Beyond the Health Plan

As healthcare becomes more complex, employee support must evolve with it.

Rising healthcare costs continue to dominate conversations with employers. But lately, another concern keeps surfacing. Even with quality health coverage, many employees are struggling to navigate today’s healthcare system and get the care they need.

Recently, I spoke with someone whose family member waited more than two months to see a specialist for a painful neck injury. After finally getting the appointment, they left with few answers and one surprising piece of advice: “Do your own research.”

Whether you’ve experienced something similar or not, it’s a story many of us recognize. Employees wait weeks or months for appointments. They move from one provider to another. They’re referred to specialists who sometimes refer them somewhere else. Along the way, they’re expected to make important healthcare decisions without feeling confident that they understand their options. Or, they are constantly rerouted while their condition worsens. 

Physicians, nurses, and healthcare organizations are working under tremendous pressure, and many continue to provide exceptional care. But the reality is finding the right care and navigating today’s healthcare system has become increasingly difficult.

That raises an important question for employers: If getting care has become harder to navigate, shouldn’t employee benefits evolve to help direct people?

A Better Support System

Today’s healthcare experience looks different than it did even five years ago. Employees often encounter longer wait times, physician shortages, fragmented care, and increasingly specialized treatment options.

According to AMN Healthcare, the average wait for a new patient appointment has climbed to 31 days — up 19% since 2022 and 48% since 2004. At the same time, the Association of American Medical Colleges projects the United States could face a shortage of up to 86,000 physicians by 2036.

Those numbers don’t explain every gap in the patient experience, but they explain why so many people feel frustrated before treatment even begins.

Healthcare hasn’t simply become more expensive. It has also become more complicated. For employers, that means thinking beyond the health plan to how we support employees throughout the process of seeking, understanding, and receiving care.

Finding Answers

Most employers invest significant resources in providing quality health benefits. But insurance coverage alone doesn’t always give employees the support they need to make informed healthcare decisions.

A difficult diagnosis, an unfamiliar treatment recommendation, or the question of whether to seek a second opinion can leave employees unsure where to turn next. That’s understandable. Most employees aren’t healthcare experts, nor should they need that level of expertise to receive appropriate care. 

As employers, we often focus on helping employees pay for care. We also need to think about how we help them use their benefits effectively. This means looking beyond coverage to the guidance, education, and practical resources that help employees make informed decisions.

Fortunately, employers have more opportunities than ever to provide that support. Care navigation services, advocacy programs, second-opinion resources, centers of excellence, nurse advocates, and trusted educational resources can all help employees better understand their choices before making important healthcare decisions.

The same is true as employees seek health information on their own. More people are turning to online resources and AI tools to better understand symptoms and treatment options before or after an appointment. Those tools can be valuable, but they also make it increasingly important for employees to know which sources are credible, what questions to ask, and when additional medical guidance is appropriate.

The goal isn’t to replace healthcare professionals or turn employees into medical experts. It’s about helping people become more informed participants in their care - ask better questions, understand treatment recommendations, and make thoughtful decisions throughout their healthcare journey.

With the right support, employees are more likely to access appropriate care, avoid unnecessary delays, and feel confident in the decisions they’re making. 

What Next?

Healthcare will always begin with access to quality care. What has changed is the complexity employees encounter once they enter today’s healthcare system.

As employers continue investing in healthcare benefits, it’s worth asking: Are we only providing coverage, or are we also helping employees make the most of it?

Organizations preparing for the future will recognize that healthcare navigation as part of the employee experience. Helping employees understand where to go, what questions to ask, and where to find trustworthy information can support improving the healthcare experience, and maximizing the value of an employer’s healthcare investment.

And employers don’t have to build these resources from scratch or deliver this education alone. We’re here to support you. Education is what we do, including offering just-in-time programming that address employees’ immediate needs in our ever-changing market. 

Not sure where to start? Begin with our communications toolkitsand other available resources.

How else can we help? We want you to have the resources needed to support informed healthcare decisions, improve the employee experience, and help organizations maximize the value of your healthcare investment. 

We invite you to learn more about our programs and share how you’re finding new ways to help your employees get the care that their benefits promise. Let’s start a conversation.​​​​​​