Castlight’s Workforce Health Index Details the Adverse Health Effects of Delayed Care Due to COVID-19

Report finds preventive care spending continues to lag but musculoskeletal and behavioral health spending steeply rising

SAN FRANCISCO, April 5, 2022 – Castlight Health, Inc., a leader in connected navigation, today released a new Workforce Health Index, revealing how the COVID-19 pandemic has impacted the way commercially-insured populations across the U.S. utilize their healthcare and wellbeing benefits. The annual Workforce Health Index provides detail on medical spending and benefits utilization from 2018 through 2021 and projected spending for 2022, as well as a state-by-state dataset demonstrating regional variation in medical spending over this five-year period. 

Overall, the report analyzed more than 160 million medical claims to calculate future spending projections so employers and health plans can plan for what’s coming in late 2022 and 2023.  According to the findings, 2022 preventive care medical spend is projected to surpass 2020 preventive spend but will still fall below 2018 and 2019 levels, with colorectal cancer and cervical cancer screenings continuing to lag. Delayed or forgone care (e.g., missed routine physicals, immunizations, and cancer screenings) and deteriorating mental health and wellbeing continue to exacerbate existing health issues for today’s workforce.

“Employers have implemented numerous benefits to expand access to critical healthcare services during the pandemic, but the Workforce Health Index shows there is more work to be done when it comes to breaking down barriers for care for the most vulnerable populations,” said Dr. Dena Bravata, chief medical officer at Castlight and Stanford health services researcher. “The insights in the report and the details in the state-by-state dataset can help employers and policymakers develop new strategies to mitigate rising commercial medical costs and make healthcare—particularly for hard-to-reach populations—more affordable and accessible.” 

Health Inequities Threaten to Widen Due to Socioeconomic Barriers to Care
The Index found that, although telehealth utilization has increased overall by 30X in 2020, adoption in low-income communities still hovers at approximately half that of wealthier communities year over year. Families in low-income areas face more barriers to in-person care than their wealthier counterparts, such as the ability to get time off work and access to low-cost transportation, and may have more concerns regarding unexpected costs with telehealth visits.

Castlight also found that people in low-income communities forgo care more often compared to their wealthier counterparts—and the pandemic only exacerbated this trend. The Index forecasts that, in 2022, individuals in low-income communities will complete 10% fewer mammograms, 20% fewer cervical cancer screenings, and 24% fewer colorectal screenings per 1,000 members than individuals in wealthier communities.

“We must continue to find ways to broaden access to care in order to achieve more equitable health benefits use,” said Dr. Bruce Sherman, advisor to the National Alliance of Healthcare Purchaser Coalitions, adjunct professor at UNC-Greensboro’s Department of Public Health Education, and one of the co-authors of the report. “Employers are in a unique position to address socioeconomic and workplace barriers to care among their employees and family members, through benefit design and organizational policies. Ultimately, employees’ health and wellbeing has a direct impact on their performance, productivity, and retention—and the employer’s bottom line. Identifying and addressing inequities in workforce health benefits is not only the right thing to do, it’s a compelling business opportunity.” 

Pediatric Behavioral Health Spend Is Projected to Reach $190 PMPY in 2022
Burnout and work-related stress and anxiety continue to plague today’s workforce. Telehealth for mental and behavioral health care ​​represents nearly 60% of virtual visits in 2021, a 2.5X increase from 2018. Per member per year (PMPY) behavioral health medical spend, for both in-person and virtual services, had been steadily increasing for several years prior to the pandemic and is forecasted to increase by 25% to $133 between 2020 and 2022.

Children and teens have been particularly impacted by school closures, social isolation, and adjusting to new social norms. The growth rate for pediatric behavioral healthcare spend doubled from 12% in 2020 to 23% in 2021 and is forecasted to hit $190 PMPY in 2022 (compared to $177 PMPY in 2021). The behavioral healthcare trend is similar for teens.

It’s clear employers are recognizing these issues—in 2021, 78% offered a behavioral health program to their workforce (not necessarily specific to children or teens), up from 54% in 2019.

Employers Are Increasing the Number of Digital Health Programs They Offer Employees In addition to behavioral health programs, employers are making substantial efforts to address the health issues affecting their workforces. As a supplement to traditional healthcare benefits, the average employer offered more than 12 digital health programs to their workforce, prioritizing: activity, fitness, and sleep programs; nutrition and weight management tools; and diabetes management and prevention programs. They’re also incentivizing employee engagement with these programs, resulting in engagement levels that are eight times higher than those without incentives, on average. 

View the complete Workforce Health Index for more details on the report findings, the impact of COVID-19 pandemic on employer healthcare costs, and detailed analyses on medical spend, preventive care trends and healthcare utilization trends across different socioeconomic communities. To download a copy of the report, click here. To access a state-by-state view of top medical spend, click here.

Methodology
The Castlight Workforce Health Index is an analysis of more than 160 million medical claims of  commercially-insured U.S. adults and children for the years 2018 to 2021. Medical spending for 2022 was projected from these claims.

About Castlight Health
Castlight is on a mission to make it as easy as humanly possible for people to navigate the healthcare system and live happier, healthier, more productive lives. As a leader in connected healthcare navigation, we provide a world-class digital platform with a team of clinical and benefits experts to help members easily connect and engage with the right programs and care, at the right time. Castlight partners with Fortune 500 companies and health plans to transform employee and member benefits into one comprehensive health and wellbeing experience to deliver better health outcomes and maximize returns on healthcare investments.

For more information visit www.castlighthealth.com. Follow us on Twitter and LinkedIn and like us on Facebook.

Media Contacts:

Natalie Pacini

Castlight Health

[email protected]