The year 2020 will likely be remembered as a wellness crisis. Over the past six months, the COVID-19 public health crisis has evolved into an economic and mental health crisis. There are two recent survey findings from June that drive this point home. The CDC assessed mental health, substance use and suicidal ideation during the pandemic (CDC Survey) where about 41 percent of respondents reported one or more adverse mental or behavioral health condition. Broken down further:
■ 31% reported symptoms of anxiety disorder or depressive disorder,
■ 13% started or increased substance use to cope with stress or emotions, and
■ 11% reported having seriously considered suicide in the prior 30 days. Some of the highest-risk groups for suicidal ideation were 18–24 year old's (26%), unpaid caregivers for adults (31%), and essential workers (22%).
Additionally, The Charles Schwab Financial Literacy Survey (Schwab Survey) revealed widespread financial vulnerability, showing 50 percent of all Americans would experience financial hardship if they had to cover an emergency expense of $1,000 or less in the next 30 days. While American workers have been financially vulnerable for a number of years and mental health and substance abuse have been on the rise over the past decade, the pandemic accelerated the trend.
What does this information mean to you and your employees? How do we use this information to improve workplace wellness in an “essential” industry during the present crisis? We’ll start by defining “wellness.”
Most employers would define wellness as “workplace wellness,” which is “any workplace health promotion activity or organizational policy designed to support healthy behavior in the workplace and to improve health outcomes.” Workplace wellness often comprises activities such as health education, medical screenings, weight management programs and on-site fitness programs or facilities.
Unfortunately, the track record of broad strokes workplace wellness programs is quite poor. While group health outcomes remain the same, Sherri the ultra-marathoner wins the Apple watch prize for the company step challenge and Jim is pumping just as much iron as before at your shiny, new onsite gym – not a great return on investment (ROI). Concerning mental health, we hear employers proudly exclaim, “We offer an EAP (Employee Assistance Program)!” and then crickets (silence). While EAPs are an important piece of the puzzle, sadly, most employees see their EAP at Open Enrollment but don’t remember to access it when it’s needed most. Ultimately, most current workplace wellness programs are tools and tactics sold as a strategy by carriers and outside vendors.
At Insurance Office of America (IOA), we focus on a true Population Health Management strategy. “Population health” is “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” First, determine what is affecting your group. There are various medical, physical, mental, emotional and environmental factors that are proven to intensify comorbidities, other chronic conditions that prevent recovery and prolong disease. Once your factors have been identified, we match those factors to proven tools and tactics that effectively and respectfully encourage behavioral changes that mitigate or reverse those conditions. By focusing on targeted and proven solutions, you can empower employees to pursue a healthier and more fulfilling life.
In order to implement a Population Health Management program, first identify a factor that is both a cost-driver to your health plan or workers’ comp claim history AND fits into company culture. Common environmental factors are financial and family stressors, such as childcare and elder care, diet and sedentary lifestyle, difficult commutes and a hostile work environment. Common medical factors are diabetes, cardiovascular disease and substance abuse.
Next, see what tactics are already available to you, such as health insurance carrier wellness funds or their discounted turnkey vendors, but only implement a solution that’s relevant to your target factor. If your free options don’t apply, ask your benefits
consultant to evaluate your options for outside vendors. Remember, when all you have is a hammer, everything starts looking like a nail. A vendor that promotes fitness tracking and weight loss contests may try to convince you that’s the best solution for diabetes management, but specialized medical case management to promote treatment adherence is likely to be more effective. Like most other purchases, avoid flashy sales pitches and be skeptical of wellness vendors that promise quick-fixes and high first-year ROI. Most effective population health initiatives take time and must be targeted to a specific clinical outcome to generate a positive ROI. Fortunately, many effective vendors include performance guarantees to help you take the leap, but make sure the vendor’s performance targets and measurement align with your desired goals for population health improvement.
Generally speaking, roofing is one of the few industries where an employer’s workers’ compensation costs often outpace health plan costs. For this reason, it makes sense to leverage population health strategies toward employees’ comorbidities to reduce or prevent workers’ compensation claims. The National Council on Compensation Insurance (NCCI) has provided data that shows claims with a comorbidity diagnosis have about twice the medical costs of otherwise comparable claims and the most common comorbidities were hypertension, drug abuse, diabetes and chronic pulmonary diseases. When drug abuse was identified as a comorbidity, 73 percent of claimants were male. Roofing specifically and construction generally, are predominantly male industries and the addiction and substance abuse crisis within the crisis may be creating a tinderbox of more severe workers’ compensation claims that could ignite at any time.
From the CDC survey, 13 percent of the population has reported increased substance abuse and 22 percent of essential workers have reported suicidal ideation, which means the pandemic and “mitigation” measures have potentially created significant stressors within the households of many of your employees (AKA comorbidities). Dr. Lantie Jorandby, a board-certified psychiatrist with a specialty certification in Addiction, summed it up in Psychology Today, “[The COVID-19 pandemic] has created new challenges for millions of people living with addictions or substance use disorders, revealing potential triggers at every turn.”
Additionally, job losses may lead to a larger uninsured population (health insurance), so claim frequency may also increase due to a surge in “Monday morning syndrome” (fraudulent workers’ compensation claims from over the weekend presented as fresh, on-the-job injuries on Monday mornings). FREQUENCY + SEVERITY = HIGHER PREMIUMS.
While the landscape appears bleak, now may be the perfect time to focus on mental health, addiction and financial literacy, as you have a captive audience. The COVID-19 pandemic has forced many employees to confront their need to manage their finances differently in the future to be less vulnerable and 89 percent of Schwab Survey respondents believe a lack of financial literacy contributes to larger social issues, such as poverty, fewer job opportunities and addiction. It is time for employers to offer relevant education and tools to help employees better manage their financial and mental health going forward. This is a preventive measure that can boost your population’s overall well-being and increase workplace productivity. Several companies, such as Prudential, have developed turnkey, no-cost financial wellness education packages for companies to introduce to their employees; or, ask your 401(k) provider if they have available resources. Now is also the time to dust off that EAP. Some dental and life insurance carriers are currently offering their Basic EAP at no charge, due to the pandemic. Don’t wait, reach out to your broker-consultant or carrier today to identify the available resources that fit your organization.
Jared Mongold is an Employee Benefits Specialist at Insurance Office of America (IOA). Jared is licensed in life, health and property and casualty insurance. Contact Jared about your insurance needs by phone at 727-565-7073 or by email at jared.mongold@ioausa.com.
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