The health divide: Access and affordability of employer-funded health benefits 

Building a smarter health benefits system starts with a conversation around access and affordability.

For reward professionals, the challenge of providing employer-funded health benefits is changing. While offering a competitive package will always be important, employers also need to ensure that access to care is fair, affordable and economically sustainable for businesses.

Economic pressures, workforce expectations, evolving health requirements and difficulties accessing care at the point of need are exposing gaps in current provision. At the same time, benefits budgets are under greater scrutiny. The result is growing pressure to do more with the same, or even less.

This report explores how forward-thinking organisations are responding. The most urgent priority is often clarity: understanding what is already in place.

Many employers still operate with fragmented provision spread across multiple providers, departments or business units. A full inventory is the first step toward identifying duplication, inefficiencies and missed opportunities.

The future of health benefits isn’t about offering the same to everyone but ensuring that all employees, regardless of role or location, can easily access timely, effective support. This might mean embedding services into existing platforms, offering virtual care, or leveraging underused features in current insurance or occupational health arrangements.

To achieve this, employers need to start by understanding the different contexts in which their people work. A frontline worker in a distribution centre has different access needs than a remote software developer or a hybrid head-office employee. Mapping these employee experiences can highlight where health and wellbeing support is missing or inaccessible and where existing resources can be better used.

Employees are often juggling demanding roles and personal responsibilities, so benefits need to be easy to find, simple to use and relevant to individual needs. That means shifting from broad awareness campaigns to more targeted, personalised messaging.

What unites organisations leading in this space is a mindset shift – from viewing health benefits as a static offering to managing them as a strategic system that can be audited, streamlined and shaped to deliver better outcomes for people and businesses in an affordable and sustainable way.

Reward leaders have a pivotal role to play in reshaping how health benefits are delivered and experienced. This isn’t a challenge to defer to next year’s renewal cycle – the pressures around access, equity and cost are already here. The opportunity to lead is now.

The constant drive for innovation has result in a range of products and providers arriving at the same conclusion. More is more. However, these evolutions and enhancements has resulted in duplication and direct competition.

To ensure that your benefits programme delivers the greatest value for money, organisations need to understand all products in detail to maximise the value within.

MMB help clients achieve this by breaking down the component parts of their benefit provision, identify areas of duplication, and identify where an alternative pathway may achieve the same result without incurring extra cost or impacting the premiums paid.

The best way to ensure that you are personalising your benefits offering is to understand your needs.

This is especially true when it comes to the preventative aspect of a healthcare programme. You need to understand why your employees are claiming, or are absent from work, as well as their potential risks and the propensity for future claims.

Advancements in the ability of AI to predict and project the future, which when coupled with employee demographic will help to create targeted programmes to address your current and future health risks.

For employees, who typically need to be making use of their benefits at a time of crisis or concern, being able to seamlessly navigate and arrive at the most appropriate solution can be complicated. This is especially true when you consider the evolutions and enhancements spoken about earlier. Add to this the fact that in a number of cases we direct employees to their line manager as the first line of defence, education, awareness and engagement are key.

Although some employees will be informed about their benefits programme, most won’t know about all available solutions and interventions – nor will they know the best or most appropriate pathway. By increasing education, awareness and engagement, better health outcomes can be achieved, reducing the health gap and in time controlling or reducing premiums.