Dive Brief:

• One in three workers with annual family incomes less than $35,000 experienced a cost-related barrier to obtaining medical care between 2007 and 2017, according to a study by the Integrated Benefits Institute (IBI), and nearly one in four delayed medical treatment. The study is based on data collected by the Centers for Disease Control and Prevention.
• IBI found that on average, employees with cost barriers to medical care had an average of 1.9 more lost workdays per year than low-income workers without cost barriers to care. These barriers led to a 70% increase in lost work time compared to a baseline of 2.7 lost workdays, IBI said. While fewer employees with annual family incomes above $35,000 faced cost barriers to care, their decision to delay or skip medical care took a similar toll on workplace absences.
• Enrollees in a high-deductible health plan were 75% more likely than low-deductible enrollees to experience barriers to healthcare based on cost, researchers said, and health savings accounts (HSAs) did not reduce the risk of cost-related barriers for employees with high deductibles. IBI noted an association between both flexible spending accounts and coverage for prescription medications and a reduction in the risk of experiencing cost-related barriers to care.

Dive Insight:

Faced with hefty increases in the cost of providing health plans, many employers have turned to high-deductible plans — either with or without HSAs. As of 2017, about 43% of U.S. adults under the age of 65  with private health insurance coverage were enrolled in a high-deductible health plan, according to a CDC report.

Research on consumer-directed health plans, which are high-deductible plans that typically include an HSA or health reimbursement arrangement and usually have lower premiums, has shown that people with common chronic diseases enrolled in high-deductible, consumer-directed plans spend less on healthcare and use fewer services than peers enrolled in other plan types.

In an effort to address concerns that the large deductibles associated with consumer-driven health plans cause people to go without medications and healthcare services, the IRS issued a rule earlier this month that effectively allows people to use HSAs to pay for treatment associated with the conditions, Healthcare Dive reported.

Apart from reducing cost barriers to medical care, employers may want to examine research on how sick leave should be structured. Workers need at least 10 paid sick leave days to significantly raise the odds that they will take time out for preventive healthcare, according to researchers in a joint study by Florida Atlantic University and Cleveland State University.