Rising Healthcare Expenses Driving Riskier Decisions. What Can HR Do About It?
When employees are stressed and stretched thin financially, their health decisions suffer and your healthcare costs pay the price.
American workers are making a troubling calculation. According to new research from ADP, 26% of employees skipped needed medical care last year because of out-of-pocket costs—up from 21% just six years ago. Another 22% stopped taking or reduced their medication to save money, up from 17% in 2020.
These aren't just financial decisions. They're health decisions with long-term consequences that will ultimately show up in your company's healthcare claims data.
The 2026 ADP TotalSource Employee Benefits Survey found that affordability "now outweighs nearly every other factor in benefits decision-making," and the pressure isn't going away. Nearly 40% of employees say they still feel unprepared for unexpected healthcare costs, even though more are actively trying to save. Rising costs and ongoing uncertainty, ADP concludes, are "leading employees to make harder, and sometimes riskier, healthcare decisions."
For HR and benefits leaders, this is a critical moment. But the opportunity isn't just in better benefits communication—it's in addressing the underlying behaviors and mindsets that drive health outcomes in the first place.
The Stress-Cost Spiral
Here's what often gets missed in the healthcare cost conversation: financial stress and poor health don't just coexist… they amplify each other.
When employees are under chronic stress, their impulse control weakens. They're more likely to reach for comfort food, skip the gym, put off that overdue check-up, or reach for a cigarette. Sleep suffers. Mental health erodes. And over time, these behaviors translate into higher rates of chronic disease, hospitalization, and higher healthcare claims.
This is why the "cost problem" can't be solved purely through benefits restructuring or financial wellness programs alone. The behaviors that drive healthcare spend are deeply tied to how people think, feel, and respond to adversity. That's a resilience problem.
What the Research Shows
At meQ, we've spent years studying the relationship between psychological resilience and physical health outcomes. What we've found is striking: resilience isn't just a feel-good concept—it's a measurable predictor of the very behaviors that drive healthcare costs.
Mental health. meQ members show 13% lower depression risk and 21% lower anxiety risk. And members with high mental health risks show significant improvements in as little as 90 days—before their stress has time to manifest as physical illness.
Tobacco use. Tobacco use rates drop from 26% among the least resilient to 19% among the most resilient—a meaningful difference that compounds into major savings when multiplied across a workforce.
Sleep. Sleep quality scores more than double from the least to the most resilient cohort (39% vs. 82%). Poor sleep is a known contributor to a cascade of health conditions, from cardiovascular disease to metabolic disorders.
Hospitalization. The most resilient individuals are more than twice as likely to stay out of the hospital: just 6% reported a past-year hospital stay, compared to 13% of the least resilient. Resilient people are more proactive about managing chronic conditions and adhering to treatment plans, which means fewer emergency interventions.
The $400 ROI
The business case is clear. Independent actuaries analyzing meQ customer data found that companies save over $400 per year in healthcare costs for every employee who actively uses meQ. That's a consistent, year-over-year impact across a broad population—not a one-time bump.
The mechanism is straightforward: meQ uses evidence-based cognitive behavioral therapy (CBT) techniques to help people change the way they think, feel, and behave. When employees replace unhealthy thinking patterns with healthy ones, the downstream effects touch every dimension of health—sleep, anxiety, weight, substance use, and preventive care engagement.
Resilience changes behavior. Behavior changes health outcomes. Health outcomes change costs.
What HR Leaders Can Do Now
The ADP research is right that employees need clarity, guidance, and an employer they can trust. But the most effective response goes deeper than better benefits communication.
The employers who will win on healthcare costs in the years ahead are those who invest in the psychological foundation that makes healthy behavior possible—who help their people build the mental and emotional resilience to make better choices even when life is hard and money is tight.
Because when your workforce is resilient, they don't skip their medications. They don't skip their screenings. They manage their stress before it becomes a chronic condition. And they show up—healthier, more present, and less costly to cover.
Ready to See the Impact?
Download our guide, "6 Ways Building Workforce Resilience Reduces Healthcare Costs" to see the data behind each of these outcomes and learn how meQ helps employers translate resilience into measurable savings.
meQ uses evidence-based cognitive behavioral therapy techniques to help members change the way they think, feel, and behave—driving measurable improvements in health outcomes and healthcare spend.
