A better place to work: How well-being impacts the bottom line

Did you know: One in 10 employers are skeptical about the value of well-being programs. Health challenges, near stagnant wages, financial stress and more can take a personal toll on your employees, causing their stress levels to rise. Read this blog post to learn more.


Logically, employees bring their “whole selves” to work. Unfortunately, health challenges, relatively stagnant wages, heightened financial pressures, always-on technology and contentious geo-political climates around the world all take a personal toll on employees in the form of rising stress.

Employers recognize that the health and well-being of their workers is vital to engagement, performance and productivity, yet one in ten are skeptical about the value of well-being programs. But by learning from peers’ experiences, employers can take steps to help employees improve their well-being through access to related programs and services. And that contributes strongly to the overall success of the organization.

Survey says

According to the 252 global employers polled in the Working Well: A Global Survey of Workforce Wellbeing Strategies, building a culture of well-being is a higher priority than ever. Fully 40 percent of organizations believe they’ve actually achieved it, up from 33 percent in our 2016 survey. Of those who have not, another 81 percent are making plans to get there.

Top priorities for wellness programs in North America were to reduce stress and boost physical activity. Stress is a bottom-line issue for employers: 96 percent identified employee stress as the biggest challenge to a productive workforce.

Closely related priorities were improving nutrition and work-life issues, addressing depression and anxiety, and getting better access to health care services. On the latter, discussion with many employers confirms this includes sufficient access to mental and behavioral health providers—directly related to the top challenge of stress and its more serious potential debilitative consequences that can include anxiety, depression, addiction and more.

Health

The most frequently offered employee health benefits which respondents also assessed as most effective included the following:

  • Employee assistance programs (EAPs): By far the most frequent program, offered by 86 percent of global employers and 96 percent of US respondents. About 7 in 10 of those who offer an EAP said it’s effective in achieving their objectives, although actual experience reveals a wish that many more employees would take full advantage of EAP services. Know your numbers assessments, including health screenings and health risk appraisals, rose in prevalence globally and were considered effective by 86 percent of respondents.
  • On-site care: While smaller numbers of employers offer on-site immunizations, delivery of medical care, or fitness centers, they were still rated at just over 80 percent effective – demonstrating that convenience and access can remove barriers and enhance results.
  • Flexible working policies: These rose in prevalence over our last survey, consistent with other research demonstrating that multiple generations prize work flexibility to enable balance and help manage life’s stressors.
  • Wearables: Sensors and trackers also rose in prevalence. Globally, two-thirds of respondents credited them with effectiveness in monitoring and perhaps motivating healthy activities.

The survey also found health literacy is required to engage and drive behavioral change, and employers need targeted solutions to build it.

Finances

Validated by other research, a majority of employees live paycheck to paycheck today. Of US respondents, 87 percent reported financial distress among employees (the global average was 83 percent). Employers cited negative bottom-line results from financial stress, such as lower morale and engagement, delayed retirement and lower productivity, among other detrimental impacts. Other studies show financially stressed employees spend three hours or more each week distracted by it.

In prior years, this survey showed a top focus on saving for retirement; now, non-retirement-related objectives are rapidly catching up as priorities. It’s hard to focus on retirement when current needs are pressing. As a result, well over 7 in 10 employers also seek ways to ensure adequate insurance protection, help in saving for other future needs, better handling day-to-day expenses, reducing debt, and having emergency savings.

ROI vs. VOI

Just under half of respondents have specific, measurable goals or targets and outcomes for their well-being programs overall. But measurement is tricky, and 45 percent of respondents noted a lack of resources to support measurement as the top barrier to metrics. Nevertheless, only 8 percent perceived “no measurable return.”

Of those measuring the health care cost impact, 54 percent reported their programs were reducing trend by 2 to 5 percentage points per year. Financial well-being ratings were more challenging, with only 4 percent globally saying they have objective data to demonstrate their financial well-being program effectiveness.

Concurrently, many placed their bets on technology tools to inform program design and outreach: 84 percent rated predictive analytics as effective in helping to support well-being, even if just over a quarter offer it today—another half plan to do so in the next 2 to 3 years.

A value-of-investment priority emerges from the data. Employers intuitively pursue programs that build goodwill by providing helpful resources. The top four objectives globally focused on engagement and morale, performance and productivity, attraction and retention, and overall, enhancing the total rewards offering while managing spend. While reducing health care costs was the top objective for the US, it was fifth globally. Other objectives linked the organization’s image or brand and values and mission—if the company has a message to external customers, it needs to “walk the talk” internally with employees.

Holistic strategy

Compared to prior surveys, employers continue to explore new ways to support well-being, in response to employee and business needs. The historically stronger emphasis on health-related well-being continues, but financial well-being efforts are on the rise. For the US/Canada, the recent fast-rising program elements have been spiritual well-being (67 percent), retirement financial security and preparedness (57 percent), social connectedness (57 percent), and financial literacy/skills (63 percent).

In total, survey responses suggest employers understand that these well-being issues are interconnected and cannot be effectively addressed in isolation without a more holistic strategy and delivery solutions.

That’s where value of investment comes in, acknowledging that enhancing physical and emotional, financial, social, and other aspects of employee well-being can help make the organization a better place to work.

SOURCE: Hunt, R. (11 April 2019) "A better place to work: How well-being impacts the bottom line" (Web Blog Post). Retrieved from https://www.benefitspro.com/2019/04/11/a-better-place-to-work-how-well-being-impacts-the-bottom-line/


Fresh Brew with Rich Arnold

Welcome to our brand new segment, Fresh Brew, where we will be exploring the delicious coffees, teas, and snacks of some of our employees! You can look forward to our Fresh Brew blog post on the first Friday of every month.

“I enjoy helping people over 65 understand Medicare and the many options they have. Explaining Medicare in easy to understand terms, clearly showing them the options based on their doctors and prescriptions, and letting them make a choice which they are comfortable with has been one of the most gratifying things I’ve ever done.”

Rich Arnold is a Senior Solutions Agent at Saxon Financial Services.

Over the years, Rich has been a teacher, an owner of several printing businesses, and retired after 10 years of running the Sharonville Chamber of Commerce. In his spare time, Rich is actively working with non-profits, helping with community projects and spending time with his 5 grandchildren.

Diet Mountain Dew

Rich is not a coffee drinker but enjoys a Diet Mountain Dew!

Honey Roasted Peanuts

Rich enjoys sipping on his favorite brew while eating Honey Roasted Peanuts.

Give It A Try & Share It!


What's a simple addition to your day to decrease stress & improve well-being?

Gratitude is more a state of mind rather than a personality trait, varying over the course of time. A recent study shows that gratitude reduces stress and fosters well-being. Continue reading to learn more.


Previous research on the positive effects of gratitude has shown that gratitude appears to reduce stress and foster well-being (e.g. Wood et al., 2010). A recent prospective study in which people were instructed to list things they were grateful for on a daily basis supports this notion (Krejtz et al., 2016). However, little if any, research has looked at whether spontaneous (non-directed) changes in gratitude track with well-being and stress response. Rather than being a stable personality characteristic (a “trait”), gratitude may be more of a “state,” varying over the course of time—or perhaps a combination of both. Do daily fluctuations in gratitude correlate with well-being and indicators of happiness, stress, and depression? Furthermore, does gratitude serve as a buffer for stress and negativity, helping to offset toxic effects on more challenging days?

In order to look more closely at how natural day-to-day levels of gratitude may interact with various indicators of well-being and stress, researchers Nezlek, Krejtz, Rusanowska and Holas (2018) followed 131 participants for two weeks, using daily self-assessments to investigate correlations among gratitude and factors related to well-being and stress. Daily measures included gratitude, positive and negative emotional states, self-esteem, depressogenic adjustment (optimism about oneself and life), worry, and rating of important events of the day on how stressful and how positive they were. Participants reported on 10 possible categories for events: family, interpersonal, partner, work, finances, official, health, hobby, values, and other/everyday events.

As in previous studies looking at intentionally cultivated gratitude, researchers found that on every measure, gratitude was significantly correlated with well-being. On days when people felt more grateful, well-being was reported as being higher. Likewise, on higher stress days, participants reported lower well-being, and on lower stress days, participants reported greater well-being.

Using gratitude to buffer stress responses.

Importantly, they found that gratitude did in fact appear to act as a buffer for stress. On days with fewer positive events, gratitude and well-being were more strongly related, suggesting that gratitude may serve to bolster resilience, amplifying lower positive emotions on difficult days or perhaps even providing, essentially, internal positive events to compensate for a lack of external positive events. This is especially noteworthy because people often have difficulty tapping into gratitude when difficulties arise, focusing on negatives with bitterness or pessimism.

Gratitude therefore appears to provision us internally with a positive response when external events fail to do so. For people who are able to muster up gratitude when the going gets rough, not only as a generally characteristic but also as a just-in-time response to stress and negative events, gratitude can be a “bridge over troubled water” that helps to keep us from getting pulled down into a negative spiral of maladaptive coping. People who use gratitude in this way must be able to do so, rather than undermining resilient responses.

Gratitude, compassion and resilience.

In keeping with research showing that resilience is related to cognitive flexibility, active coping, optimism, and related beliefs, the current research suggests that a subset of people use gratitude automatically, generating a state of mind which buffers negative events and stressful responses to sustain greater overall well-being. Religious belief, which often emphasizes gratitude, is also associated with greater levels of resilience. In addition, recent research by Abbondandolo and Sigal (2018) also found a positive relationship between self-compassion and active coping, suggesting that there are common pathways governing gratitude, self-compassion, and resilience.

Additional research is required to further understand the causal relationships between gratitude, resilience, well-being, and related factors in order to spell out what innate factors help make us stronger, as well as what interventions can bolster overall well-being. Understanding whether those who naturally utilize gratitude to buffer stress and sustain well-being tend to do this consciously or not, how they had learned to do so during the course of development, and whether there are intrinsic factors that predispose one to feel grateful would help us learn how to teach the effective use of gratitude—especially for those who have difficulty seeing for what, if anything, there is to be grateful.

SOURCE: Smith, K. (26 March 2018) "What's a simple addition to your day to decrease stress & improve well-being?" (Web Blog Post). Retrieved from: https://www.provanthealth.com/industry-trends/2018/3/26/whats-a-simple-addition-to-your-day-to-decrease-stress-improve-well-being

Original source: Psychology Today | Grant Hilary Brenner M.D. | How Does Spontaneous Gratitude Increase Daily Well-Being?


Bringing personal services to work

Onsite employee benefits and personal services are now within reach of many employers. Read this blog post to learn more about onsite employee benefits.


Onsite employee benefits that go beyond big-ticket items like health clinics, gyms and child care centers are now within the reach of many employers.

When Cassandra Lammers, vice president of total rewards at Audible Inc., a publisher of audio books in Newark, N.J., wanted to encourage employees to schedule regular dental visits, she focused on the large percentage of the firm's employees who are part of the Millennial generation. These younger workers tended not to use their dental benefits, claims records showed.

To address the situation, Lammers began researching mobile dental services, looking for a vendor that would provide dental care onsite during the workday. That was not as easy as it sounded. "Most of these services are designed to help the elderly and the disabled who are not able to get to a dentist's office," she noted.

Also see: 6 Employee Benefits Trends in 2017

After many months of looking, Lammers connected with Henry the Dentist, a mobile dental office that parks its trailer at an employer's location for a few days to provide onsite dental services. The trailer offers state-of-the-art dental services and can serve three patients at a time.

The biggest selling points for Audible were the convenience for employees and the fact that all of the dentists were in-network providers for the company's dental plan, so audible does not have to pay for the service.

"We now schedule a few days each quarter to help employees get into a normal cycle for dental visits," Lammers said. The initial visit was scheduled to last only two or three days. However, employee demand for appointments was so great that the visit lasted six full days to serve 189 employees. Lammers expects to schedule five days per quarter going forward.

"The feedback from employees has been fantastic, and they love the convenience," she said.

Alexandria Ketcheson, marketing and brand director at Henry, said that under the company's current employment model "all our dentists are full-time employees of Henry," and that "a large part of our promise to our corporate clients is that their employees will see the same medical staff during every visit."

Fill'er Up

Onsite benefit programs should be designed to save employees time and to make their lives easier. Miami-based Carnival Cruise Line offers a range of onsite benefits to accomplish just that, including dry cleaning, a coffee shop and deliveries from a flower vendor every Friday so that employees can buy fresh flowers for the weekend.

"This is all part of our effort to be an employer of choice," said Tami Blanco, the company's vice president of shoreside human resources. "We focus on providing services that employees use or need regularly. Employees want to spend their time off with family, not running errands."

Also see: Our Employee Benefits Team

One of the more popular onsite benefits is access to Neighborhood Fuel, a service that comes to Carnival Cruise employees in South Florida and fills up their gas tanks in the parking lot while they are working.

By using a smartphone app, employees can request a fill-up, leaving the gas cap door ajar on their cars. Once the fuel truck completes the fill-up, the app sends an alert with the total cost of the gas.

So far, half of Carnival Cruise's Miami-based employees have signed up to use the service, and 75 percent of those employees say it is of great value to them, Blanco said.

Beware Upselling

When an employer offers any onsite benefit to employees, it comes with an implicit endorsement of the vendor's services, so it's important for employers to proceed with caution when choosing those vendors.

Also see: The Most Desirable Employee Benefits

Carnival Cruise Line, for example, often offers new services to one group of employees as a pilot project to see if it is something the company wants to offer to all employees.

Before offering onsite dental care, Lammers not only read the reviews of the dental providers working for Henry the Dentist but also asked pointed questions about how the service ensures the safety of employees while they are walking to and from the mobile facility and while they are inside receiving treatment. "We also wanted to understand how they operate [and] how they interface with employees, ensure confidentiality, et cetera," said Lammers, who inspected the mobile dental facility personally.

Once employees begin using any onsite service, employers should check in periodically to make sure employees are happy with the service and comfortable using it. For example, if employees feel a vendor is putting pressure on them to buy more or to upgrade, that's something an employer may want to address directly with the vendor so that employees don't feel pressured.

SOURCE: Sammer, J (5 July 2018) “Bringing personal services to work” (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/bringing-personal-services-to-work.aspx


How tech solutions can take aim at employee stress

Workers are stressed out. Stress can lead to a number of grave health conditions and unhealthy coping mechanisms. Read this blog post to learn how technology is helping battle employee stress.


In case you haven’t noticed, today’s workforce is completely stressed out. Overwhelming workloads, looming deadlines and the 24/7 always-on mentality is becoming the corporate America norm. Unfortunately, long-term stress can contribute to everything from heart disease to strokes, cancer and other grave conditions. Stressed employees also are more likely to be unmotivated, quit their jobs, perform poorly and have low morale and higher incidence of illness and accidents.

Because everyone copes with stress differently, some deal with it in unhealthy ways, such as overeating, eating unhealthy foods, smoking cigarettes or abusing drugs and alcohol, according to the American Psychological Association. This vicious cycle makes stress one of the top health concerns, with 49% of individuals at risk for stress-related illnesses, second only to weight, which impacts 69% of individuals, according to internal research.

All in all, employee stress is causing employers … well, stress. In fact, the cost of work-related stress in the US is $300 billion annually, according to the American Institute of Stress. Further, behavioral-related disability costs have increased more than 300% in the past decade and account for 30% of all disability claims.

While more than two-thirds of US corporations have adopted some kind of health and wellness program, the majority doesn’t adequately address or even include solutions that support mental health. That’s why it’s critical to educate employers on the real cost of stress and the benefits of an effective stress-related wellness initiative to help keep health costs down, while keeping employee productivity and retention up.

However the realities of promoting a healthy balance for employees, while simultaneously ensuring the delivery of quality work that’s completed on time, is much easier said than done. Anecdotally, we often hear that employees don’t feel they are benefiting from their corporate wellness plans because they don’t have time or they can’t break away from their desks.

Walk the walk
What can employers do to break the cycle? First and foremost, stress reduction starts from the top-down as management and bosses play a key role in employee adoption and lasting engagement. Not only are they responsible for communicating about available resources, they need to literally and figuratively walk the walk. When leadership incorporates stress management into their own lives, employees understand the company's commitment to these practices and feel more comfortable taking a break.

The role of technology
Some of the most effective wellness programs leverage a variety of technologies that offer something for everyone and makes it easier for employees to engage and benefit, regardless of where they are or the time of day. Popular technology-based solutions include:

· Digital health platforms — Connecting employees to health coaches, board-certified physicians, and colleagues who can provide support for those dealing with stress and offer guidance with chronic disease resulting from, or adding to, individuals’ stress levels.
· Digital health games — Employees receive encouragement and rewards through fun, engaging games in which they compete against others in stress-busting exercise to reach health goals.
· Wearables — Employees can sync popular wearable devices, such as their Apple Watch, to visualize the impact of guided meditations on their heart rate. Through smart feedback, employees can better understand which meditation exercises, locations, and times of day have the greatest impact on their heart rate, and therefore, stress level.
· Virtual Reality guided meditation — Combining an immersive VR with mindfulness meditation can help transport employees to relaxing environments, bringing a whole new dimension to the meditation experience. Using apps on their cell phones and portable VR headsets, employees are able to practice meditation from any place, at any time. In addition to stress reduction, a growing body of scientific evidence suggests that meditation can heighten attention spansimprove sleepreduce chronic pain and fight addictions like drug and alcohol abuse, and binge eating.

The bottom line: Stressed-out employees can have significant health and financial consequences for your clients. With the start of open enrollment season just a few short months away, it’s time to start educating your customers about the benefits of incorporating mental health programs, like digital health platforms and meditation, into their corporate wellness plans to mitigate employee stress and improve productivity.

Miller, M. (11 July 2018) "How tech solutions can take aim at employee stress" (Web Blog Post) Retrieved from https://www.employeebenefitadviser.com/opinion/mental-fitness-why-your-corporate-wellness-portfolio-needs-mental-health-solutions


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Improve workplace fitness by focusing on the collective "we"

Do your employees participate in workplace wellness programs? Try involving the collective "we" to increase involvement. Continue reading to learn more.


Workplace wellness programs are implicitly focused on the individual: biometric screenings, individual incentives, gym member reimbursements. This approach can leave employees feeling less than motivated to take part because, even though the programs focus is on the individual, by no means does it make the program personalized.

As workplace wellness programs rapidly improve to meet the expectations of today’s workers, it’s important to remember the value of accountability and what a culture of health can do to create a workplace committed to wellness solutions.

Since wellness programs have traditionally focused on the individual, oftentimes employees never know if their colleagues are participating in any of the programs being offered. Bring it into the light by giving your employees a program they want to talk about, while still keeping it personalized. The collective “we” are not only more likely to try a wellness program, but we are also more likely to stick with it, if we know our peers are also partaking.

The power of sharing with your peers

We all know writing down a goal gives you a much higher chance of achieving it, but research from the Association for Talent Development says someone is 65 percent more likely to achieve a goal if the goal is shared with another person. Why? Because it creates accountability.

We are in the day and age of a social media frenzy, and, it’s cross-generational. We share everything we do and spend a lot of our time concerned with what our friends, family and co-workers are doing through these social platforms. Wellness practitioners can and should be taking advantage of this, especially as you build your culture of health.

To find the right wellness solution for your company or client, look for solutions that are social and easy to use. If the company as a whole has buy-in, or even a few internal advocates, word-of-mouth can be incredibly powerful. Whether that is around the water-cooler at work, on employees’ personal social media channels, or within the work intranet, create opportunities for employees to talk about your program and encourage them to use it. We know when an employee knows a few of their coworkers are planning to attend yoga or kickboxing on a Tuesday evening, they are much more likely to sign up and actually go.

These “wellness relationships” help not only build stronger bonds at work, but they also help you create and maintain healthy habits. You want your employees to engage with your wellness solution, so encourage them to share and become part of the “solution” themselves. At the end of the day, workplace wellness solutions are there to help everyone get healthier and stay that way, but they have to use the program.

More than just an incentive

We have spent at least a decade looking at incentives and how we align them to solve problems with low participation in our wellness program, when we should have focused on building a program that empowers our employees and puts them in the driver’s seat. I’m not suggesting you stop incentivizing your employees, but I do suggest you measure what it is you are rewarding. If it can’t be measured you may as well burn the money you are investing.

Remember, your employees are the real reason your program will sink or swim. Take care of your employees and encourage them to be and find their healthiest selves. Empower them in the process and give them choice in how, when and with who they participate in your wellness program and let them become your wellness solution.

Maurer E. (18 July 2018). "Improving workplace wellness by focusing on the collective 'we'" (Web Blog Post). Retrieved from https://www.benefitspro.com/2018/07/18/improve-workplace-wellness-by-focusing-on-the-coll/.


A vacation can't undo the damage of a stressful work environment

Researchers say employees experience chronic stress during their workday and vacations aren't helping to fix it. Take a look at why a stress free work environment is critical for productivity.


That easy breezy feeling after taking a vacation slips away pretty quickly when people have to face the same systemic workplace issues that wore them down in the first place, according to the American Psychological Association’s 2018 Work and Well-Being survey.

The Harris Poll surveyed 1,512 U.S. adults who were employed either full time, part time or were self-employed, and found that nearly a quarter (24 percent) say the positive effects of vacation time – such as more energy and feeling less stress – disappear immediately upon returning to work. Forty percent say the benefits last only a few days.

“Employers shouldn’t rely on the occasional vacation to offset a stressful work environment,” says David W. Ballard, head of APA’s Center for Organizational Excellence. “Unless they address the organizational factors causing stress and promote ongoing stress management efforts, the benefits of time off can be fleeting. When stress levels spike again shortly after employees return to work, that’s bad for workers and for business.”

More than a third (35 percent) of respondents say they experience chronic stress during their workday, due to low pay (49 percent), lack of opportunity for growth or advancement (46 percent), too heavy of a workload (42 percent) and unrealistic job expectations and long hours (39 percent each).

However, just half say their employer provides the resources necessary to help them meet their mental health needs. When adequate resources are provided, only 33 percent of the respondents say they typically feel tense or stressed out during the workday, compared to 59 percent of those who say their employer doesn’t provide sufficient mental health resources. When it comes to overall well-being, nearly three-fourths of employees supported with mental health resources (73 percent) say their employer helps them develop and maintain a healthy lifestyle, compared to 14 percent who say they don’t have the resources.

“Chronic work stress, insufficient mental health resources, feeling overworked and under supported – these are issues facing too many workers, but it doesn’t have to be this way,” Ballard says. “Psychological research points the way in how employers can adopt effective workplace practices that go a long way in helping their employees thrive and their business grow.”

Even in a very supportive workplace environment, encouraging vacations can boost morale and performance even more, according to the survey. Upon returning from vacation, employees who say their organization’s culture encourages time off were more likely to report having more motivation (71 percent) compared to employees who say their organization doesn’t encourage time off (45 percent). They are also more likely to say they are more productive (73 percent vs. 47 percent) and that their work quality is better (70 percent vs. 46 percent).

Overall, respondents are more likely to say they feel valued by their employer (80 percent vs. 37 percent), that they are satisfied with their job (88 percent vs. 50 percent) and that the organization treats them fairly (88 percent vs. 47 percent). They are similarly more likely to say they would recommend their organization as a good place to work (81 percent vs. 39 percent).

“A supportive culture and supervisor, the availability of adequate paid time off, effective work-life policies and practices, and psychological issues like trust and fairness all play a major role in how employees achieve maximum recharge,” Ballard says. “Much of that message comes from the top, but a culture that supports time off is woven throughout all aspects of the workplace.”

SOURCE:
Kuehner-Hebert, K (13 July 2018) "A vacation can't undo the damage of a stressful work environment" [Web Blog Post]. Retrieved from https://www.benefitspro.com/2018/07/02/a-vacation-cant-undo-the-damage-of-a-stressful-wor/


Quality trumps convenience among employees

Convenience, or quality? Take a look into why researchers are saying quality of a doctors visit outshines convenience when scheduling the next appointment.


Faced with the choice between going to a conveniently located doctor’s office or a more qualified physician, group health plan members are four times more likely to embrace the better-perceived medical professional.

“Traditional metrics like patient ratings, prescribing rates and volume of patients seen were not nearly as compelling to respondents as more qualitative, contextualized statements about a doctor’s clinical expertise,” according to Nate Freese, senior director of data strategy at Grand Rounds, a healthcare service provider for employees in need of local and remote specialty care.

The data is based on a study of 1,100 members covered by Grand Rounds, which is headquartered in San Francisco.

While surprising, Freese says that result depends on the information and messaging that’s provided to employees. Just 14% of respondents based their choice on clinical expertise if they saw traditional physician profiles, whereas it was 69% if they saw contextualized profiles. Contextualized profiles offered more information in complete sentences compared to traditional profiles. These profiles also compared data against other doctors and specialists, such as appointment wait times, expertise and patient satisfaction.

Freese is encouraged by these findings, which were recently presented at the National Healthcare Ratings Summit. “Don’t sell employees short in terms of their ability to appreciate quality and willingness to sacrifice convenience,” he says.

Offering more subjective interpretation of hard quality metrics would be helpful, Freese explains, as long as employers and their advisers are careful not to “overstep what can be reasonably inferred based on available data.”

Another caveat to consider is that finding high quality providers may not be inherently more difficult in narrow networks. Rather, he says, the issue is when health plan members “lack the ability to identify them. And so, it’s more about presenting information in the right way.”

Providing compelling quality information can achieve the same results of a narrow network, he notes. But he hastens to add that even narrow networks must be sufficiently broad enough for members to have a reasonable amount of choice. Geography also plays a role. “You could be in the broadest network, but by virtue of where you live, have reduced choice,” he says.

Michael Hough, executive vice president and U.S. founder of Advance Medical, believes the quality metrics that are currently available are insufficient for several reasons. “We’re looking at things like frequency and whether the outcomes are horrible,” he says. “But just because the outcomes weren’t horrible doesn’t mean they were good, either.” Desired outcomes depend on what’s going on with patients and whether their objectives are being achieved.

The context of care is “extremely important,” Hough explains, noting the importance of relationships between the patient and a trained physician based on human interaction, as well as the delivery of services. Also, while he believes the rise of telemedicine and self-service “is good for many parts of our lives,” Hough cautions that it’s not necessarily true for healthcare because meaningful relationships trump convenience.

SOURCE:
Shutan, B (22 June 2018) "Quality trumps convenience among employees" [Web Blog Post]. Retrieved from https://www.employeebenefitadviser.com/news/quality-trumps-convenience-among-employees?tag=00000151-16d0-def7-a1db-97f0240f0000


Are You And Your Primary Care Doc Ready To Talk About Your DNA?

Knowing your genes could save your life, especially if a genetic mutation is hereditary. See why incorporating DNA testing is a crucial part of your primary care.


If you have a genetic mutation that increases your risk for a treatable medical condition, would you want to know? For many people the answer is yes. But such information is not commonly part of routine primary care.

For patients at Geisinger Health System, that could soon change. Starting in the next month or so, the Pennsylvania-based system will offer DNA sequencing to 1,000 patients, with the goal to eventually extend the offer to all 3 million Geisinger patients.

The test will look for mutations in at least 77 genes that are associated with dozens of medical conditions ranging from heart disease to cancer, as well as variability in how people respond to pharmaceuticals based on heredity.

“We’re giving more precision to the very important decisions that people need to make,” said Dr. David Feinberg, Geisinger’s president and CEO. In the same way that primary care providers currently suggest checking someone’s cholesterol, “we would have that discussion with patients,” he said. “‘It looks like we haven’t done your genome. Why don’t we do that?’”

Some physicians and health policy analysts question whether such genetic information is necessary to provide good primary care — or feasible for many primary care physicians.

The new clinical program builds on a research biobank and genome-sequencing initiative called MyCode that Geisinger started in 2007 to collect and analyze its patients’ DNA. That effort has enrolled more than 200,000 people.

Like MyCode, the new clinical program is based on whole “exome” sequencing, analyzing the roughly 1 percent of the genome that provides instructions for making proteins, where most known disease-causing mutations occur.

Using this analysis, clinicians might be able to tell Geisinger patients that they have a genetic variant associated with Lynch syndrome, for example, which leads to increased risk of colon and other cancers, or familial hypercholesterolemia, which can result in high cholesterol levels and heart disease at a young age. Some people might learn they have increased susceptibility to  malignant hyperthermia, a hereditary mutation that can be fatal since it causes a severe reaction to certain medications used during anesthesia.

Samples of a patient’s blood or spit are used to provide a DNA sample. After analysis, the results are sent to the patient’s primary care doctor.

Before speaking with the patient, the doctor takes a 30-minute online continuing education tutorial to review details about genetic testing and the disorder. Then the patient is informed and invited to meet with the primary care provider, along with a genetic counselor if desired. At that point, doctor and patient can discuss treatment and prevention options, including lifestyle changes like diet and exercise that can reduce the risk of disease.

About 3.5 percent of the people who’ve been tested through Geisinger’s research program had a genetic variant that could result in a medical problem for which clinicians can recommend steps to influence their health, Feinberg said. Only actionable mutations are communicated to patients. Geisinger won’t inform them if they have a variant of the APOE gene that increases their risk for Alzheimer’s disease, for example, because there’s no clinical treatment. (Geisinger is working toward developing a policy for how to handle these results if patients ask for them.)

Wendy Wilson, a Geisinger spokeswoman, said that what they’re doing is very different from direct-to-consumer services like 23andMe, which tests customers’ saliva to determine their genetic risk for several diseases and traits and makes the results available in an online report.

“Geisinger is prescribing DNA sequencing to patients and putting DNA results in electronic health records and actually creating an action plan to prevent that predisposition from occurring. We are preventing disease from happening,” she said.

Geisinger will absorb the estimated $300 to $500 cost of the sequencing test. Insurance companies typically don’t cover DNA sequencing and limit coverage for adult genetic tests for specific mutations, such as those related to the breast cancer susceptibility genes BRCA1 or BRCA2, unless the patient has a family history of the condition or other indications they’re at high risk.

“Most of the medical spending in America is done after people have gotten sick,” said Feinberg. “We think this will decrease spending on a lot of care.”

Some clinicians aren’t so sure. Dr. H. Gilbert Welch is a professor at the Dartmouth Institute for Health Policy and Clinical Practice who has authored books about overdiagnosis and overscreening, including “Less Medicine, More Health.”

He credited Geisinger with carefully targeting the genes in which it looks for actionable mutations instead of taking an all-encompassing approach. He acknowledged that for some conditions, like Lynch syndrome, people with genetic mutations would benefit from being followed closely. But he questioned the value of DNA sequencing to identify other conditions, such as some related to heart disease.

“What are we really going to do differently for those patients?” he asked. “We should all be concerned about heart disease. We should all exercise, we should eat real food.”

Welch said he was also concerned about the cascading effect of expensive and potentially harmful medical treatment when a genetic risk is identified.

“Doctors will feel the pressure to do something: start a medication, order a test, make a referral. You have to be careful. Bad things happen,” he said.

Other clinicians question primary care physicians’ comfort with and time for incorporating DNA sequencing into their practices.

A survey of nearly 500 primary care providers in the New York City area published in Health Affairs this month found that only a third of them had ordered a genetic test, given patients a genetic test result or referred one for genetic counseling in the past year.

Only a quarter of survey respondents said they felt prepared to work with patients who had genetic testing for common diseases or were at high risk for genetic conditions. Just 14 percent reported they were confident they could interpret genetic test results.

“Even though they had training, they felt unprepared to incorporate genomics into their practice,” said Dr. Carol Horowitz, a professor at the Icahn School of Medicine at Mount Sinai in New York, who co-authored the study.

Speaking as a busy primary care practitioner, she questioned the feasibility of adding genomic medicine to regular visits.

“Geisinger is a very well-resourced health system and they’ve made a decision to incorporate that into their practices,” she said. In Harlem, where Horowitz works as an internist, it could be a daunting challenge. “Our plates are already overflowing, and now you’re going to dump a lot more on our plate.”

SOURCE:
Andrews, M (12 June 2018). "Are You And Your Primary Care Doc Ready To Talk About Your DNA?" [Web Blog Post]. Retrieved from https://khn.org/news/are-you-and-your-primary-care-doc-ready-to-talk-about-your-dna/


Employee benefit satisfaction has direct relation to job fulfillment

New reports say that employees would sacrifice pay increases for better benefits. Heres some tips on how to keep your employees satisfied.


A link between the satisfaction workers feel about their benefits — both employment based and voluntary — has a direct relation with retention opportunities for employers.

Eight in 10 employees who ranked their benefits satisfaction as extremely or very high also ranked job satisfaction as extremely or very high, according to Employee Benefit Research Institute’s recent 2017 Health and Workplace Benefits Survey. Additionally, nearly two-thirds of respondents who ranked benefits satisfaction as extremely or very high ranked their morel as excellent or very good.

“It is important for employers to understand that benefits continue to be valued by employees,” says Paul Fronstin, director of the health research and education program at EBRI. “Health insurance, retirement plans, dental, vision and life insurance continue to be highly important when making job change decisions.”

In fact, the survey finds that more than four in 10 respondents say they would forgo a wage increase to receive an increase in their work-life balance benefits, and nearly two in 10 state a preference for more health benefits and lower wages.

Employees continue to indicate benefits play a key role in whether to remain at a job or choose a new job. Since 2013, health insurance consistently remains one of the top benefits that employees consider in assessing a job change.

Last year, 83% say health insurance is very or extremely important in deciding whether to stay in or change jobs. A retirement savings plan is also one of the critical benefits, with 73% indicating it is extremely or very important in determining whether to stay in or switch jobs.

Although employees say they are generally satisfied with the employee benefits provide today, there is a growing concern benefit programs might start to dwindle. When asked, only 19% of respondents say they are extremely confident in what will be provided will be similar to what they have now in three years.

Other challenges remain

“The challenge is how employers can continue to provide the strong employee benefits package that employees want and need, while still controlling the costs of these benefits, particularly healthcare,” Fronstin notes.

Employee education on benefit offerings could use some beefing up. According to the study a little more than one-half (52%) of employees say they understand their health benefits and 43% indicate they understand their non-health benefits very/extremely well.

Some of this limited understanding of benefits may come from the lack — or perceived lack — of benefit educational opportunities that employees are receiving from their employer, according to the study.

Nearly one-third (31%) of employees indicate that their employer or benefits company provides no education or advice on benefits. Only 39% state that their employer provides education on how health insurance works, 24% say that their employer provides education on how a health savings account works, and 28% confirm that their employer offers education on how to invest money in their retirement plan.

In any case, Fronstin adds, “as employers weigh the future of benefits, they should consider that health insurance consistently remains one of the top benefits that employees consider in assessing a job change, with retirement savings plan also viewed as a critical benefit.”

SOURCE:
Otto N (4 June 2018) "Employee benefit satisfaction has direct relation to job fulfillment" [Web Blog Post]. Retrieved from https://www.benefitnews.com/news/employee-benefit-satisfaction-has-direct-relation-to-job-fulfillment