What should an employer do when employees are not getting regular preventive and work-related medical checkups or recommended care because it costs too much, even when they have health insurance coverage?

A newly released Commonwealth Fund 2023 Health Care Affordability Survey confirms previous studies that show Americans are delaying or declining recommended medical and dental care. In the survey, a significant percentage of working-age people enrolled in employer, marketplace and individual-market plans reported it was “very” or “somewhat difficult” to afford health care. They also said that they or a family member had delayed or skipped care and/or use of prescription medications due to cost, and that their health had gotten worse as a result.

In addition, medical and insurance benefit costs have been found to be disproportionately higher among employees with health risks such as obesity, diabetes, high blood pressure or heart disease in comparison to lower-risk colleagues. Employees with multiple health risks also have higher-than-average risk for work-related accidents and injuries and prolonged absences when compared to healthier colleagues. These types of health risks are often associated with behavioral factors such as smoking, drinking alcohol, poor nutrition and lack of exercise.

Along with insured employees, low-income, underserved and uninsured employees with limited access to care comprise another vulnerable segment of the working population with specific, potentially costly health risks and consequences.

Costs Add Up

According to the U.S. Centers for Disease Control and Prevention (CDC), 90 percent of the nation’s $4.1 trillion in annual health care expenditures are for people with chronic diseases and mental health conditions. Most of these conditions could either be prevented or detected earlier and treated to produce better health and economic results – as long as needed care is sought.

The RAND Corporation reported in August 2023 that spending on mental health services rose by 53 percent from March 2020 to August 2022 among people covered by employer-provided insurance plans; utilization increased by 39 percent. Mental health conditions identified among 7 million covered adults in the RAND study included anxiety disorders, major depressive disorder, bipolar disorder, schizophrenia and post-traumatic stress disorder.

One thing can lead to another. For example, it is estimated that 48 to 64 percent of lifetime medical costs for a person with diabetes are attributed to related complications such as heart disease and stroke. Studies also show that employees with physical and mental health risks tend to be more susceptible to illness and injury.

Health risks include exposure to extreme temperatures, infectious particles, noise or toxic materials, rapid pace, repetitive or strenuous physical tasks, and emotionally stressful environments. Exposure risks that are not managed well with personal protective equipment, ergonomic adjustments, industrial athlete coaching or safety training can have a cascade of ill effects on workforce health.

What Can Be Done?

To help close care gaps and encourage employee engagement in their own health, safety and well-being, WorkCare provides occupational health services onsite and through secure virtual connections. With expertise that spans the care continuum, employees’ work-related physical and mental health care needs are never overlooked. For personal care, WorkCare clinicians refer employees to qualified local providers.

Our occupational health practitioners are well-versed in the delivery of preventive interventions, self-care recommendations and health education based on personal health risks as well as risk of exposure to hazardous workplace conditions. WorkCare provides first aid and care guidance for minor injuries, vaccinations to help prevent the spread of contagious diseases, work-related medical exams, industrial athlete interventions, biometric screening to detect health risks and other services to help keep employees healthy, safe and on the job.

The availability of occupational health expertise increases the likelihood that employees will be receptive to receiving work-related medical services as an alternative to skipping care because of out-of-pocket costs. This approach is cost-effective for employers. Prevention and early intervention are repeatedly shown to lower workers’ compensation case rates, and reduce absence and disability days, and limit legal costs while demonstrating to employees that their employer believes they are worth the investment.

Here’s a related blog post on the critical role of occupational medicine physicians.