Health Insurance

Big picture healthcare: The hidden costs of cost-sharing

Read Time

5 Minutes

Written by

Team Curative

Featured Insights by

Dr. Brandon Charles

Published

Aug 19, 2026

What if we thought differently about cost-sharing—and the barriers it can create?

We’re talking about chronic diseases — and the inherent conflict between short-term savings and long-term health.

So, what happens when cost-sharing shifts from a reactive expense to a proactive investment?

For employees, reducing financial barriers can make it easier to seek care and stay engaged with their health. For employers, it raises a bigger question: Could removing barriers to earlier care help prevent health needs from becoming more complex down the road?

Traditional health plan design has long relied on a familiar assumption: giving members more financial responsibility will encourage them to make more thoughtful healthcare decisions.

Curative Chief Medical Officer Dr. Brandon Charles shares his perspective on how copays and deductibles can create barriers to earlier care—and why employers may want to think differently about the role cost-sharing plays in their benefits strategy.

When Cost-Sharing Becomes a Barrier

“Cost shares were put in place supposedly so members would have skin in the game,” Dr. Charles said.

The idea? To keep people from running to the doctor for every runny nose. To make sure they go for care when they really need it.

“That just really hasn't proven out," Dr. Charles said.

But cost can also influence whether someone seeks care in the first place. When employees are worried about what an appointment, test, or follow-up visit might cost, they may find themselves asking: Can this wait? What if it’s nothing? Is it worth the expense?

But it’s not a waste if the doctor notices a problem.

The copay problem’s even worse for people with chronic illness. Chronic conditions account for a significant share of healthcare spending, which makes prevention, early intervention, and ongoing support especially important.

When cost becomes a concern, some people may delay seeing a doctor when symptoms appear or something feels off. That can mean missed opportunities to identify and address health needs earlier.

Delayed care can allow health needs to become more complex, potentially requiring more intensive—and more expensive—care later.

When Short-Term Cost Control Creates Long-Term Challenges

What happens when people wait for care? Bad things, for the most part.

When chronic conditions aren't well managed, the stakes can become much higher. Uncontrolled hypertension, for example, increases the risk of serious complications such as stroke, while poorly controlled diabetes can lead to acute health issues and emergency care.

“As costs continue to rise, the solution has been to keep increasing cost-sharing and shifting more costs to the employee,” Dr. Charles said. And clearly cost burdens getting bigger doesn’t help anyone’s health.

But traditional insurance keeps putting short-term cost control over people’s health.

Financial barriers can be especially significant for employees who have less room in their budgets for an unexpected medical expense. For those employees, even routine cost-sharing can influence when—and whether—they seek care.

And the hope is always to be preventive.

When conditions can be safely managed proactively in lower-acuity settings, it may help avoid the need for more intensive—and often more expensive—care.

Managing Costs For Better Health

Curative focuses on the barriers that can get in the way of care—from affordability and healthcare literacy to medication adherence and navigating the healthcare system.

"The front end of our health plan is centered around a wellness model of the Baseline Visit that starts with a clinician who talks to the member for about 30 minutes, takes history, and develops a plan,” Dr. Charles said.

That upfront engagement creates an opportunity to better understand a member's health needs, identify potential risks, and help connect them with appropriate next steps.

The goal is to keep members engaged in their health—not just when something goes wrong, but throughout their healthcare journey.

But removing financial barriers is only part of the equation. Members also need the information, guidance, and support to understand their benefits and navigate their care.

They want to make sure members are supported so they can make the right decisions when they’re getting care.

Support + affordability = real healthcare access.

What Better Access Can Mean for Employers and Employees

What does support look like? Making sure people stay healthy and a real sense of follow-up.

"If a member is supposed to be on blood pressure medication and abruptly stops taking it, within a couple of days their symptoms and illness can return, driving people to emergency states,” Cosani said.

When they end up in danger? They’re out of work, too, "which is expensive for our customers, the employers, and raises medical costs for everybody in the group because they're paying for care at a higher setting."

And people suddenly not taking their meds? It’s not rare.

Medication affordability is one factor that can affect adherence. When members have fewer financial barriers and more support navigating their care, it can be easier to stay engaged with a treatment plan.

Building Your Benefits Approach

So how can you create a care package for your employees?

Thoughtfully.

A strong benefits strategy isn't just about what a plan costs. It's also about whether employees can understand, access, and use the benefits they're being offered.

1. How easy is it for employees to actually access care?

2. What could be keeping employees from following through on care?

3. Do employees know where to turn when they need help?

Do they have somewhere to ask questions? Is there navigation support to help them understand their benefits and determine their next step?

"We believe that extra support combined with making care affordable and accessible creates a winning combination," Dr. Charles said.

And that winning combination isn’t just about employee experience (though some of it is!). It’s also about ROI.

For employers, the bigger opportunity is to look beyond what healthcare costs today and consider what happens when employees can—or can't—actually use it.

Removing financial barriers is only one piece of that equation. Access, education, navigation, and ongoing support matter, too.

Because the real measure of a health plan isn't simply what it costs on paper. It's whether employees can get the care they need, understand how to use their benefits, and stay engaged with their health over time.