Employees Are Delaying Health Care. Here’s How Employers Can Help

Kathryn Mayer By Kathryn Mayer June 5, 2023

​Scores of employees are skipping or delaying both necessary and preventive medical care—which spells a major problem for employers.

More than half of employees (58 percent) delayed necessary medical care due to cost or insurance barriers, according to new analysis out from the Integrated Benefits Institute (IBI), an Oakland, Calif.-based nonprofit research organization. Meanwhile, 42 percent of workers reported delays because there wasn't an appointment available, and 35 percent delayed or avoided care due to fear of getting or spreading COVID-19.

The group's research also found that fewer than three-fourths of employees are up-to-date on preventive screenings and immunizations. Among those who are not up-to-date on preventive screenings, employees' top reasons were that it wasn't necessary because they said they are "young and healthy" (17 percent) and that it cost too much or they could not afford it (14 percent). The top reasons cited for not being current on immunizations were that they don't like shots, don't want them, or don't trust them (37 percent) and that immunizations aren't necessary because respondents claim they "have a strong immune system" (15 percent). For the data, IBI surveyed 5,003 employed individuals in the U.S.

IBI President Kelly McDevitt said the findings indicate a major problem and are a call to action for organizations.

"Delaying care has significant health impacts for employees, which in turn affects their presenteeism and productivity. A healthy employee is a productive one," she said, noting that delays in care also have significant impacts on employers in the form of lower productivity and potential increased health care costs.

"To address the issue of high costs down the road, employers must act now to ensure their employees are receiving the care they need," she said. "Part of that equation for employers includes addressing affordability, equity and access."

Even more concerning, the research noted, individuals with chronic conditions were more likely to delay care. Sixty-nine percent of individuals with three or more chronic conditions delayed care due to cost and insurance barriers, compared to 51 percent of those with no chronic conditions who did so. However, those with chronic conditions are also more likely to be up-to-date on preventive care.

"If chronic conditions go untreated, employers will eventually see higher rates of disability and leave claims among their employee population," McDevitt said.

The data from IBI is not an outlier: Gallup research from earlier this year found that the percentage of Americans who said they or a family member postponed medical treatment in 2022 due to the cost rose 12 percentage points since the year prior. That figure is now 38 percent, the highest it has been in the 22 years that Gallup has been following that trend.

"It's unfortunate but not surprising," Dr. Terry Layman, corporate medical director at Indianapolis-based Marathon Health, a health clinic provider that works with employers, said about the findings. "Traditional health care is inadequately structured to support the health of our population. Overall inflation—specifically medical CPI [consumer price index]—has continued to put health care out of reach for ever-increasing numbers of Americans year after year.

"Add to that the access problems created by labor shortages and backlogs of closures during the pandemic, along with some remaining apprehension about entering medical facilities, and we are set up for some difficulties ahead."

Going forward, Layman said, employers must incentivize people to get needed acute, chronic and preventive care in a timely fashion. "We really need to remove the cost, access and stigma barriers to head off delays in diagnosis, worsening morbidity and increasing cost of care," he said.

What Employers Should Do

There are several strategies employers can use to address the problem of employees delaying necessary or preventive care, IBI noted.

Ask why employees are delaying care. Any setbacks in treatment may exacerbate symptoms or illnesses and make treatment more difficult, all of which increase health care costs. That's why it's important for employers to track rates of delayed care, so they can encourage workers to get the treatment they need as well as budget for health care costs.

Acknowledge the impact of mental health. Mental health conditions often occur alongside chronic conditions such as asthma, diabetes, and obesity and can impact employees' ability to adhere to treatment recommendations for other physical health conditions. "It's important to acknowledge that mental health issues may cause additional barriers to getting physical health care needs addressed. Making additional efforts could help to improve this problem," McDevitt said. The IBI analysis, she noted, found that individuals with co-morbid anxiety and depression are least likely to be up-to-date on preventive screenings or adult immunizations.

Improve access to care where barriers exist. A big barrier to timely health care is cost; that's especially the case now with persistent high inflation, which is causing employees to pay more for virtually every expense. In particular, IBI noted, high-deductible health plans can cause major challenges for affordability. Employers could help hold down costs for employees by contributing money to health savings accounts, keeping lower deductibles or holding off on any premium increases. And to address accessibility challenges, employers can utilize mobile clinics to meet employees wherever they are.

Create a culture that encourages receiving care. Consider having some employees in an organization act as champions for benefits programs and encourage healthful behaviors, IBI suggests. Managers can also be trained to encourage conversations around health care and well-being.

Address the lack of available appointments. Finding appointments, especially for certain specialists, has been a major problem. For instance, almost 1 in 3 Americans who need mental health care report they are unable to receive it, according to the latest data from Mental Health America. Employers can help by looking into other solutions, such as virtual care when possible, or scheduling assistance programs, McDevitt said.



Hire the best HR talent or advance your own career.

Member Benefit: Ask-An-Advisor Service

SHRM's HR Knowledge Advisors offer guidance and resources to assist members with their HR inquiries.

SHRM's HR Knowledge Advisors offer guidance and resources to assist members with their HR inquiries.



HR Daily Newsletter

News, trends and analysis, as well as breaking news alerts, to help HR professionals do their jobs better each business day.