Employees want to do what is best for their health, but sometimes that decision is a difficult one to make. If we value our employees and the care they receive from medical facilities, we must provide them with better health care benefits that make medical checkups and procedures affordable and convenient. 

If a policy is inconvenient, it is worthless to employees. A friend of mine posted all over social media she was recently diagnosed with a tumor. When I learned she was seeking treatment, I offered to pull some data to determine the highest-value and lowest-cost treatment options in Kentucky and Tennessee. She seemed delighted. I pulled the three highest quality facilities, each of which was about 100-200 miles away. She thanked me.  Two days later she posted (again on social media) she had decided to use one of the hospitals down the street. Even armed with the best data available, my friend was preoccupied with convenience. Seemed if her friends and family couldn’t easily visit her at a facility, she didn’t want to receive treatments there. 

Although she is now recovering post-op, the tumor removed, data shows she’s doing so at a higher price point and with a lesser quality of care. So far, the prognosis looks good, and she has her health care benefits to thank. Without her benefits plan, she may have had a more difficult time picking a facility for treatment. Finding the best care at the right price sometimes becomes a deadly scenario for employees. 

When Benefits Become Life-Threatening

One of our clients chose a $5,000 deductible to ‘buy down’ their renewal as a strategic option for their plan. For one employee, the costs were too high for her to seek care for the chronic pain in her legs, she was functionally uninsured. Worried about costs, she decided to wait until she was 65 and receiving Medicare to address her problem. 

With new strategies and solutions available to us, we improved the client’s plan so that employees had a $0 deductible and $3,000 in max out-of-pocket costs. To protect the company we limited their risk to a $10,000 deductible for each employee, with secondary insurance picking up the rest.

Although the plan was helpful, we were too late. Eventually, the woman’s legs turned white. An examination at a medical center revealed numerous blood clots throughout her legs. Surgeons were unable to remove all the blood clots, quickly removed her left leg. Three days later, they took the left knee. A week later, they had to remove her right leg. All told, the employee racked up some $1.5 million in claims because she waited too long to seek treatment. 

The story is bittersweet. Thanks to the new health care plan, the woman only has to pay $3,000 on $1.5 million of expenses, and the company is only responsible for $10,000. But now the employee is on a long, painful road to recovery. 

First and foremost, a health care plan should help the people it serves. Had she known about the potential severity of her condition earlier on, she could have avoided disaster and received the medical attention she needed to correct the problem. 

Review your health care benefits with your employees to ensure it provides a high level of care at a price point that is affordable for them. If employees are unable to use it because of the price tag attached to it, consider a change that gives them access to meaningful health care.