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Health insurance coverage and employee health outcomes

We often hear people in the healthcare sector talk about ‘health outcomes’, but what does it really mean? According to World Health Organization, an outcome is “a change in the health status of an individual, group or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status.” In other words, a health outcome can be described as the efficacy of interventions (healthcare or health insurance coverage, for example) in improving the health status of patients, employees, or the society at large.

As populations continue to age, and Non Communicable Diseases (NCDs) continue to rise at alarming rates, a growing proportion of the world’s population are experiencing a decline in their health status. As such, it’s become more important than ever for governments, key decision makers, health care providers, insurers, and employers to focus on improving the health status of patients, employees, and populations. To shed some light on the issue, today’s article looks at the relationship between health insurance coverage and employee health outcomes.

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Health-related quality of life

Before we look at the relationship between health insurance coverage and health outcomes, we’d first like to address how outcomes are usually measured. While there exists many variations of definitions for the term health outcomes, one primary aspect that almost all concepts focus on are the central measures or indicators used to measure the health status of patients.

One such indicator is health-related quality of life, which is a multidimensional concept that encompasses domains related to physical, mental, emotional, and social functioning. Put differently, it refers to how physically, mentally, emotionally, and socially healthy people feel when they are alive. An oft-used measurement of health-related quality of life is “healthy days”, which is generated by asking people about the number of physically or mentally unhealthy days they experience per month.

health outcomes and health insurance coverage article

Healthcare costs and health outcomes

In the past 20 years, consumer price inflation (CPI) has grown at an average rate of about 2.2 percent, whereas the price level of medical care has grown at an average rate of 3.6 percent – that’s about 70 percent faster. Explanations are not hard to find. In our International Private Medical Insurance Inflation – 2017 report, we looked at the main forces behind hiking healthcare costs and, subsequently, health insurance costs: new medical technology, an imbalance of health resources, increased compensation for medical professionals, and healthcare overutilization.

As healthcare spending continues to exceed economic growth at an unsustainable level, more and more people are finding it increasingly hard to afford and access quality care. Demographic changes such as ageing populations, and the growing incidence of NCDs, are further exacerbating the healthcare ‘cost crisis’. Some commentators believe the challenge of delivering better health outcomes with lower overall costs can be attributed to ineffective cost measurement processes, leaving better value care out of reach for both providers and patients.

If healthcare costs are better controlled, people (in theory) have a greater ability to access the care they need to live healthier lives. For instance, patients can undergo more frequent screenings and health check-ups to ensure early detection of cancer, diabetes, and other serious conditions. This can help ensure that less costly and complex care is needed in the long run, and can also limit health deterioration.

The role of health insurance coverage

Health insurance is a key tool for managing financial risk and offsetting the cost of care. According to an article in the New England Journal of Medicine, there is abundant evidence that suggests having health insurance improves financial security. For example, the article cited a US-based study on the ACA’s 2014 Medicaid expansion’s links to reduced bill collection and bankruptcies, thus confirming that health insurance reduces the risk of unforeseen medical costs.

From an employee benefits perspective, the annual Employee Benefit Trends Study has long reported the importance employees place on financial security. One of the key ways businesses address this need is by offering employer-provided health insurance as part of their employee benefits package. In addition to bolstering employee financial security, there’s also a good chance that implementing the right employee health benefits leads to better workforce health outcomes, which translates to lower healthcare costs for employers in the long run.

Health insurance and access to care

According to the aforementioned New England Journal of Medicine article, several studies have shown that health insurance coverage has been linked to higher rates of patients being able to afford care, a factor which is oft-associated with better health outcomes. In fact, the CDC states that health insurance coverage provides a strong indication of a population’s access to care.

In recognizing the importance of ensuring universal access to quality care, a growing number of locations have made or are in the process of making health insurance mandatory. For example, Abu Dhabi introduced universal health insurance coverage in 2006, which led to an immediate 40 percent increase in hospital and clinic visits by people able to afford care for the very first time. A rise in the utilization of care has also been witnessed in Dubai, where employers of all sizes are now required to provide compliant health insurance coverage to employees.

Access to preventative services

The New England Journal of Medicine study further revealed that the expansion of coverage benefits increases access to preventative services, which can help patients detect health issues early on so they can better manage their health.

To mitigate rising healthcare costs, a growing number of employers are also seeing the importance of offering preventative care cover in employee benefit plans. In fact, a Willis Towers Watson study found that 39 percent of employers throughout the world now offer some form of preventative care and wellness program, and this percentage is projected to grow significantly in 2018.

Self-reported health and wellbeing

There’s also evidence to suggest that health insurance coverage improves patients’ perceptions of their health. Why is this important? According to World Health Organization, subjective physical and mental wellbeing (i.e. the notion of feeling better or feeling healthy) is one of the key goals that medical care should aim to achieve. Additionally, people who report that their health is poor have been found to have mortality rates 2 to 10 times higher than those who report being in the healthiest category.

What about mental health?

In addition to addressing physical health, the issue of mental health has also been brought into the spotlight as a key factor that is closely linked to health outcomes. In fact, as employee stress continues to rise, 61 percent of global insurers now offer coverage for mental health treatment and stress in their standard health insurance plans.

Our recent article, written in partnership with Asia Care Group, further revealed a number of key findings which show the importance of addressing employee mental health. These include:

  • Demanding jobs increase the chances of physician-diagnosed illness by 35 percent, and long working hours increase mortality by almost 20 percent.
  • Job insecurity increases the likelihood of reporting poor health by 50 percent.
  • The global cost of mental disorders is expected to reach USD 6 trillion by 2030, which primarily includes the costs and strains to the healthcare sector.

While health insurance plays a significant role in enabling access to better mental health care, employers are advised to look beyond health insurance in order to employ a more holistic approach to employee benefits which includes considerations for wellness benefits that target mental health. Examples of what employers can do to address mental health include:

  • Inviting a mental health professional to talk to employees about various mental health topics
  • Providing mental health management resources, such as online counselling services.
  • Partnering with an employee benefits specialist like Pacific Prime, who can help devise, implement, and manage your company’s benefits and mental wellness solutions.

Looking to learn more about improving your employees’ health outcomes?

As employee benefits specialists, we’ve had almost 20 years of experience delivering employee benefits solutions to companies of all sizes and industries. Holding the unique ability to devise, implement, and manage the most optimal plans that improve employee health outcomes, while also ensuring that they remain sustainable and cost-effective year-on-year, it’s no wonder why we are the broker of choice for over 3,000 corporate clients.

What’s more, we’re an insurance intermediary, which means we are not beholden to any one insurance provider. As such, we work for you, and not the insurer, so you can rest assured that we’ll find you the best plan for your employee’s needs. To learn more about how Pacific Prime can help your company, contact us today! Our corporate team are standing by to offer their impartial advice, as well as give you a no-obligation, free quote.

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