Healthcare costs in the U.S. have reached a critical tipping point, and employers are paying the price.
With average employer-sponsored healthcare costs now exceeding $15,000 per employee per year1, HR and Benefits leaders are grappling with a balancing act: manage escalating spend while still providing high-quality, competitive care that attracts and retains top talent.
This isn’t just a numbers problem. It’s a business performance problem, an employee experience problem, and a leadership challenge. However, there’s also good news: forward-thinking employers are adopting a more innovative approach—and seeing measurable results.
The True Drivers of Healthcare Costs
While inflation and drug pricing are part of the story, they don’t fully explain the trajectory of healthcare costs. The deeper issue lies in how care is delivered and accessed.
- Fragmented, uncoordinated care often results in unnecessary procedures, conflicting diagnoses, and duplicative testing.
- Chronic and complex conditions drive long-term, high-cost care, especially when employees struggle to access the right specialists.
- Delayed diagnoses and over-treatment increase total cost of care and risk poor health outcomes.
In fact, studies show that as much as 30% of healthcare spending in the U.S. is unnecessary—driven by poor navigation, low-value care, and lack of clinical guidance at the outset.
The Hidden Costs of Poor Navigation
Beyond the direct financial impact, the ripple effects of poor healthcare experiences can be enormous.
- Employees who struggle to manage a health condition or navigate care may experience burnout, stress, and absenteeism.
- Productivity suffers when workers spend hours coordinating appointments or recovering from unnecessary procedures.
- Morale takes a hit when high out-of-pocket costs make employees feel unsupported by their employer.
Many cost-containment strategies—like trimming benefits or shifting more costs to employees—can actually backfire, resulting in disengagement, turnover, and deferred care that later becomes more expensive.
In today’s tight labor market, these trade-offs simply don’t work. Employees expect benefits that work for them when it matters most.
The Employer’s Dilemma—and a Better Way Forward
How can employers get control of healthcare spend without compromising employee well-being?
The answer isn’t to do more. Rather, it’s to do care differently.
Summus offers a smarter path. Our platform connects employees and their families to leading physicians through virtual consultations at the first sign of a health concern. Instead of entering the system blind, they engage with trusted Summus MDs who provide expert clinical insight early—preventing missteps before they become claims.
What Sets Summus Apart:
- Doctor-led Clinical Navigation
Employees connect with top-tier doctors virtually and quickly—getting expert guidance to validate diagnoses, assess options, and plan next steps with confidence. - Smarter, More Efficient Care Decisions
Summus helps employees avoid unnecessary procedures, imaging, and referrals by aligning care decisions to evidence-based best practices. - Reduced Waste and Avoidable Costs
Our data shows that 52% of cases result in a changed treatment path, and clients experience at least a 47% reduction in treatment costs as a result. - Seamless Integration with Existing Benefits
We direct employees to the highest-value, in-network care and employer-sponsored solutions—helping you extract more ROI from the benefits you already offer.
This isn’t another vendor. It’s a strategic lever for transforming the way your employees experience healthcare and the way your organization manages healthcare costs.
It’s Time to Stop Reacting and Start Rethinking
Rising healthcare costs may feel inevitable, but they’re not unmanageable.
The key is to shift from reactive cost control to proactive care navigation. That means guiding employees to the right care at the right time, avoiding unnecessary interventions, and aligning each decision with better value and outcomes.
Summus can help you make that shift without sacrificing your employees’ trust or your organization’s bottom line.
1 Mercer’s 2023 National Survey of Employer-Sponsored Health Plans
