Want Your Workplace to Thrive?

Start seeing “invisible” workers.

The working poor are sometimes referred to as invisible Americans. But given their numbers, it is hard to ignore their impact on our workplaces.

Almost 10 million American workers fall below the Federal Poverty Level (FPL), according to the Bureau of Labor Statistics. That means annual earnings of about $12,000 for an individual and $25,000 for a family of four. Some of these low-income workers are part-time or contract employees, some are hourly workers, and some are in low-wage, low-skilled jobs.

As employers look for innovative ways to manage health costs, it is important to remember these vulnerable individuals and the unique challenges they face in accessing healthcare. Roadblocks that keep low-income workers from important, preventive care can lead to serious health issues, lost productivity, and higher costs down the road.

For example, we know that inflexible work schedules can make it harder for lower-income workers to schedule doctor’s visits. As a result, some workers may delay seeking necessary care, and that can result in avoidable hospitalizations.

Now, new research tells us that lower-income individuals also have a hard time finding the basic health information they want and need to manage their healthcare. That sometimes results in confusion and non-adherence to treatment plans.

These are the findings of a major, multi-disciplinary study conducted by my firm, Oliver Wyman, and Altarum Institute. The year-long “Right Place, Right Time” research, which was funded by the Robert Wood Johnson Foundation, investigated how vulnerable consumers search for and use health care information. (For this study, vulnerable consumers were defined as Medicaid beneficiaries, caregivers of any socioeconomic status, and lower income, Spanish-speaking, and/or uninsured individuals.)

The study also explored marketplace perceptions of vulnerable consumers’ health information needs. We learned that while most stakeholders understand the importance of providing better health information, few are taking steps to do so.

However, there were bright spots: The research uncovered a number of innovative employer-led initiatives that are helping to connect vulnerable consumers with the health information they want and need. By sharing the findings of the “Right Place, Right Time” study and showcasing a few of these examples, we hope to foster dialogue around the information needs of lower-income workers, and also drive change to better serve those that need the most help navigating the healthcare information landscape.

What consumers told us:

For the consumer component of this study, Altarum Institute surveyed more than 4000 individuals. The survey revealed that many vulnerable consumers feel disrespected by doctors, some fear stigmatization for being immigrants, and the majority have a hard time finding health information. As a result, most vulnerable healthcare consumers struggle to understand their options, their costs, and even the language around their care.

The uninsured and lower-income demographics, in particular, struggle to connect with health information. The uninsured, the majority of whom are in families with at least one full-time worker, are less likely to search for all types of health information, including general information on managing health.

When it comes to seeking and receiving health information in person, our research found that 35 percent of lower-income individuals in poorer health feel disrespected by providers. This has broad implications because patients who feel disrespected by providers were three times more likely to believe doctors are inaccurate and two times more likely to not take their medications as directed. The indirect and direct cost of medication non-adherence is estimated to be between $100 billion and $300 billion each year, and so the consequences of perceived disrespect are enormous.

What employers told us:

For the marketplace component, Oliver Wyman conducted interviews with approximately 100 executives from across the health landscape. We learned that most employer-provided health information is available only to enrollees in the company’s health plan. The Henry J. Kaiser Family Foundation estimates that one-third of working poor have health insurance through their employer. That means millions more workers are excluded from employers’ health outreach.

Some progressive employers, however, are focusing on improving the health of both enrolled and unenrolled employee populations. These employers are creating clinics or other forms of on-site access to healthcare and are addressing non-clinical health needs, such as access to healthier food and resources for regular exercise.

One employer is preparing their employees for a provider environment that may not always treat them with respect. They have held sessions for their employees on how they should expect to be treated by physicians, how to ask questions, and how to advocate on behalf of themselves to receive the best care.

Finally, a number of employers recognized the influence social and lifestyle factors have on an individual’s health. One large retailer provides significant discounts on healthy food options. “Our team members have pretty good access to healthy foods, but don’t feel they can afford it,” an executive told us. “As a team member, you get an additional 20 percent off all fresh and frozen fruits and vegetables that we sell.” In addition, the company hosts social workers at some of its workplace sites, offering further support to employees with lifestyle and social needs.

Moving forward

The right information at the right time can enhance the efficiency and effectiveness of the entire healthcare system, and improve people’s health and quality of life.

But health information is only as valuable as it is accessible. As employers look to manage rising health costs, it is important they see all employees and take into consideration the health information needs of vulnerable individuals in our workforce.

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