Electronic Health Reporter

Maestro Health, a tech-enabled third-party administrator (TPA) for employee health and benefits, released “The Poor Health of America’s Healthcare System,” a whitepaper that examines why Americans are disengaged with and distrustful of the healthcare system.

The findings are based on a survey of more than 1,000 consumers about the difficulties they’ve faced in navigating the healthcare system and making decisions about the quality and cost of their care.

The study found 70% of respondents feel that today’s healthcare system is difficult to navigate, and 39% said they don’t feel they have the support they need when it comes to understanding their healthcare. Without guidance on which services are covered and which providers are in-network, high-quality and cost-effective, people overpay and put their own health at risk.

Employers must take an active role in educating their health plan members about their benefits to instill confidence in navigating the complexities of the healthcare system.

“The healthcare industry is currently under a spotlight with a lot of players looking to disrupt the way we receive and pay for care. To build back trust in our healthcare system, the average American needs to better understand their own health plan, including what is covered and how to best use that coverage,” said Anne Brunson, CCXP, vice president of service operations at Maestro Health. “Navigating that information alone can be daunting, so employers should play an active role in increasing transparency and educating employees, which ultimately drives down employer costs.”

In addition to uncovering feelings of distrust and a lack of understanding, the survey revealed that the high cost of healthcare is causing people to put their health at risk—61% have been more concerned about the medical bill than their health while receiving care. Other key findings from the report include:

• 55% said they have avoided seeking out care because of cost.
• 65% don’t understand their medical bills.
• 31% don’t know how to tell if a provider is in-network.
• 36% said that virtual access to their providers, via apps and portals, improved their healthcare experience.

“Given the statistics we found in our most recent report, it’s not surprising that many people struggle with their healthcare today. We know there’s room for improvement, and we want to be a leader in driving change in the industry,” said Craig Maloney, CEO at Maestro Health.

“One of our core missions at Maestro Health is to reconnect people with their health and wellbeing by providing optimal support and removing barriers to access. We do this through a unique combination of data, analytics, care management and claims repricing services designed to empower our members with the resources they need to navigate the system and achieve better health outcomes.”

For more information about how Maestro Health works with employers to administer self-funded healthcare plans, please visit: www.maestrohealth.com.