Almost everyone has had personal experience with unexpected medical bills, but very few understand the complex healthcare ecosystem that allows anti-consumer products, processes, and practices to thrive. A recent article in the New York Times highlighted just one of these opaque products that helps medical payers find ‘savings’ by charging individuals more for out-of-network events. MultiPlan, the company that makes this product, is one of those companies that very few Americans have ever heard of and will never interact with directly. But their products have a profound impact on many peoples’ lives.

Even for those in the know, it can be nearly impossible to understand why a particular bill is not covered by insurance, and equally difficult to change the outcome.

I recently spent hours on the phone fighting with my insurance company because they would only cover 20 physical therapy sessions per year for my son’s permanent disability - less than half of what was prescribed by his pediatric neurologist and orthopedic specialist. I am just one of millions who face similar interactions every year.

People in the United States have built up more than $220 billion in medical debt, with over 14 million people owing more than $1,000.* More than half of Americans are worried about a major health event bankrupting them, and in fact, medical debt is one of the leading causes of bankruptcy in the US. These are symptoms of systemic issues that the employee benefits industry has a responsibility to address head-on.

It is time to build a better healthcare ecosystem for consumers. But who is responsible for building this system? In the US, over 158 million or roughly 48.7% of the population is covered by employer-based health insurance.** So employers, benefits brokers and consultants, carriers, and HR technology companies bear this responsibility.

Putting consumer experiences and outcomes at the center of the benefit design process will positively impact every entity in the ecosystem over the long term. We believe that technology can be harnessed to benefit both individuals and the business ecosystem in which they operate. At Nayya, we are building all of our products with long-term consumer impact in mind, and our partners are equally committed. Join us as a partner and innovator, and build the next generation of benefits technology.

*Source: The Burden of Medical Debt in the United States, KFF, 2024 **Source: Employer covered health insurance: What percent is covered, eHealth, 2024