America's healthcare: Are we working hard enough for our workers?

Amid the cheers over billion-dollar valuations and the praise for splashy deals and new corporate synergies in healthcare, let’s stop for a second and ask the bottom-line question. What’s actually going to help our 150 million working Americans??

The Wall Street Journal described one company’s recent exit from employer-sponsored?healthcare as “an extreme version of the direction most of the insurance industry is taking, as companies focus more on government-backed products, particularly the private plans known as Medicare Advantage.” Depending on your view, such big moves are either opportunistically targeting the most unhealthy, highest margin population or bringing a necessary level of focus to our oldest and sickest citizens.

It’s both, of course. But to improve healthcare the most, for the most Americans, soon and lastingly, we also need to reach people well before Medicare age. That’s when engagement can have the biggest and longest impact, hopefully for decades.

The good news is that behind the headline grabbing healthcare shifts, from big new entrants to better drug stores to partnerships, expansions, mergers, and acquisitions, savvy players do actually have working Americans — that’s the nearly 50 percent of the U.S. population who get healthcare through employer-sponsored plans — in mind.

Take this comment from UnitedHealthcare ’s CEO at the company’s most recent investor day: “Having spent so many years in Medicare, I'm perhaps most excited about the opportunity that I do see in commercial.” That’s a meaningful signal from an organization with the highest Medicare Advantage enrollment (8.6 million lives). They’re seeing the potential for investment and impact in the commercially insured segment. And they’ve been ahead of the game before.

Sure, the variability of the commercial population makes serving them a complex challenge. It’s tougher to manage risk and fine-tune intervention. But there’s opportunity here. Prompting proactive engagement, including care guidance and advocacy, and making it easy to access medical professionals, online and in-person (professionals informed by employee health histories, unique preferences, identities, and needs). Approaches like this don’t just increase employee loyalty, they drive improved health outcomes. And, as external validation recently confirmed, they also reduce healthcare spend.

?Thoughtful innovation in the commercial sector is showing the profound advances we can make if we serve this swath of our population better. Consider virtual-first models. They are changing the game in areas, such as rural communities, where primary and behavioral health care shortages are historic and persistent. Think about tailored care advocacy for Black Americans and those who identify as LGBTQ+. This is now reaching millions who have been egregiously underserved by healthcare, or so mistreated by it they avoid it altogether. Investments here will be good for both people and bottom lines.?

Iteration and collaboration is key. Those who are innovating have got to try, learn, fail, and share what’s working and what’s not. Proactive employers are already doing this. Companies of all types and sizes, from national retailers to chain restaurant franchises, big box stores to tech mammoths, mid-size manufacturers and more have been quietly testing investments in novel whole-person healthcare approaches.?

There’s no magic to be pulled out of a hat here. But there’s a lot of value to be unlocked by anyone willing to invest in untangling convoluted care systems, overcoming artificial barriers to better health, and alleviating all the headaches that plague patients from the corner office to the cubicle, warehouse to manufacturing line, and everywhere in between. We need more of this investment. It’s not just an annoyance that half of Americans are confused by their healthcare benefits, it’s a serious obstacle to making our country more healthy at lower cost.

To make healthcare in America work better, we need a commitment to healthcare, not sickcare, for all Americans. Employers, payers, and the healthcare solutions companies serving them, must seek out and standardize better health interventions, interactions, and engagement. Done at scale, this approach will be one of our country’s best chances to offset the mounting pressures of inflation, reign in the rising cost trend of healthcare, and make all people, not just folks on Medicare, healthier. You shouldn’t have to get old to get healthy.

#healthcare #health #benefits