KFF Survey Provides Insights Into Consumer Experiences With Health Insurance
This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.
A recent health care consumer experiences survey by Kaiser Family Foundation (KFF) found that most insured adults feel positively about their health insurance, with 81% rating their insurance as either “excellent” or “good.” Individuals with fair or poor health rated their insurance lower (68%). Medicare received the highest positive ratings at 91%. The survey relied on interview data from 3,605 U.S. adults with employer-sponsored health care, Medicare, Medicaid or Affordable Care Act (ACA) Marketplace coverage.
While most adults rated their insurance positively, 58% reported encountering at least one problem using their coverage in the past year, with a larger percentage of individuals (67%) with the greatest health care needs reporting similar issues. Problems included denied claims, difficulty finding in-network providers, and delays or denials of care due to preauthorization issues. Nearly 17% of insured adults said they were unable to receive their recommended care because of these problems, with 15% reporting a decline in their health and 28% paying more than expected.
Other key findings include the following:
- Adults with worse physical or mental health were more likely to report having problems with their health insurance. Of individuals who received mental health treatment in the past year, 74% reported a problem. Additionally, 78% of individuals with more than 10 health care provider visits in the past year said they experienced problems using their health insurance.
- Many insured adults did not receive needed mental health services or medication. Nearly 43% of insured adults who reported being in “fair” or “poor” health stated they did not receive mental health services or medication they needed in the past year, with 45% rating their insurance negatively when it came to available mental health providers. Approximately 40% of individuals skipped or delayed care in the past year due to costs.
- More than one-third (36%) of insured adults struggle to understand their health insurance. About half (51%) of adults said they find at least one aspect of their health insurance at least somewhat difficult to understand. Moreover, approximately 90% of adults support public policies to make health insurance simpler to understand—such as easier-to-read explanation of benefits, disclosures of claim denial rates and advance notice of whether care is covered and out-of-pocket costs—and help individuals avoid or resolve insurance problems.
“The survey shows that the sheer complexity of insurance is as big a problem as affordability, particularly for those with the greatest needs.”
– KFF President and CEO Drew Altman
Employer Takeaways
This survey confirms what many employers already know: Most employees value having health coverage. However, it also reveals that many individuals have issues when trying to use their coverage. These problems are more pronounced among individuals with poorer health, high utilizers of health care and people who receive mental health care.
The survey also uncovers potential barriers that may prevent adults from receiving needed physical and mental health care services, such as in-network provider issues, difficulties understanding health insurance policies and high costs related to care. While the U.S. Congress has taken steps in the last few years to make health insurance more affordable and easier to understand, employers are uniquely positioned to help employees understand and effectively use their health plans. A better understanding may help employees increase their health care literacy and improve their health and well-being.
Contact RISQ Consulting for more health care resources.
- Published in Blog
Coping With A Serious Diagnosis
This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.
Getting an unexpected health diagnosis can flip your world upside down. Upon receiving a serious diagnosis, you must evaluate treatment options and consider how it will affect your life, health, job and finances. On top of all that, you will also need to manage the emotional toll receiving a diagnosis may have on your well-being.
This article explores the general stages of grief one may go through after receiving a serious diagnosis and tips for coping with the news.
The 5 Stages of Grief
Grief is an experience that can completely consume you mentally, physically and emotionally—and it doesn’t just happen with the traditional sense of loss. The grief that accompanies a life-changing diagnosis is complex.
Psychiatrist Dr. Elisabeth Kubler-Ross proposed a framework referred to as the “five stages of grief”: denial, anger, bargaining, depression and acceptance. Consider the following five stages of grief that you may experience following a serious diagnosis:
- Denial—Denial is the act of rejecting reality. It often comes first in the stages of grief because the mind and body have to work to process the significant life change. In this stage, you might downplay the severity of the situation to cope by rejecting pain, ignoring symptoms or hiding symptoms from loved ones.
- Anger—A strong emotion you might experience is anger. This feeling may be directed at yourself, your doctors or even the world. This phase is helpful since anger allows you to start feeling again and examine how you feel about the situation.
- Bargaining—Though this stage isn’t the same as denial, bargaining may feel similar because you’re thinking of how the situation could have gone differently. This is considered the “what ifs” stage, and people often seek a second onion hoping for different results.
- Depression—Grief and depression go hand in hand. You may pull away from loved ones or feel sad or lonely. When faced with a serious diagnosis, you may also be mourning the loss of your former and healthier self and the life that went with it.
- Acceptance—The final stage is achieved when you’ve come to terms with the diagnosis and have stopped any internal fights against it. You accept your life will be different and start taking steps to manage the condition better and improve your health.
These stages are attempts to process change and protect yourself while you adapt to a new reality. Once you’ve cycled through these stages of grief, you’re more likely to be open to coping strategies.
Tips for Coping With a Diagnosis
You’re likely to be flooded with a wide range of emotions when given a serious diagnosis. Everyone responds differently, but consider the following ways to take control of the situation:
- Give yourself time to process the news. You’ll likely need to go through the five steps of grief—which takes time—to work through any emotions. Don’t hold back on sharing your feelings with family members and friends.
- Get the facts. Learning as much as possible about your condition and treatment options is essential. Ask for resources from your doctor or pharmacist and search reputable online sources (e.g., government websites, condition-specific websites and medical journals).
- Create a support system. It can be helpful to have a network of people (e.g., family, friends, neighbors and others with the same diagnosis) to lean on and talk to during your treatment or recovery. Remember that it’s OK to accept help during a difficult time.
- Focus on healthy habits. Talk to your care team to understand the best lifestyle choices, nutrition and exercise options for your condition. Maintaining a healthy lifestyle can also help improve your energy level and mood.
- Stick to your daily schedule. Routine is important, and staying busy can positively impact your mental health. Just as you’d schedule time for work or social activities, be sure to include sufficient downtime to recharge.
- Make time for your favorite activities. What has been comforting before your diagnosis will likely still ease any worries. If needed, modify your activities to still participate in them. Don’t dwell on your limitations or compare your situation with how things used to be.
Depending on the diagnosis and your health situation, be open to trying new activities or other coping strategies. For example, journaling or seeking a professional mental health provider can be healthy outlets to help you navigate the condition and move forward mentally.
Summary
It isn’t always possible to prepare for life-changing news, and it’s a learning process to figure out how to cope with a difficult health diagnosis. However, you can find a way to adapt to the changes coming with some time and patience.
As you cope with a serious condition, it’s crucial to prioritize your physical, mental and emotional health. If you’re struggling to stay positive most days or are held back by fear and anxiety, it may be helpful to seek professional help. Bring up any concerns to your doctor or use the Substance Abuse and Mental Health Services Administration’s National Helpline by calling 800-662-HELP (4357).
- Published in Blog
Tips for Effective 2023 Open Enrollment Communication
This article is from RISQ Consulting’s Zywave client portal, a resource available to all RISQ Consulting clients. Please contact your Benefits Consultant or Account Executive for more information or for help setting up your own login.
Now more than ever, employees are looking to their employers for guidance on navigating their available benefits and how to stretch their dollars further. As such, effective open enrollment communication is critical this year. According to a Voya Financial survey, nearly one-third of American workers (31%) eligible for benefits admitted they don’t fully understand any employee benefits they selected during their most recent open enrollment period. However, employees are likely paying more attention this year as they also navigate record-high inflation and work to maximize every hard-earned dollar.
Many of today’s workers want help understanding how much money to put aside for retirement, emergency savings and health care expenses. That means employers have an opportunity to shine by effectively communicating and guiding employees throughout the open enrollment process and even the rest of the year.
As the 2023 open enrollment season approaches, employers are poised to provide their employees with resources and digital tools they can use to better understand and act with more confidence when making benefits decisions. This article highlights communication tips for employers.
Communicating With Employees
Educating and informing employees about their benefits package is an integral part of open enrollment. Effective communication is critical to educate and inform employees about new, returning or expanded benefits options. Consider these eight communication tips:
- Start early. Get the word out early about benefits offerings so employees have ample time to understand their benefits, consult with family members and determine their needs for the following year. There’s no such thing as communicating “too soon” about enrollment. Research shows that repetitive messaging and reminders increase the odds of an employee seeing enrollment information and understanding the upcoming benefit changes and how they work.
- Develop key messaging. After solidifying benefits options, employers need to plan their communication strategies. The first step is figuring out key messaging, focusing on new or updated benefits offerings, and developing FAQs to address common concerns quickly.
- Select a mix of appropriate channels. Just as many workplaces operate in a hybrid model, employee communications can be successful when done in a similar manner. For example, digital channels can help distribute and house information virtually, allowing employees to access it when and where they need it. Chat functionality with benefits vendors can also be a helpful digital tool to assist employees in figuring out which benefits they need. Alternatively, there’s still a time and place for companywide on-site meetings and mail-to-home print communication. Postcards and other mailers are still relevant and can serve as a reminder to discuss and review benefits options at home. Every workplace is different, so it comes down to selecting various channels that are relevant and engaging to each organization’s specific employees.
- Keep it simple. It’s vital to simplify any benefits information being shared. Employees don’t need to know everything, so employers should highlight what’s necessary to understand about the benefit and the information to help them decide if they need it. Links or attachments could explore the benefits further and offer the fine print.
- Make it digestible. It’s crucial to catch employees’ attention and present the key message immediately before they lose interest. Traditional benefits booklets can be lengthy; instead, employers could deliver bite-sized information to employees through methods such as videos and emails. If all open enrollment information is given at once, it’s easy for employees to become overwhelmed and, ultimately, disengage with employer-provided information. Digestible communication makes it easy for employees to know what to focus on and take action.
- Use real-world examples. When possible, employers can put benefits offerings in context with real-world scenarios. Employees can relate to stories, so find ways to bring the options to life. For example, instead of describing telemedicine as a 24/7 benefit, highlight that an employee could get health care answers in the middle of the night when they or a child are running a high fever. The chances of employees needing to use health care benefits during the next year are highly likely, so help reiterate the importance of complete coverage.
- Avoid jargon. Avoiding HR or benefits-related jargon is best to help make benefits easier to understand. Additionally, many benefits are acronyms, so employers should help decode and explain the alphabet soup to employees.
- Personalize communication. Ultimately, employers want to engage employees with open enrollment information, and a personalized approach can help. It’ll depend on the workforce and their working environments, but employers will likely need to segment their employee audience and tweak messaging so it resonates. For example, open enrollment methods and communication would look different for remote, on-site and nonwired employees.
Benefits can be complicated. Although open enrollment is the most pivotal time to highlight benefits to employees, employers have an opportunity to educate employees throughout the year. Ongoing communication after open enrollment can help encourage employees to understand and utilize the benefits available to them.
Summary
Educating and informing employees about their benefits options is an important part of open enrollment. Effective employee communication is an ongoing process, but it comes down to helping employees feel well-informed about their benefits options and confident about their choices.
Reach out to RISQ Consulting for additional open enrollment support, including employee communication resources.
- Published in Blog
