To check or not to check: Managing blood sugar in diabetic employees

There's been a growing prevalence of Type 2 diabetes in the U.S. over the last 20 years. This chronic condition significantly impacts employees, their family members and even employers clinically and financially. Read this blog post to learn more.


Over the last 20 years, there’s been a growing prevalence in the U.S. of Type 2 diabetes, a chronic condition that significantly impacts employers, their employees and family members clinically, financially and through quality of life. With that comes an increase in the use of insulin for people with Type 2 diabetes to better control blood sugar to reduce long-term complications, which includes eye, kidney and cardiac disease, as well as neuropathic complications.

Most of these patients manage their condition with oral medicines versus insulin, and it’s estimated that 75% of patients with Type 2 diabetes regularly test their blood sugar, even though doing so may not be needed. Blood sugar testing is an important tool in managing diabetes as it can help a patient be more aware of their disease and potentially control it better. But it also can be painful, inconvenient and costly.

Blood sugar testing can be an important tool in managing diabetes, and there are two types of tests. The first is a test conducted at home by the patient that shows the blood sugar at a specific point in time. The second type is called HA1c (a measure of long-term blood sugar control) that shows the average blood sugar over the last two to three months. The value of at-home testing is now thought to be questionable.

In 2012, the Patient-Centered Outcomes Research Institute began a study to evaluate the value of daily blood sugar testing for people with Type 2 diabetes not taking insulin. The endpoint for the study was whether there was a difference in HA1c levels for those who did daily testing and those that did not. The conclusion of the study found that there were no significant differences between those two populations.

In response to these findings, the institute developed an initiative called Rethink the Strip that involves stakeholders including primary care practices, healthcare providers, patients, health plans, coalitions and employers. Given the cost for test strips and monitors for patients with Type 2 diabetes who test their blood sugar daily, it’s important to adopt an evidence-based patient-centered approach around the need for and frequency of self-monitoring of blood glucose.

As employees and employers cope with the costs associated with blood sugar testing, there are several strategies that should be considered to better manage this issue. They include:

1. Support shared decision-making. Like all interventions within healthcare, it’s important to weigh both the benefits and the risks of daily blood sugar testing in a thoughtful manner between the patient and their provider.

2. Managed benefit design. Employers should pay for daily blood sugar test strips in cases where it brings value (e.g., Type 1 and Type 2 patients who are taking insulin as well as patients that are either newly diagnosed or are going through a transition period, for example, post hospitalization or beginning a new medication regimen).

3. Involve vendors. To ensure alignment in all messaging to plan members, ask health systems and/or health plans and third-party vendors to align their communication, measurement and provider feedback strategies on when it’s appropriate for daily blood sugar testing.

These strategies can help employees with diabetes understand how their daily activities (nutrition, exercise and stress) and medications impact their condition. This benefits the employee in reaching treatment goals and feeling their best, while also helping employers and employees reduce the need for unnecessary and costly test strips.

SOURCE: Berger, J. (14 March 2019) "To check or not to check: Managing blood sugar in diabetic employees" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/managing-blood-sugar-in-diabetic-employees?brief=00000152-146e-d1cc-a5fa-7cff8fee0000


Do paycheck advance apps improve financial health?

Do you allow your employees access to draw money from their paycheck before payday? Many apps now let workers have early access to their money. Read this blog post to find out more about paycheck advance apps and how these may improve financial health.


Fintechs that let workers draw money from their paycheck before payday through an app are having a moment.

Such apps, including Even.com, PayActiv, EarnIn, DailyPay and FlexWage, are designed for consumers who live paycheck to paycheck — roughly 78% of the U.S. workforce according to one study.

More than 300,000 Walmart employees, for example, use this feature, called Instapay, provided by Even and PayActiv. PayActiv, which is available to 2 million people, announced a deal with Visa on Thursday that will let people put their pay advances on a feeless prepaid Visa card.

Earnin, which lets consumers retrieve up to $100 a day from upcoming paychecks, received $125 million in Series C funding from DST Global, Andreessen Horowitz, Spark Capital, Matrix Partners, March Capital Partners, Coatue Management and Ribbit Capital in December. The Earnin app has been downloaded more than a million times.

In theory, such apps are useful to those who run into timing problems due to large bills, like mortgage and rent, which come due a few days before their paycheck clears. Getting a payday advance from an employer through an app can be less expensive and less problematic than taking out a payday loan or paying overdraft fees.

But do these programs lead to financial health? Or are they a temporary Band-Aid or worse, something on which cash-strapped people can become overdependent?

Volatile incomes, gig economy jobs

One thing is clear — many working poor are living paycheck to paycheck. Pay levels have not kept up with the cost of living, even adjusted for government subsidy programs, said Todd Baker, senior fellow at the Richman Center for Business, Law and Public Policy at Columbia University.

“That’s particularly evident when you think of things like home prices and rental costs. A large portion of the population is living on the edge financially,” he said. “You see it in folks making $40,000 a year, teachers and others who are living in a world where they can’t handle any significant bump in their financial life."

A bump might be an unexpected expense like medical treatment or a change in income level, for instance by companies shifting to a bonus program. And about 75 million Americans work hourly, with unstable pay.

“Over the last several decades, we’ve changed the equation for many workers,” said John Thompson, chief program officer at the Center for Financial Services Innovation. “It’s harder to have predictable scheduling or even income flow from your job or jobs. But we haven’t changed the way we pay, nor have we changed the way bills are paid. Those are still due every month on a certain date. This income volatility problem that many people experience hasn’t been offset by giving the employee control of when they do have access to these funds.”

Where on-demand pay comes in

Safwan Shah, PayActiv's CEO, says he has been working on the problems for consumers like this for 11 years. The way he sees it, there are three possible ways to help: by paying these workers more, by changing their taxes, or by changing the timing of when they’re paid.

The first two seem out of reach. “I can’t give more money to people; that’s not what a Fintech guy does,” Shah said. “I can’t invent money. And I can’t change the tax laws.”

But he felt he could change the timing of pay.

“I can go to employers and say, your employees are living paycheck to paycheck,” Shah said. “They’re bringing that stress to work every day. And you are suffering too, because they are distracted — a Mercer study shows employers lose 15 hours a month in work from these distracted employees.”

Shah persuades employers to let their employees access a portion of the wages they have already earned. His early wins were at companies whose employees frequently request paycheck advances, which generates a lot of paperwork. Employees can access no more than 50% of what they have already earned — a worker who has earned $300 so far in a month could at most get $150.

Employees pay $5 for each two-week period in which they use PayActiv. (About 25% of the time, the employer pays this fee, Shah said.)

PayActiv also gives users unlimited free bill pay and use of a Visa prepaid card. In July, PayActiv became part of the ADP marketplace, so companies that use ADP can use its service.

PayActiv's largest employer is Walmart, which started offering it via the Even app in December 2017. In October, Walmart began allowing employees to pick up cash through the app in Walmart stores, so users who were unbanked could avoid ATM fees.

Shah said the service helps employers reduce employee turnover, improve retention and recruit employees who prefer real-time pay. He also has a guilt pitch.

“I was first in the market to this, in 2013,” Shah said. “People looked at me and said, ‘What? I’m not going to pay my employees in advance. Let them go to a payday lender.’ Then I’d show them pictures of their offices surrounded by payday loan shops. I’d say, ‘They’re here because of you.’ ”

Does early access to wages lead to financial health?

When Todd Baker was a Harvard University fellow last year, he studied the financial impact of PayActiv’s earned wage access program. He compared PayActiv’s $5 fee to payday loans and bank overdraft fees.

Baker found that a $200 salary advance from PayActiv is 16.7% of the cost of a payday loan. Payday lenders typically charge $15 per $100 borrowed, so $30 for a two-week, $200 loan. If the borrower can’t pay back the amount borrowed in two weeks, the loan gets rolled over at the original amount plus the 15% interest, so the loan amount gets compounded over time.

With PayActiv, "there is always a full repayment and then a delay before there is enough income in the employee’s payroll account for another advance," Baker said. "It never rolls over.”

Baker also calculated that the PayActiv fee was only 14.3%, or one-seventh, of the typical $35 overdraft fee banks charge.

So for people who are struggling to manage the costs of short-term timing problems and unexpected expenses, Fintech tools like PayActiv’s are a lot cheaper than alternatives, Baker said.

“Does it create extra income? No. What it does is help you with timing issues,” he said.

Aaron Klein, a fellow at the Brookings Institution, said workers should have access to money they’ve already earned, whether that’s through real-time payments or through apps that provide pay advances.

“I also am on board with the idea that by saving your $35 overdraft and saving your payday loan rate, you’ll be better off,” Klein said.

But he’s not willing to say these tools solve the problems of low-income people.

“If the core problem is I used to make $35,000 a year, now I make $30,000, and because of that shock I’m going to end up accruing $600 of payday loan and overdraft fees, eliminating that $600 makes you a lot better off,” Klein said. “But it doesn’t negate the overall income shock.”

Thompson at CFSI says it’s too soon to tell whether earned wage access brings about financial well-being.

“We’re just beginning to explore the potential for these tools,” he said. “Right now they feel very promising. They could give people the ability to act quickly in an emergency and have access to and use funds in lieu of a payday loan or some other high-cost credit or consequence they would rather avoid, like an overdraft fee.”

What could go wrong

Thompson also sees a potential downside to giving employees payday advances.

“The every-other-week paycheck is one of the few normal structures we have for people around planning, budgeting and managing their money,” he said.

Without that structure, which is a form of savings, “we’re going to have to work hard to make sure we don’t just turn people loose on their own with even less structure or guidance or advice on their financial life.”

Another common concern about payday advance tools is that if you give people access to their money ahead of time, they’ll just spend it, and then when their paycheck arrives, they will come up short.

But Klein, for one, doesn’t see this as an issue.

“I trust people more to manage their money,” he said. “The people who work paycheck to paycheck spend more time budgeting and planning than the wealthy, because it’s a necessity.”

A related fear is that people could become addicted to payday advance tools, and dig themselves into a deeper hole.

Jon Schlossberg, CEO of Even.com, somewhat surprisingly acknowledges this could happen.

“Getting access to your pay on demand is a tool you can use the right way or the wrong way,” he said. “If you offer only on-demand pay, that could cause the problem to get worse, because getting access to that money all the time triggers dopamine; it makes you want to do it more and more. If you are struggling with a very low margin and you’re constantly up against it, getting more money all the time accelerates that problem."

Quantitative and qualitative analyses have borne this out, he said.

Even has granted users $700 million worth of Instapays; they typically use Instapay 1.4 times a month. Schlossberg doesn't see high use of the feature as success.

“You shouldn’t need to be using Instapay,” he said. “You should be becoming financially stable so you don’t have to.”

Baker said addiction to payday advances isn't a danger because they don't roll over the way payday loans do. With a salary advance, “It’s conceivable you could get $200 behind permanently, but it’s not a growing obligation and it’s not damaging,” he said.

Shah at PayActiv said users tend to withdraw less than they're allowed to — about 75%.

“When it comes to usage of their own salary, instead of asking for more, people behaviorally ask for less,” he said.

They see PayActiv more as a headache reliever like Tylenol, rather than an addictive candy or drug, Shah said.

Pay advances are just one of many tools that can help the working poor. They also need help understanding their finances and saving for goals like an emergency fund and retirement.

“This conversation about on-demand pay is a double-edged sword because people are paying attention to it now, which is good, but they’re viewing it as this magic tool to solve all problems,” Schlossberg said. “It isn’t that. It is a piece of the puzzle that solves a liquidity problem. But it is by no means going to help people turn their financial lives around.”

SOURCE: Crosman, P. (14 March 2019) "Do paycheck advance apps improve financial health?" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/do-paycheck-advance-apps-improve-financial-health?brief=00000152-146e-d1cc-a5fa-7cff8fee0000

Editor at Large Penny Crosman welcomes feedback at penny.crosman@sourcemedia.com.


Goodbye, suits and ties. Hello, sneakers

As the workplace evolves, one thing many managers have in common is that they are throwing out their traditional business dress code. Continue reading this blog post from Employee Benefit News to learn more.


Casual Friday? Try casual Monday through Friday.

As the modern U.S. workplace evolves, one thing many office managers have in common is that they are throwing the traditional business dress code out the window.

About 88% of employers today offer some type of casual dress benefit, up from 81% five years ago, according to the 2018 employee benefits survey from the Society for Human Resource Management.

The most recent company to join the ranks of the suit-and-tie-less workplace is banking giant Goldman Sachs. The decision — once believed unthinkable for such a straight-laced organization — comes as the company looks to keep up with “changing nature of workplaces,” according to a Goldman memo last week.

“Casual dress attire at work is just one of the many ways employers are trying to retain and attract top talent in this competitive job market,” says Amelia Green-Vamos, an employer trends analyst with Glassdoor. “The unemployment rate is at a historic low, and casual dress attire is an inexpensive perk creating a more approachable and comfortable culture for new and existing employees.”

All employers want to attract the best possible talent and in today’s job market that talent is younger. Indeed, more than 75% of Goldman Sachs’ employees are members of the millennial or Gen Z generations. When it comes to hiring younger talent the more traditional companies — such as big banks — are competing against tech giants and hedge funds that are offering a different kind of workplace.

Facebook, for example, has had a relaxed dress code since the beginning. “We don’t want our people to have a work self and a personal self,” says Facebook spokesman Kyle Gerstenschlager. “That aspect of our culture extends to our lack of a formal dress code.”

Google is another company with a simple dress policy. “You must wear clothes,” was the response Susan Wojcicki — current CEO of YouTube — gave in a 2007 interview with Bay area media outlet The Mercury News. She was VP of ad services at Google at the time.

But, it’s not just the Silicon Valley tech companies that have embraced a more laid back attire policy. When Mary Barra — current CEO of General Motors — was vice president of global human resources at the automaker, she set out to replace the company’s 10-page dress code exposition with two words: “Dress appropriately.”

It’s a simple idea, but Barra was perplexed when she received pushback from HR and one of her senior-level directors, she explained at the 2018 Wharton People Analytics Conference. But this actually led to what Barra called an “ah-ha” moment, giving her better insight into the company and teaching her a lesson about making sure managers feel empowered.

Office culture has been evolving for decades, with offices with sleep pods and ping-pong tables now commonplace. But it’s practicality rather than entitlement that is leading offices to adapt their dress codes.

“I have a hard time imagining a position where wearing a tie could be considered an essential part of the job’s responsibilities,” says SHRM member Mark Marsen, director of human resources at Allies for Health + Wellbeing. “Even using arguments that it contributes to or enhances corporate image, client perceptions, or establishing a form of respect. What matters at the end of all, for everyone concerned, is that a successful service was rendered.”

SOURCE: Shiavo, A. (12 March 2019) "Goodbye, suits and ties. Hello, sneakers" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/goldman-sachs-embraces-casual-dress


Pay transparency: A new tool to boost employee engagement

Some companies require new hires to sign an agreement promising not to disclose their pay to co-workers. Continue reading this blog post to learn more about pay transparency.


For many companies, discussing salaries has always been taboo. Some firms even required new hires to sign an agreement swearing they wouldn’t disclose their pay to co-workers. 

This “loose lips sink ships” approach is largely illegal, of course: Employees are generally free to talk about pay rates as part of their rights under the National Labor Relations Act.

Nonetheless, for years, companies held salary information very close to the vest.

But times are changing. Many firms have now gone to a policy of transparency in matters of compensation.

2 separate approaches

Stephanie Thomas, program director of the Institute for Compensation Studies at Cornell University, writes that pay transparency comes in two flavors: salary disclosure and pay process transparency.

1. Salary disclosure: In this approach, the company distributes a spreadsheet listing employees, their titles and their salaries.

This approach can be tricky. There are always going to be cases where an employee asks, “Why is Stephanie paid more than me? We have the same title and the same duties.”

Whole Foods explains the rationale for adopting its policy in a statement on its website:

“Salary information for all –including the company’s leadership – is available to all inquiring team members. Wage transparency helps promote inclusiveness and ensures our compensation system is fair.”

2. Pay process transparency: The second approach explores how compensation decisions are made, and explains to individuals why they’re making what they are and what they need to do to earn more.

This involves having detailed discussions with employees, either individually or in a group, about the overall compensation plan – salary ranges and midpoints, goals and objectives that need to be met, performance metrics, etc. Most companies prefer this approach because it focuses the conversation away from rankings of employees toward individual performance.

Both approaches signal a new trend in employee engagement – helping workers understand the inner workings of their organizations.

SOURCE: Mucha, R. (15 February 2019) "Pay transparency: A new tool to boost employee engagement" (Web Blog Post). Retrieved from http://www.hrmorning.com/pay-transparency-a-new-tool-to-boost-employee-engagement/


Dispelling the stigma around mental health disorders in the workplace

Forty million adults in the U.S. are affected by anxiety disorders each year, according to the Anxiety and Depression Association of America. Continue reading to learn more about the stigma associated with mental health disorders in the workplace.


It’s no secret that poor mental health impacts employee performance. Anxiety disorders, for example, affect 40 million adults in the U.S. each year, and nearly six in 10 American workers report that anxiety impacts their workplace performance, according to the Anxiety and Depression Association of America.

But because of the stigma often associated with mental health disorders, employees might not be using the benefits and programs clients have in place to help address the problem. That’s why just having programs in place isn’t enough, experts say. Instead, employers need to help remove the stigma of mental health conditions by creating a culture of inclusiveness in the workplace and forming employee resource groups.

Employers including Johnson & Johnson, Trulia and Verizon Media are doing just that, company executives said during a webinar last week hosted by the National Alliance of Healthcare Purchaser Coalitions.

When Margaux Joffe, associate director of accessibility and inclusion at Verizon Media, started working on a proposal to form a mental health-focused employee resource group (ERG), dispelling stigma and empowering workers was one of her first priorities.

“We wanted to create a paradigm shift,” she said, speaking as part of the webinar. “Growing up, you’re taught to think you’re ‘normal or not normal;’ you’re mentally ill or you’re not. We started with the idea there is no such thing as a ‘normal brain’ as we’re increasingly understanding neurodiversity in the human race.”

A lot of people with mental health issues don’t necessarily identify with the word disability, added Meredith Arthur, content marketing manager at Trulia.

“We struggled around removing the word disability because there was a desire to face the stigma and take it on,” she said of Trulia’s ERG. “Ultimately, we wanted to reach as many people as we could. We wanted to be sharper in our focus on mental health.”

Trulia expanded its ERG statement of purpose from just focusing on mental health education and awareness to advocating for the needs of different abilities.

Joffe said putting in place an ERG for mental health at Verizon was done with the support of senior leadership. “We’ve been lucky to get a lot of support from the company for ERG,” she said. “A common challenge that exists across the board is lack of organization readiness.”

Readiness is a huge component of success in mental health programs, added Kelly Greenwood, founder and CEO of Mind Share, a nonprofit organization addressing the culture of workplace mental health.

“It is so important to achieve true culture change,” she said. “Oftentimes we work with leadership first and do workshops for executive teams before rolling them out to the company to really get that buy-in and understanding from the top down to build a transparent culture.”

At Johnson & Johnson, it took the company about nine months to get its ERG program up and running. “There was a lot of conversation internally if it should be its own ERG for mental health or integrated into another employee resource group,” said Geralyn Giorgio, talent acquisition change management communications and training lead at the pharmaceutical and consumer packaged goods manufacturing company.

At that time, she said, the company had an ERG called the alliance for disability leadership. The decision was made to put mental health under that ERG umbrella. “Since than happened, there were a lot of [employees] not seeing themselves in this ERG. We felt strongly we had to rebrand the ERG, and we went live last year, using the name alliance for diverse abilities to make it more inclusive,” she said.

This year, Giorgio said, the company will work to empower managers to handle mental health conversations.

“If you have a manager open to the conversation, [employees] have a different experience than someone whose manager is ill-informed,” she said. “That’s something we need to focus on this year — helping our managers feel more comfortable with having the conversation.”

SOURCE: Otto, N. (12 March 2019) "Dispelling the stigma around mental health disorders in the workplace" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/dispelling-workplace-mental-health-stigma?brief=00000152-146e-d1cc-a5fa-7cff8fee0000


Nine Ways To Motivate Employees That Don't Always Involve Cash

Employers are reporting that recruiting and retaining talent is the single greatest challenge they've experienced since the U.S. unemployment rate hit historic lows. Continue reading this blog post from Forbes for nine ways employers can motivate their employees.


With unemployment at near historic lows in the United States, employers report that their single greatest challenge is recruiting and retaining talent. The answer for many companies is to throw money at the problem: Bonuses, incentive pay, and out-of-cycle salary increases are often seen as motivators that will entice greater effort and loyalty out of workers.

Turns out, using cash as a carrot isn’t always the best answer, according to new research by Harvard Business School Assistant Professor Ashley V. Whillans. More than 80 percent of American employees say they do not feel recognized or rewarded, despite the fact that US companies are spending more than a fifth of their budgets on wages.

What employees crave even more is to feel that their managers appreciate them and aren’t afraid to show it, not only in paycheck terms, but in other ways such as flexible work-at-home schedules, gift cards for pulling off impressive projects, or even just by saying “thank you” for a job well done.

“Cash matters in people’s lives, but it’s not all that matters,” says Whillans, who researches what makes people happy. “What really matters in the workplace is helping employees feel appreciated.”

Whillans co-wrote a recent article in Compensation & Benefits Review, “Winning the War for Talent: Modern Motivational Methods for Attracting and Retaining Employees,” with Anais Thibault-Landry of the Université du Québec à Montréal and Allan Schweyer of the Incentive Research Foundation.

Rewards that signal to employees that they did a good job and that their manager cares about them will encourage employees to want to work even harder, the research shows. Whillans provides nine tips for business leaders on how best to reward their workers in ways that will bring them greater job satisfaction and motivate them to work harder.

When recruiting, emphasize benefits. Talking up a job’s perks, such as flexible work schedules and skill training, can give companies a recruiting edge. A 2018 study that Whillans and her team conducted of more than 92,000 job ads found that the more benefits an employer described, the higher the application rates.

Cash can motivate workers—in some types of work. Cash rewards are best suited as a motivator for work that is measured quantitatively, Whillans says. But money is less meaningful as a motivator in the complex creative jobs that make up most work in our modern knowledge-based society.

If you give cash, include a meaningful note. It’s best to avoid merely adding a cash bonus to a worker’s paycheck; a separate bonus check stands out more as a recognition of their work. And managers should also include a sincere handwritten note explaining why the employee deserved the bonus.

Reconsider performance incentives. Decades of research confirms that financial incentives can boost effort and performance. But when an employee’s pay is contingent on performance, they can become obsessed with earning more. What often works better is to turn around the timing of the reward, handing it out immediately after an employee excels at a particular task, rather than dangling it beforehand.

Consider thoughtful gifts instead of cash. A 2017 study of 600 salespeople found that when a mixed cash and prize reward program was replaced with an equivalent value all-cash package, employee effort dropped dramatically, leading to a 4.36 percent decrease in sales that cost the company millions in lost revenue, Whillans’s article says. The firm may have inadvertently demotivated salespeople who preferred prizes or discouraged workers who liked having a choice.

Give the gift of time—and other intangible perks. A Glassdoor survey Whillans and her team conducted with 115,000 employees found that providing intangible non-cash benefits, like flexible work options or the ability to choose assignments, led to much stronger job satisfaction than straightforward cash rewards.

Encourage employees to reward one another. Companies can build recognition into their business practices by creating peer-to-peer recognition programs in which employees are provided monthly reward points that they can give away to colleagues for work-related wins. Employees who earn a certain number of points can redeem them for various perks, such as a restaurant gift card or an extra personal day.

Make the recognition public. If employees are receiving a $500 bonus, hold a workplace event to hand out checks, and invite the employees’ peers. Perhaps add a certificate of appreciation along with the check.

Sometimes a simple thank you is enough. Among the happiest employees, 95 percent say that their managers are good at providing positive feedback, Whillans says. A simple, heartfelt “thank you” from a manager is often enough for employees to feel like their contributions are valued and will motivate them to try harder.

Why rewarding employees works

Whillans says these types of rewards work because they tap into three strong psychological needs: Employees long for autonomy, with the freedom to choose how to do their work; they want to appear competent, armed with the skills needed to perform; and they want to feel a sense of belonging by socially connecting with colleagues in a meaningful way.

When these needs are satisfied, employees feel more motivated, engaged, and committed to their workplace—and they report fewer intentions of leaving their jobs, Whillans says.

SOURCE: 


The benefit you may not be offering to employees — but should be

The costs, gaps in care and stress associated with serious, long-term illness can negatively impact the health and productivity of your workforce. Surveys show that about 17 percent of full-time workers act as caregivers. Read on to learn more.


When it comes to getting better value for their healthcare dollars, employers and other healthcare purchasers may be overlooking a significant cost driver that negatively impacts the health and productivity of their workforce.

It’s the costs, gaps in care and stress associated with serious, long-term illness. In addition to the roughly 11.4 million adults and children living with serious illness, about 17% of full-time workers are also caregivers. And while a caregiving role is rewarding, it’s also been shown to reduce work productivity by more than 18%, costing U.S. businesses up to $33 billion annually. Given this, it’s surprising that palliative programs are not nearly as widespread as they should be.

Employers should give serious consideration to offering palliative care as a benefit to employees. Here are two misconceptions that can get in the way of implementing palliative care programs — and two reasons why serious illness care may be right for your organization.

First, the misconceptions:

It’s not the same as hospice care. While hospice care is a part of palliative care, they’re not synonymous. Palliative care is specialized medical care for people living with a serious illness that is appropriate at any age and any stage of their disease and can be provided along with curative treatment. It focuses on providing patients with relief from the symptoms, pain and stress of their medical condition(s) — whatever the diagnosis.

The goal is to improve quality of life for both the patient and their family. Those who would greatly benefit from access to palliative care face conditions such as diabetes with complications, metastatic cancer or chronic obstructive pulmonary disease.

It doesn’t affect my population. While people with a serious illness typically represent only a small proportion of the commercial population — roughly 2% to 3% — and up to 10% of retiree populations, they consume a disproportionate amount of healthcare resources. By addressing the needs of those living with serious illness, helping them avoid unnecessary, unwanted, and even potentially harmful care, employers can make a big impact on employees’ lives and the bottom line. Moreover, palliative care also greatly benefits caregivers, who can experience stress, negative impacts on their own health, and lessened productivity and presenteeism at work, even when they find their role fulfilling.

Now, why should employers offer palliative care benefits?

Quality can generate cost-savings. Palliative care’s focus on improving the quality of life of patients and their families means it leads with quality. The logic of “quality first” applies to many high-value healthcare strategies including accountable care organizations, centers of excellence (COEs) and second opinion programs. And like those other strategies, leading with quality can lead to lower costs. For instance, by providing access to high-quality care for certain services or conditions at a COE, employers hope that costly complications from low quality or inappropriate care can be avoided, just as introducing a palliative care team to a treatment plan can help patients better manage their symptoms, such as severe pain, proactively and lead to fewer trips to the emergency room.

Employers can make a big difference for patients and caregivers. Employers and other healthcare purchasers can play a powerful role in improving care for people living with serious illness by demanding certain capabilities and services from contracted health plans, other vendors and healthcare providers.

These include:

· Proactive identification of the population of patients living with a serious illness
· Training all healthcare providers in basic communication and symptom management skills
· Access to certified specialty palliative care teams across care settings
· Access to appropriately trained case managers
· Specific benefits that include home-based services and support for caregivers

To change the healthcare system, it’s important for purchasers to be on the same page with each other to ensure that providers and plans are on board with providing this type of care. After all, at the end of the day, it’s about the patient and their family. In focusing on palliative care, along with other key areas, purchasers have the power and influence to make a difference in the quality and affordability of care their employees receive.

SOURCE: Delbanco, S. (6 March 2019) "The benefit you may not be offering to employees — but should be" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/the-benefit-employers-may-not-be-offering-to-employees?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


4 questions to ask before adding biometric screenings

According to the Kaiser Family Foundation (KFF), fifty-two percent of large firms that provide employee health benefits offer workers the opportunity to complete a biometric screening. Continue reading this blog post to learn more.


A growing number of employers are adopting workplace wellness programs to improve employee health and subsequently lower their health insurance spend. As they do, benefit managers are tasked with vetting options that will deliver meaningful health and financial results for their companies.

This vetting process typically involves answering questions that range from which types of participation incentives their organization should offer to what type of wellness programs will yield the greatest health-improvement outcomes.

But there’s a problem: Very few benefits managers ask for details about wellness biometric testing, even though most programs are, at least in theory, designed around the information that screening provides. Biometric screening typically involves one or more laboratory tests as well as physical readings, such as blood pressure and body weight, to identify markers of health risks if not an actual disease.

According to the Kaiser Family Foundation, 52% of large firms that provide employee health benefits offer workers the opportunity to complete a biometric screening.

Just as workplace wellness programs are not all the same, biometric screening can vary. Failure to question the specific details of a proposed biometric screening program can lead to suboptimal results.

Before moving forward with biometric screenings as part of a workplace wellness program, benefit managers should pause to ask themselves certain questions. Doing so will enhance the likelihood of favorable outcomes — both for employee wellness and the financial bottom line.

1. Why should we screen?

It sounds simple, but setting clear goals for biometric screening is a step too many benefits managers overlook. This may be because they do not know how to anticipate the kind of actions that will be available to them and their employees given the results.

Based on my experience, the most compelling reason to provide biometric screening as part of a wellness program is to help individuals identify risks for several chronic conditions that, if caught early, may be prevented. With insights from a biometric screening, an individual may be better able to take steps to reduce health risks. Common goals may be to reduce body weight, exercise more or visit a physician for treatment.

Biometric screening often can reveal disease risks an individual may not otherwise know. A study published in the peer-reviewed journal PLoS ONE, for instance, found that one in three first-time participants in a company-sponsored, lab-based wellness program by Quest Diagnostics were not aware they were at risk for a serious medical condition, such as diabetes or heart disease, according to biometric screening results. Many of these individuals were in a health plan, suggesting that healthcare access alone does not guarantee preventive care to identify risk for common chronic health conditions.

Biometric screening also can help an employer identify programs to target at-risk employee segments based on the type of risk with appropriate interventions. Reliable insight into disease risks for a workforce population may also aid the prediction of future healthcare costs.

2. What should we screen for?

Ideally, biometric screening should provide enough information into disease risks for both individuals and the employer in order to take meaningful actions. Here, many employers miss the mark by implementing bare bones biometric screening options. The result is potentially misleading results — and missed opportunities to identify individuals at risk.

Take diabetes screening, for instance. A non-fasting fingerstick glucose screening really doesn’t tell us anything considering the variety of food individuals might have eaten, and how that may have affected their measurement.

A fasting fingerstick glucose test may help identify diabetes risk in some individuals and be less costly to perform than a hemoglobin A1c test, which involves a venipuncture blood draw. However, a study from Quest Diagnostics found that some individuals in a workforce population with normal fasting glucose results were still at higher risk for diabetes, and a glycated hemoglobin (HbA1c) test identified them.

In a similar manner, many employers overlook screening for chronic kidney disease, one of the major causes of kidney transplantation. Eighty-nine percent of participants identified as at risk for chronic kidney disease did not know it, according to the aforementioned PLoS ONE study. The estimated glomerular filtration rate (eGFR) lab test can help identify this condition very cost-effectively, but it’s often absent in biometric screening programs. Other conditions that laboratory tests can help identify include metabolic disorders, thyroid disease, and colorectal cancer, among others.

3. How often should we screen?

Annual biometric screening reinforces the importance of management places on employee wellness. It can also help identify health risks in individuals who are new to the organization. An annual program also provides a regular cadence of engagement that is not too onerous on employees while minimizing the confusion that can occur when screening happens less frequently.

Annual screening has an added benefit of allowing the employee to track her progress over time. Quest provides graphic charts that show changes in an individual’s numbers year over year. This is a powerful motivator for those who have adopted healthful behaviors to stay the course. And longitudinal changes also can reveal patterns, like modest annual weight gain, that the individual may otherwise dismiss until they see the cumulative effect.

4. How can we connect employees to care and intervention?

Screening is just one facet of a successful wellness program. Some individuals who identify health risks may proactively modify their behavior or consult a physician. But not all will. Employers can improve the odds of at-risk employees accessing the care they need following biometric screening.

Most employees in biometric programs receive a personalized report of their screening results. Additionally, many participants can consult over the phone with a third-party administered physician.

At Quest, for instance, we offer programs that help at-risk employees access behavioral change programs. If an individual’s screening results suggest evidence of prediabetes, that employee may participate free of charge in a 16-week, CDC-based diabetes prevention program that includes coaching and lifestyle modification. An individual with a problematic cholesterol result may be able to access a similar program for heart disease prevention.

Biometric screenings can be a powerful facet of an employee wellness program. Understanding the reasons to screen, which methods to use and how often to use them, and the paths to connect employees to care are key. Benefit managers who do this well will be rewarded with a wellness program that results in healthier employees and lower healthcare costs over time.

SOURCE: Goldberg, S. (21 February 2019) "4 questions to ask before adding biometric screenings" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/4-questions-to-ask-before-adding-biometric-screenings


6 key features your employee training program needs – and how LMS can help

One way employers can keep the right employees around and happy is by providing opportunities for professional development and training. Continue reading this blog post to learn more.


Hiring the right employees is important, but keeping them around and happy is just as essential. One way to do that is to provide opportunities for professional development and training as a way to encourage workers to improve their skills and engage further with their jobs.

While you likely have a solid training program for new employees to get them accustomed to your organization, the training options for ongoing employees are often more limited.

It’s always a good idea to encourage all employees to continue learning new skills, perfecting old ones and developing as professionals. Having well-rounded workers with a range of skills boosts your business and opens up opportunities for their advancement.

Beyond making workers happier and more productive, there are revenue benefits associated with comprehensive training, too. Companies that offer workers training programs have 24% higher profit margins than those that don’t, according to the American Society for Training and Development.

And if you don’t yet have a learning management system (LMS) solution, consider investing in one. It can help streamline the training process and strengthen your entire program while offering a range of other benefits.

Whether you already have a training program you’re looking to improve, or you’re aiming to implement one, there are certain elements every successful training and development program has.

Short, specific sessions

You know better than anyone that employees’ attention spans aren’t long. No one wants to sit through hours of training, no matter how valuable the information is.

Focus instead on short, specific bursts of information that will interest workers and guarantee they retain the information.

This strategy, called microlearning, emphasizes brief (usually three to five minutes) sessions designed to meet specific outcomes. You can use it for both formal training and informal, but it’s generally more successful when applied to informal skills training instead of intense or complex processed-based training.

There are four essential characteristics of microlearning to hone in on. Make sure your training is:

  • Lean: It shouldn’t need a mob of people to implement
  • Adaptable: There should be ways to apply the training to many employees across a range of departments and locations. Although specificity is a key component of microlearning, it can’t be so specific that only one employee will benefit, otherwise, it’s not worth the time and resources.
  • Simple: Avoid over-complicating things and confusing workers.
  • Seamless: Use the technology at your disposal. Your solution shouldn’t require in-person sit-downs, but instead should be transferable to employees’ mobile devices and laptops when possible.

Many LMS solutions are accessible on mobile devices and desktops and allow you to create your own courses to provide the exact content you want to employees.

Remember: Microlearning doesn’t have to be the centerpiece of your training program. After all, there are some topics that simply can’t be condensed into bite-sized pieces. But integrating this method can help spice up your program and supply a new way of doing things.

Assessments

An effective training program is only as good as what employees retain, so you’ll want a way to measure where they started and how the training has impacted them.

A pre-training assessment can also shine a light on what workers are looking for and what they still need to learn. This allows you to target specific skills training and development to the employees who need it, while not wasting the time of workers who’re all caught up.

Post-training assessments, meanwhile, help you see who’s mastered the training and who still needs help. They can also show you where your training program could be improved.

To ensure assessments are as helpful as possible:

  • Avoid yes or no questions, instead of allowing workers to provide a variety of feedback.
  • Look over how the training objectives line up with workers’ perceptions of their professional development.
  • Offer both task- and skill-based evaluations that look at performance and adaptation of the skill, rather than memorization ability.

Note: These evaluations don’t need to take the form of traditional tests. Very few people enjoy taking tests, so taking the time to turn assessments into a game or more fun activity encourages workers to participate and provide their honest opinions without worrying about being “graded.”

With some LMS solutions, assessments can be taken online with the information stored right where you can access it easily. Often, you can also compile the results into reports that give you at-a-glance clarity on who benefited most from the training and who still needs improvement.

Collaboration

Providing chances for your workers to interact and form connections has multiple benefits for your training program and organization at large.

When employees have bonds with their co-workers, they’re more engaged in their tasks and more productive. Getting them to collaborate during training can help convince them to take the course seriously while encouraging teamwork beyond the training.

Collaboration tools, such as built-in messaging systems and discussion boards, are prevalent among LMS solutions and give workers the chance to learn together and develop along the same paths.

Multimedia options

You’ll also want to expand your horizons beyond basic text-based training. We’re living in an age with constantly evolving technology, and your training program should take advantage of the options at your disposal.

Workers will be more engaged with the content you offer if it’s more than words on a page. And with LMS solutions, creating and importing multimedia content into your training is easier than ever.

This doesn’t mean you can’t implement text into your training, of course, but rather that you should also have:

  • video
  • interactive content
  • images, and
  • audio.

Video and images are already extremely popular in training, and if you have a current program it’s likely there are already videos and photos in it. Don’t forget about graphs and other diagrams that could help clarify certain concepts.

Interactive content can take a range of forms, from quizzes given to workers after each module to games employees play to help them retain the information they’ve learned.

These games can also increase collaboration during training, which helps participants stay engaged in what they’re learning and form connections with co-workers. Bonding with co-workers is one of the benefits offered by in-house training programs and these bonds often strengthen employee engagement with your company.

Another option is audio content, like podcasts. Offering audio content allows workers to train while performing other tasks, since they don’t have to be in a specific room or looking at something to follow along.

If you’re worried about carving enough time out in employees’ workdays to add training or professional development, podcasts and other audio content are a good bridge to get them learning new skills while still able to complete their jobs.

Easy access

A training program won’t work if its inaccessible. If workers have to show up on a specific day and time to a certain conference room, it’s significantly less likely they’ll take you up on the offer.

And if the training is mandatory, employees won’t be excited to learn and may resist absorbing the info.

This is where an LMS solution comes in handy the most. It provides a central location for training and courses to be stored and accessed. Workers can check out training from all of their devices and tackle the topics individually or in groups, depending on what works best for them.

Having an LMS solution also helps if you employ remote workers or have multiple locations, since you don’t have to coordinate a time for them to come in or run multiple training sessions at once.

Professional development

Workers, especially younger ones, want a way forward in their careers. They don’t want to just learn skills applicable to their current jobs. They want options and the chance to develop further and pick up skills that will serve them well as they advance.

Clearly define how your training program will factor in professional development, so employees can see what the payoff will be down the line. This also motivates them to stay with your company in the long run, since you’re enabling them to develop and practice new abilities and investing in their futures.

Most LMS solutions have the ability to create customized learning paths depending on where employees are in their careers and what they’re aiming to learn and accomplish.

Laying out the ways forward can also help with recruiting and hiring, since prospective employees can see the opportunities for advancement and growth available to them.

Bottom line

Training matters for every employee, not just new hires or recent transfers. A strong comprehensive training program is essential to building up your workforce and keeping workers engaged in their jobs.

When given the chance to boost their skills and develop professionally, employees are also happier and more productive, making the potential expense of implementing training programs worth it.

Plus, LMS solutions can help improve your training and offer a variety of features to employees and trainers alike in a cost-effective way.

Your training doesn’t have to reinvent the wheel to be helpful for your workers and provide benefits for your business. It just has to work for your company and employees.

SOURCE: Ketchum, K. (18 February 2019) "6 key features your employee training program needs - and how LMS can help" (Web Blog Post). Retrieved from http://www.hrmorning.com/employee-training-program-lms/


7 principles for helping employees deal with financial stress

More than 60 percent of survey participants are seeking support from their employer for all aspects of health with financial health as their priority, according to a survey by Welltok.  Read this blog post to learn more.


Employees are dealing with financial strain -- and they may want some help from their employer to address it.

The results of a recent survey on employer wellness programs from software company Welltok, reveals two important takeaways:

  • More than 60% of survey participants are seeking support from their employer for all aspects of health with financial health as their first priority.
  • If employers offered more personalized programming, 80% of respondents say they would more actively participate in their wellness offerings.

These findings attest to what we already know. First, there is no physical wellness without mental and emotional wellbeing and there is no mental and emotional wellbeing without financial wellness. Second, engagement demands personal relevance.

Today, Americans carry $2 trillion in consumer debt, student loan debt has overtaken credit card debt and 50% of consumers live paycheck-to-paycheck. Nearly half of Americans do not have $400 to cover an emergency. Over the past decade, consumers continually report that financial stress is the greatest challenge to their health and wellness.

Struggling with finances is a deeply stressful situation for employees, families, employers and communities nationwide. To date, programs to help employees address their financial concerns have been built on the assumption that if we just teach our employees financial literacy, their financial situations will improve. This ignores the fact that money is deeply emotional—a fact that any effort to change how we deal with our money must address.

When it comes to complex, emotionally-driven issues such as money, there is often a disconnect between knowing what to do, understanding how to do it and actually doing it. In this sense, financial wellness is similar to physical wellness. I may know I need to lose 20 lbs., I may even understand, in theory, how to lose weight. But I still have trouble acting on what I know.

With this in mind, there are seven core principles critical to helping employees make a real difference in their finances and their lives.

  1. Education alone is not enough. Education and financial literacy alone simply do not inspire or empower behavioral change.
  2. Personalization is key. People will engage with a solution when it feels like it’s about them and their particular situation. Support resources need to bring general financial principles home by addressing employees’ individual circumstances.
  3. Privacy matters. Money is a sensitive and emotional subject that is difficult to discuss — especially in a group setting. Support resources need to respect the need for privacy and empower participants to explore financial questions without fear of judgment.
  4. Take a comprehensive approach. Support resources must include participants’ full financial picture to ensure that each individual’s most important issues are identified and addressed.
  5. Behavior change is essential. Established principles of behavior change science work just as well for changing financial habits and decision making. Reinforcing social interaction, peer support, positive attitudes and outlooks, providing small steps and supporting regular accountability are key.
  6. Technology lowers barriers to action and change. Mobile access is key for reaching individuals, meeting them where they are and offering them self-paced, actionable advice in the moment they need it. Learning to deal with money can — and should — be gamified. It takes considerable effort to present complex financial principles in fun, friendly, accessible scenarios or modules that are easy for employees to digest. But the result is worth it: Finances are transformed from difficult and stressful to easy and even fun. Employees develop a sense of competence; their finances become something they feel confident about and want to tackle.
  7. Remember the human connection. Technology transforms the financial services landscape by expanding our ability to provide meaningful personalized advice, consistently and according to best practices. Still, nothing changes the importance of a human adviser who can create a relationship, connection, and the trust to empower behavioral change.

The time has come to give everyone the financial advice and tools they deserve, and that will engage and empower them to improve their situation. Fortunately, much of the necessary technology already exists — and it’s improving daily. At this point, then, it’s key to get these solutions into employees’ hands so they can start their journey.

Change won’t happen overnight, although the smallest insights — setting up your first budget, getting answers from a financial coach — can do wonders to relieve financial stressors. Step by step, change is possible, confidence grows and wellbeing improves.

SOURCE: Dearing, C. (20 February 2019) "7 principles for helping employees deal with financial stress" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-employers-can-help-employees-deal-with-financial-stress