In an article, published by Stanford Business, Edmund L Andrews writes about “The Staggering Costs of Health Insurance Sludge” and highlights a new study led by Jeffrey Pfeffer at the Stanford Graduate School of Business. Pfeffer and his colleagues found that administrative “sludge” in health care insurance costs employers and the economy billions of dollars in squandered work time, employee stress, absenteeism and reduced productivity. The study states the “sludge” creates $11.4 billion in direct employee costs.
Pfeffer and his colleagues estimate that the reduced job satisfaction coming from spending time on the phone with health insurers is costing the country an additional $95 billion annually in reduced productivity.
This article illustrates why everyone needs a healthcare advocate and why employers should provide care coordination services to their employees. Healthcare advocates, also called patient navigators, take the burden of begging for healthcare and insurance coverage from the employee thereby reducing presenteeism in the workplace. Presenteeism is defined as “the practice of coming to work despite illness, injury, anxiety, etc., often resulting in reduced productivity.” Though fewer people are in the office during COVID times, they are still working and managing their healthcare challenges while on the clock.
We at Marin Healthcare Navigation have stories – lots of them. Like the devoted dad who finally gave up after a year of arguing with his family’s health insurer to pay for his son’s emergency surgeries after a terrible skiing accident rendered his son a paraplegic. We filed multiple appeals and conducted negotiations until the original bill of $382k was reduced to $650.
Or the long-time employee of a multi-national company, which offered excellent coverage through their self-insured health insurance policy. The third-party administrator refused to authorize chemotherapy treatments for a Stage IV cancer patient deeming it “not medically necessary”. The employee with cancer gave up trying to fight insurance and work at the same time, and decided to contact us. We successfully appealed the denials and the chemotherapy was finally approved saving the patient over $180k in past and future out of pocket costs.
Imagine the time a healthy patient or family would have spent on the phone trying to find a way through the “NOs” to the final “YES”. Now imagine a sick patient in this battle while trying to continue working!
Presenteeism is Expensive! Administrative Sludge is the cause and it needs to be addressed. Everyone needs an advocate and we are here for you. Contact us to see how we can help your employees navigate their healthcare challenges, thereby reducing your costs.
Kathy Lord King
Founder and CEO