How employers can promote preventive healthcare for members

Employers have a stake in preventive care access

Of course, a primary goal of preventive care is to promote overall health and well-being, but preventive care access is also key to employers' bottom lines, Short explained.

"Prevention is the way to improve health in our society and to decrease the medical costs that are on employers," she noted. "We've traditionally focused on high-cost claimants and it's very important to identify people early who might end up being high-cost claimants and try and mitigate those costs."

For employers, healthcare coverage is a balancing act of promoting employee health while keeping benefits costs low.

Providing health insurance coverage that moves beyond the bare bones of the typical plan can be expensive, Short acknowledged, especially when companies contend with problems like high employee churn. If employees don't stay with the company in the long-term, any investments in preventive care might be for naught.

"But there are a few pieces here in terms of the value proposition," Short argued. "One, there's just the ROI -- the nuts and bolts of early diagnosis, keeping people in the workplace, keeping people healthy and not having those downstream costs and consequences.

"The other is this piece of the employer being an employer of choice," she continued. "It's competitive in today's market, so the employer caring about employees and that stickiness of 'people are going to stay with us if we take care of them' is a big piece of it."

Employers looking to promote better preventive care access need to understand the leading barriers to care and then examine how their benefits packages can work to overcome those barriers. By connecting those dots for employees and helping them navigate the healthcare landscape, employers can start to fill in care gaps.

Fitting benefits to employee needs

Employee care gaps start to open in large part because most folks face some type of barrier to care. For Short, the biggest barrier that comes to mind is cost.

"It's really important for employers to provide screenings at no cost to members," she stressed.

Indeed, concerns about out-of-pocket costs are a big deterrent for care, with nearly a quarter of Americans going without some form of necessary healthcare in 2022, according to a 2023 report from the Federal Reserve. In a separate survey, researchers from the Alliance for Women's Health and Prevention found that 45% of women go without primary and preventive care, with cost discouraging access for a quarter of them.

Of course, the Affordable Care Act does mandate full coverage for preventive screenings, Short acknowledged, but it's the downstream costs that can dissuade patients from getting the initial screen in the first place.

"An employer might provide a benefit for preventive screening for colonoscopy, but then if there's a polyp that's removed during that colonoscopy, which is a diagnostic procedure, then the employee will get billed for that," Short stated. "Then it's a preventive screening, but it's not for free anymore."

Employers might consider extending or expanding their definition of "preventive" to also cover at least the first diagnostic test that might stem from that screening, Short recommended. While companies need to weigh the costs of such expansions, Short said early detection nearly always yields ROI, which she said makes a strong business case.

But barriers persist beyond cost, she added, and in perhaps unexpected places.

For example, Short explained that childcare can be a barrier to screening. If a parent cannot find someone to take care of their child during the screening or preventive service, they might decide to simply go without.

Short said this presents another benefits opportunity, encouraging added PTO days for employees to get their preventive screenings or annual physicals.

Companies should also look outside of their own policies, too. By assessing their health plan and vendor partnership packages, employers can suss out the services offered to their employee populations.

"Employers need to understand what they're getting from their health plans and their vendors," Short added. "A lot of times, they don't know what kinds of programs they're even paying for and what they can leverage."

It's incumbent upon employers to assess these benefits, promote them to employees and help employees navigate them.

"The navigation piece is really important as well," Short stressed.

There's a lot of opportunity in leveraging provider directories, especially ones tailored to the company's employees. Through partnerships with local healthcare providers, employers can streamline the appointment booking process to get employees connected to care. In-office clinic days, mobile screenings and at-home tests for employees who qualify are also key.

Emerging digital tools, like ones that automate preventive care coordination, also hold potential, Short said.

As companies begin to understand the benefits options available to them and their employees, they must close the loop using patient education.

Employee education drives benefits access

At the end of the day, patient education is a leading barrier to preventive care. Many patients simply just don't know that they need it or why they need it.

"The employer's role is so important in terms of A, providing the benefits for preventive care and B, in terms of education," Short said. "Health literacy is pretty low in this country, and it's even low when you look at educated people. If you don't feel bad, then it's hard to understand why you need to be screened. And so, connecting those dots is an important piece."

In her work in employer benefits consulting, Short has seen companies excel at the education and navigation piece. It's nearly always a multi-pronged approach she said.

For example, one of her clients flagged key care gaps in certain types of screenings, prompting a communications campaign for employees. The campaign focused on custom content, mobile mammography, on-site biometrics and flu shots. The company partnered with Short to host webinars on both men's and women's health, as well as a seminar from a C-suite executive who was a breast cancer survivor to promote the importance of screening.

The effort resulted in a 14% improvement in their composite preventive screening rate, Short said.

The program was successful because it used multiple avenues to connect with and educate employees, Short indicated.

"Companies have to know, understand and have the options for interventions and have those interventions facilitated," she stated.

It's not just about nudging employees to visit their primary care provider or get their annual physical. It's also about explaining what's covered under the employer-sponsored health plan or, even better, helping the patient book the appointment.

"That's huge," Short said, "and some health plans will do that, but it could cost the employer money."

But, again, Short argued that the value proposition is undeniable. Disease is expensive for everyone involved, from patient to payer to employer. When that disease is preventable, it is most cost-effective to drive that prevention.

"Around 75% of diseases are preventable," Short concluded. "When you think about the cost and the consequences of that, people need to understand, particularly employers, their benefits, their communications and their programs."

Sara Heath has reported news related to patient engagement and health equity since 2015.