Key finding: Consumers experience an average of three different challenges when accessing healthcare; meanwhile 60% say they have had to spend time during work hours dealing with healthcare tasks


DUBLIN, OH (August 24, 2021)) – New research from Quantum Health, the industry-leading healthcare navigation and care coordination company, reveals for the first time the extent to which growing healthcare complexity impacts consumers. Findings from this groundbreaking survey show that consumers experience multiple challenges when accessing healthcare and that complexity has a compounding effect on well-being and work life.

The Quantum Health findings were based on a survey of 1,001 individual consumers ages 18-64 who have employer-sponsored health insurance; more than 250 employer organizations with at least 1,000 employees; and 152 employer benefits consultants and brokers. The survey was conducted during the months of March and April 2021. Employer organizations and benefits consultants represented companies in 11 different U.S. industry segments.

Among other things, the data revealed that 8 in 10 people who received healthcare services in the last two years experienced an average of three challenges when doing so, including administrative challenges like understanding coverage levels; making use of all available benefits; finding a provider; and understanding insurance claims or billing questions. In addition, 90% of respondents with complex or ongoing clinical needs faced additional challenges related to tasks like getting prior authorizations approved; understanding test results or diagnosis and treatment options; and developing a plan of care for more complex health issues.

“This research drives home the fact that healthcare complexity affects individuals and families in multiple and very significant ways,” said Kara Trott, founder and CEO of Quantum Health. “It’s critical that employers, benefits professionals and healthcare providers recognize and understand that dealing with this complexity is not only a disruption for individuals and families, but it can also have a negative impact on their physical and mental well-being, as well as influencing workplace productivity.”

At a high level, the Quantum Health study illustrates how consumer knowledge gaps can influence utilization of benefits, patient engagement and compliance with care plans. More detailed findings from the survey shine a light on more specific insights, including:

  • Physical and mental well-being suffers due to complexity. Among individuals who experienced challenges with healthcare (79% overall), 57% suffered a resulting negative impact, including: a significant decline in mental well-being (19%), a significant decline in physical health (17%) or interference with a prescribed treatment plan (16%). For people with complex or chronic conditions, 76% said they had suffered a negative health impact because of healthcare complexity, including a decline in mental well-being (28%); a decline in their physical health (37%); and interference with a prescribed treatment plan (28%).
  • Healthcare complexity drains workforce productivity. In fact, 60% of all respondents said they have had to spend time during their workday on healthcare-related tasks for themselves or a loved one in the past two years. When that occurred, the average time spent was 27 minutes. The average amount of time spent completing healthcare-related tasks at any time – whether at work or home – was 46 minutes.
  • There is a “confidence” disconnect between employers and their employees. Employers underestimate the impact of healthcare complexity and employee knowledge, as 88% of employers say their workers are confident in understanding their healthcare benefits. However, only 52% – barely half – of individuals surveyed actually say they feel confident. Meanwhile, only 45% find it easy to use their health benefits, and only 35% find it easy to navigate the healthcare system.
  • Consumers say healthcare navigation can make a difference. Of those surveyed, 39% of individuals overall and 56% of those with chronic conditions agree that they need professional healthcare navigation services to make their healthcare experience less stressful, to increase their confidence in understanding and using their benefits, and to save time. In addition, 50% of people with chronic or complex conditions said navigation would improve communication with doctors and improve clinical outcomes.

“The American workforce has gone through an extraordinary evolution since early 2020, and employers are stepping up to the plate to provide additional support for employees and their dependents. However, it’s clear from this research that finding the right navigation solution – one that helps employees break through challenges caused by increasing healthcare complexity – should be a priority for business leaders and benefits professionals,” said Trott.

This survey was conducted by SNG Research, an independent market research firm.