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Consumers Struggle Mightily with Basic Healthcare Tasks

Analysis  |  By Alexandra Wilson Pecci  
   August 26, 2021

New research shows that 79% of people who received healthcare services in the past two years experienced an average of three challenges when doing so.

From finding a provider to understanding bills, the healthcare experience isn't easy for most people, according to research from care navigation and coordination company Quantum Health.

It found that 79% of people who received healthcare services in the past two years experienced an average of three challenges when doing so.

Their troubles ran the gamut from administrative issues to understanding the care they received itself. For instance, consumers had trouble understanding coverage levels; making use of all their available benefits; finding a provider; and understanding insurance claims or billing questions.

Plus, 90% of respondents with complex or ongoing clinical needs faced additional challenges related to tasks like getting prior authorizations approved; understanding test results or diagnosis and treatment options; and developing a plan of care for more complex health issues.

The survey also found that these healthcare-related challenges trickled into their personal lives, with 57% suffering a resulting negative impact, such as a significant decline in mental well-being (19%), a significant decline in physical health (17%), or interference with a prescribed treatment plan (16%).

People complex or chronic conditions had an even greater impact, with 76% saying they had suffered a decline in mental well-being (28%), a decline in their physical health (37%), and interference with a prescribed treatment plan (28%).

Here are some other survey findings:

  • 60% of all respondents said they have had to spend time during their workday on healthcare-related tasks for themselves or a loved one in the past two years.
  • The average time spent at work doing so was 27 minutes.
  • The average amount of time spent completing healthcare-related tasks at any time, whether at work or home, was 46 minutes.
  • 88% of employers say their workers are confident in understanding their healthcare benefits, yet just 52% of individuals say they feel confident.
  • Only 45% find it easy to use their health benefits and only 35% find it easy to navigate the healthcare system.
  • 39% of individuals overall and 56% of those with chronic conditions agree that they need professional healthcare navigation services to make their healthcare experience less stressful, increase their confidence in understanding and using their benefits, and save time.
  • 50% of people with chronic or complex conditions said navigation would improve communication with doctors and improve clinical outcomes.

SNG Research surveyed 1,001 individual consumers ages 18-64 who have employer-sponsored health insurance, along with more than 250 employer organizations with at least 1,000 employees and 152 employer benefits consultants and brokers.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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