of above-average income, with one in five earning more than $100,000 per year and 46% in managerial or higher positions. A quantitative sample was collected in January 2024, totaling 1,516 survey responses.

The research was conducted by Nonfiction Research LLC and commissioned by Paytient, a technology company that delivers financial and care solutions to more than 25 million Americans.

Financial Wellness: Implementation and Communication

A panel of experts discuss ways to reach busy participants with financial wellness tools and resources.

Investment adviser Jenna Witherbee says that after years of working with plan participants, she and her colleagues at 401k Plan Professionals noticed a pattern of questions coming from their plan sponsor clients’ employees.

The firm decided to take the common issues from those questions to create its own in-house financial wellness program. They then went on to build that offering with a key goal in mind: making it accessible and realistic for busy employees with limited time.

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“We wanted to create something that was on demand and something that was in bite-sized pieces that would walk people through the financial steps,” Witherbee said during a PLANSPONSOR livestream on March 7. “We created an 8-step financial wellness series that lives on our website and on our YouTube channel …. That is a way that we can reach more people.”

Creation is just one aspect, Witherbee says. The next is putting the resources in front of participants consistently. That can be in formats including employer emails, regularly scheduled educational meetings, and via the use of technology tools such as QR codes.

“It’s really important to repeat and use many different channels to try and reach people, that’s what I’m finding more and more,” she said.

Meanwhile, one-on-one engagement and the ability for a participant to jump on a Zoom call with an adviser for 30-minutes is still always appreciated and gets good results, she said.

401k Plan Professionals, she said, will also work with third-party financial wellness providers when it makes sense, but the key to any program working at its best is plan sponsor interest and focus.

Many of those plan sponsors, Witherbee said, are increasingly focused on customization for their participants, a goal she is finding new ways to meet. As an example, when onboarding a new client recently, the adviser gathered a number of consistent questions she got from the new plan sponsor’s participants. From there, Witherbee was able to work with the plan sponsor on a targeted educational campaign to try and educated and provide resources on those specific areas.

“We try to meet people where they are at,” she says. “If someone is sitting in a meeting and we are talking about Social Security and they are 28 years old, they are totally checked out …. In order for people to engage and want to take action we have to be talking about things that are relevant to them and their life stage.”

Stress Management

Richard Yezzi, Jr., vice president of operations, JX Enterprises Inc., told the livestream audience that his company places an emphasis on financial wellness for employees because “the toll and the stress” of general money trouble seeps into the workplace.

“Getting engagement on these programs and having people develop good habits is key for us,” says the operations head at the Hartland, Wisconsin-based transportation company. “Making sure that we raise awareness that people have access to the resources and information that they need to relieve those stresses …. is critical.”

Yezzi said that the firm has tried a “myriad” of communication tactics to engage people with its financial education offerings. The firm has used emails, message boards, one-on-one management conversations, texting, and even phone calls—the last of which was “not popular” with younger workers.

To track the results, Yezzi’s team will look at open rates and usage for its online financial programs and the communication campaigns themselves.

“When we push text messages or make message board changes, we can watch the results and see almost in real time if a particular message drove a result that we wanted, or if there was no impact,” he said.

There is a balance between communicating enough, but not too much, Yezzi noted.

“It’s about bringing balance to it,” he said. “Keeping things fresh, certainly. If there’s something relevant going on in the world, tying [financial wellness] into that when we have their attention [works].”

Honing the Message

Jay Schmitt, principal, Strategic Benefit Advisors, works with plan sponsors on identifying and choosing financial wellness programs. He noted on the livestream the importance of starting with a review of the participants a sponsor wants to reach.

“It really all starts with, ‘What are we trying to accomplish here?’” Schmitt says. “You’ve got workers who don’t look at a computer all day but do have a phone. It’s getting to those details and getting to who we are trying to reach—you can’t reach everybody. That would be great, but you need to be focused on what you’re trying to accomplish.”

Schmitt said that when his firm meets with a plan administrator, it first identifies all the financial resources available to participants, and then brings them together into a package of materials to target the workforce.

In terms of engagement, Schmitt noted that some clients like to have a vendor provide participants with a financial wellness score that will shift depending on their actions. He said that type of tool can help get people involved with their financial situation on an ongoing basis.

Unfortunately, Schmitt said, the call to action for many people to engage with financial wellness can be when something bad has happened around debt or financial needs. That is why it is crucial, he said, for employers to get resources and materials in front of employees early and often.

“The main effort we find with our clients is getting the employee to be aware of what is available to them,” he said. “Most employees just hit the unsubscribe button, but they really need to know that they can go to the company portal, website, whatever it is to find all the resources that they have access to …. so, when they do need it, it’s there.”   

The full livestream is available on demand on PLANSPONSOR at this link.

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