Mental health, food insecurity and maternal outcomes remain critical gaps for people enrolled in employer-sponsored health plans, according to a new report from Morgan Health.
The team at Morgan Health, the healthcare division of banking giant JPMorgan Chase, released a report examining quality challenges and care gaps in the commercial market each year since 2022, and, while there have been positive changes, in some cases these disparities have carried on or worsened.
In mental health, for example, the burden has worsened for many lesbian, gay and bisexual workers. For instance, in 2021, 12.71% said they experience a major depressive episode, a figure that rose to 15.82% in 2022.
The report found that 74.32% of lesbian, gay and bisexual people who experienced a depressive episode received treatment in 2021, which dropped to 53.92% in 2022.
The Morgan Health study also notes that in tandem with these results is a rise in substance abuse among lesbian, gay and bisexual individuals that outpaces growth among straight individuals.
Dan Mendelson, CEO of Morgan Health, told Fierce Healthcare that many employers have put a focus on engaging lesbian, gay and bisexual team members through business resource groups and other efforts with the enterprise, and they can turn to those organizations for healthcare challenges, too.
Connecting with workers in the LGBTQIA+ community through these existing avenues can make them more aware of benefits they have access to or personalized supports that they could connect to.
"You can take that existing group and have it focus on healthcare very productively," Mendelson said. "It's an opportunity for employers to kind of bring that in and make sure those resources are understood by the LGBTQ populations."
Also around mental health, the report highlights that Black and Hispanic people have lower rates of depression diagnoses than whites, but those who are diagnosed have worse outcomes, including higher rates of major depressive episodes and a lower likelihood of receiving treatment.
The paper also underscores that Black and Hispanic patients are connecting with preventive and primary care services less consistently than other groups, making them more likely to seek emergency care. This impacts employers as a visit to the ER is generally far more costly than an appointment with a PCP and can lead to gaps in detecting critical risk factors or managing chronic needs.
Employers can work with their health plan to make information on provider networks and care quality more available and offer greater flexibility for workers. Mendelson said that, for example, JPMorgan operates an on-site primary care clinic in one of its hubs in Columbus, Ohio, that has been positively received by employees.
"Our employees love it," Mendelson said. "And what it enables us to do is ensure that primary care is accessible to everybody in the population, on site."
For employers that lack the resources to open a full on-site clinic, they can host on-site events for flu vaccinations or routine biometric screenings. They can also ease barriers to transportation or time off that can make it easier for people to see their doctors.
Another challenge highlighted by the study is the impact of healthcare costs on low-income individuals. Among people who earn $50,000 or less per year, 11% said they delayed care due to the cost, 9% said they avoided needed care and 14% said they managed the affordability of prescriptions by skipping certain medications, delaying scripts or not filling them.
To address this challenge, employers can evaluate their medical and pharmacy benefits to identify ways to reduce costs. Solutions could range from more narrow networks to graduated premiums, according to the report.
The Morgan Health team has compiled this study over the past several years in the hopes of seeing progress in addressing key care gaps, but there has been limited progress even as employers' healthcare costs continue to rise, Mendelson said.
"I think that there's an urgency for employers to get their arms around these issues, because they're not getting better," he said. "And this is a third year that we've done this work, and we did not see significant improvement in any categories."