3 ways to support employees with complex health problems

When an employee is diagnosed with a complex or life-threatening condition, employer support can help them get the right treatment and decrease the amount of stress and anxiety faced by the employee and their family.

There are three types of support that employers can offer to help streamline the process of connecting with physicians who have a higher level of experience treating patients with these diagnoses.

Step 1: Provide access to second opinions

When an employee is diagnosed with a complex or rare health problem, their first instinct may be to start treatment as soon as possible. However, except in emergency situations, there is usually no need to start treatment as soon as the diagnosis is received. But it’s actually wise to seek a second opinion from a physician who has a great deal of experience treating the suspected condition.

A second opinion can either confirm the first diagnosis and treatment recommendation, which would provide the employee and family with peace of mind as they move forward with treatment. Or it can change the diagnosis and offer different treatment options. A study published in the Journal of Evaluation in Clinical Practice found that as many as 88% of patients in the study who sought a second opinion at the Mayo Clinic for a complex condition had a new or refined diagnosis that changed their treatment plan. Only 12% of those patients received confirmation that their diagnosis was correct and complete. Another study conducted by the institution found that 10% to 62% of patient-initiated second opinions for any health problem yielded a major change in the diagnosis, treatment or prognosis.

There are a number of second opinion options employers can offer, including remote second opinion programs from centers of excellence, health insurers, health advisory firms and standalone programs.

Step 2: Help employees connect with the right healthcare providers

Studies have found an association between health outcomes and the level of experience of the healthcare provider. For example, researchers found evidence that suggests cancer patients who need to undergo procedures that are technically difficult to perform — and have been associated with higher mortality in lower-volume settings — should receive the care they need at facilities with extensive experience. That’s because many studies have linked successful outcomes with care delivered by healthcare providers who perform high volumes of the procedures.

To ensure employees can connect with the most appropriate physicians and healthcare centers, employers can partner with an independent case management firm — resources provided by a health insurer or a health advisory firm. Not all case managers have a process for vetting physicians and hospitals, and they may have proprietary relationships with certain practices or hospitals. Some only provide information on in-network providers, so employers should ask that question when choosing a partner. It’s also important that the partner has objective data on the volume of these types of cases, as well as their outcome and complication data.

Step 3: Offer support navigating the healthcare system

It’s an unfortunate reality that without assistance and facilitation, the task of moving from a local health system to a leading center of excellence is daunting. Many employees simply follow the path of least resistance and miss the opportunity for better care and outcomes. Even when an employee is dealing with a relatively simple illness, navigating the healthcare system can be confusing, frustrating and stressful. Stress and uncertainty is often amplified when an employee, or an employee’s family member, has been diagnosed with a rare or complex health problem.

Case managers and health advisors can help employees find providers within their health insurance network; gather, review, and consolidate the employee’s medical records and deliver them to all treating physicians; and review all medical bills for accuracy and contest any errors.

By providing these three key types of support, employers can help employees better navigate the complexities of the healthcare system and receive the care they need.