Helping a Good Employee Who Hits a Rough Patch

Are any of your top performing employees going through a rough patch? Read this blog post from SHRM for helpful tips and factors to consider when employees are going through rough times.


One of our employees, who has been a steady, solid performer the last two years, suddenly erupted in anger at one of our clients during a company event. Granted, the client is difficult and the event had all of us stressed out, but that’s no excuse to lose one’s temper and get into a shouting match. We immediately suspended him without pay.

Since then we’ve learned from coworkers that he’s dealing with stress by drinking. What should we consider as we try to decide whether to fire him or let him come back?

Suspending him without pay while you’re trying to figure out the situation is a good choice. While emotions run high, I always recommend suspending instead of “firing on the spot”. A suspension allows you to carefully choose a decision after learning all the facts, and avoids you having regrets later for having acted too rashly.

Below are some factors to weigh that will help you decide:

Value - You say he’s been there 2 years, which means he’s probably knowledgeable and you’ve made an investment in his training and development. Does this make him a keeper?

History - Is this his first offense or is this a repeat pattern? Is he well respected? or is he perceived as a hot-head? Does he have good relationships with clients and colleagues? Did you expect this or did it appear to come out of the blue?

Help available. If you were to keep him, what’s the level of support you can provide for him getting some help? For instance, does your company have access to an Employee Assistance Program (EAP) that provides therapy or substance abuse treatment? You can make this a condition of employment. In other words, you can allow him to keep his job as long as he agrees to participate in the EAP.

Note: Be careful here if you make a referral, to do so only for a generic EAP assessment and not for a “substance abuse” program, in other words, stay away from labeling or diagnosing him. Let the pros at EAP determine what he needs. His treatment will remain confidential, you’ll only know whether he’s participating.

Kudos for carefully considering your decision. He may simply be a good employee who is going through a rough time and needs some help.

SOURCE: Del Rio, E. (22 April 2019) "Helping a Good Employee Who Hits a Rough Patch" (Web Blog Post). Retrieved from https://blog.shrm.org/blog/helping-a-good-employee-who-hits-a-rough-patch

Originally posted on HR Box.


Workplace Wellness Programs Barely Move The Needle, Study Finds

A recent study from JAMA found that workplace wellness programs do not cut costs for employers, reduce absenteeism or improve workers' health. Read this blog post to learn more about this recent study.


Workplace wellness programs have become an $8 billion industry in the U.S. But a study published Tuesday in JAMA found they don’t cut costs for employers, reduce absenteeism or improve workers’ health.

Most large employers offer some type of wellness program — with growth fueled by incentives in the federal Affordable Care Act.

A host of studies over the years have provided conflicting results about how well they work, with some showing savings and health improvements while others say the efforts fall short.

Many studies, however, faced a number of limitations, such as failing to have a comparison group, or figuring out whether people who sign up for such wellness programs are somehow healthier or more motivated than those who do not.

Now researchers from the University of Chicago and Harvard may have overcome these obstacles with one of the first large-scale studies that is peer-reviewed and employs a more sophisticated trial design.

They randomly assigned 20 BJ’s Wholesale Club outlets to offer a wellness program to all employees, then compared results with 140 stores that did not.

The big-box retailer employed nearly 33,000 workers across all 160 clubs during the test.

After 18 months, it turned out that yes, workers participating in the wellness programs self-reported healthier behavior, such as exercising more or managing their weight better than those not enrolled.

But the efforts did not result in differences in health measures, such as improved blood sugar or glucose levels; how much employers spent on health care; or how often employees missed work, their job performance or how long they stuck around in their jobs.

“The optimistic interpretation is there is no way we can get improvements in health or more efficient spending if we don’t’ first have changes in health behavior,” said one study author, Katherine Baicker, dean of the Harris School of Public Policy at the University of Chicago. (Dr. Zirui Song, an assistant professor of health policy and medicine at Harvard Medical School, was its co-author.)

“But if employers are offering these programs in hopes that health spending and absenteeism will go down, this study should give them pause,” Baicker said.

The study comes amid widespread interest in wellness programs.

The Kaiser Family Foundation’s annual survey of employers found that 53% of small firms and 82% of large firms offer a program in at least one of these areas: smoking cessation, weight management and behavioral or lifestyle change. (Kaiser Health News is an editorially independent program of the foundation.)

Some programs are simple, offering gift cards or other small incentives to fill out a health risk assessment, take a lunch-and-learn class or join a gym or walking group. Others are far more invasive, asking employees to report on a variety of health-related questions and roll up their sleeves for blood tests.

A few employers tie financial incentives to workers actually lowering risk factors, such as high blood pressure or cholesterol — or making concerted efforts to participate in programs that might help them do so over time.

The Affordable Care Act allowed employers to offer financial incentives worth up to 30% of the cost of health insurance, leading some employers to offer what could be hundreds or even thousands of dollars off workers’ deductibles or premiums to get them to participate. That led to court challenges about whether those programs are truly voluntary.

In the study reported in JAMA, the incentives were modest. Participants got small-dollar gift cards for taking wellness courses on topics such as nutrition, exercise, disease management and stress control. Total potential incentives averaged $250. About 35% of eligible employees at the 20 participating sites completed at least one module.

Results from those workers — including attendance and tenure data, their self-reported health assessment and results from lab blood tests — were specifically compared with similar reports from 20 primary comparison sites where workers were not offered the wellness gift cards and classes. Overall employment and health spending data from all worksites were included in the study.

Wellness program vendors said details matter when considering whether efforts will be successful.

Jim Pshock, founder and CEO of Bravo Wellness, said the incentives offered to BJ’s workers might not have been large enough to spur the kinds of big changes needed to affect health outcomes.

Amounts of “of less than $400 generally incentivize things people were going to do anyway. It’s simply too small to get them to do things they weren’t already excited about,” he said.

An accompanying editorial in JAMA noted that “traditional, broad-based programs like the one analyzed by Song and Baicker may lack the necessary intensity, duration, and focus on particular employee segments to generate significant effects over a short time horizon.”

In other words, don’t give up entirely on wellness efforts, but consider “more targeted approaches” that focus on specific workers with higher risks or on “health behaviors [that] may yield larger health and economic benefits,” the editorial suggested.

It could be, the study acknowledges, that 18 months isn’t enough time to track such savings. So, Baicker and Song also plan to publish three-year results once they are finalized.

Still, similar findings were recently reported in another randomized control trial conducted at the University of Illinois, where individuals were randomly selected to be offered wellness programs.

In one interesting point, that study found that wellness-program participants were likely already healthier and more motivated, “thus a primary benefit of these programs to employers may be their potential to attract and retain healthy workers with low medical spending.”

Everyone involved in studying or conducting wellness agrees on one thing: Changing behavior — and getting people motivated to participate at all — can be difficult.

Steven Aldana, CEO of WellSteps, a wellness program vendor, said that for the efforts to be successful they must cut across many areas, from the food served in company cafeterias to including spouses or significant others to help people quit smoking, eat better or exercise more.

“Behavior is more complicated than simply taking a few wellness modules,” said Aldana. “It’s a lifestyle matrix or pattern you have to adopt.”

SOURCE: Appleby, J. (16 April 2019) "Workplace Wellness Programs Barely Move The Needle, Study Finds" (Web Blog Post). Retrieved from https://khn.org/news/workplace-wellness-programs-barely-move-the-needle-study-finds/


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


3 ways anxiety can hold back your employees’ careers

According to the Anxiety and Depression Association of America, nearly six in 10 American workers report anxiety impacts their workplace performance. Continue reading this blog post to learn more about workplace anxiety.


Employers want their employees to grow and succeed at their jobs. Unfortunately, there are a variety of external and psychological obstacles that can stand in the way of employees reaching their full potential. While most workers would like nothing better than to perform well on the job, anxiety can prevent them from doing so.

Anxiety disorders are extremely common: They affect 40 million adults in the U.S. each year, and nearly six in 10 American workers report anxiety impacts their workplace performance, according to the Anxiety and Depression Association of America. A study in the academic journal Anxiety found the economic effects of this mental health condition are huge — costing employers almost $35 billion from lost or reduced productivity in the workplace, the study says. The good news is 80% of employees treated for mental health problems report improvements in their job satisfaction and productivity.

For employers to mitigate the impact anxiety has on their employees, it’s important to understand the form it takes in the workplace. Anxiety often takes shape in various thinking traps that can sabotage an employee’s growth. Three of the most common traps are social comparisons, personalization and overmagnification.

To explore how these thinking traps manifest in the workplace, let’s consider a scenario in which an employee sees a co-worker gets a promotion instead of them.

The social comparison trap. The research is clear that comparing yourself to others is bad for your mental health. However, that doesn’t stop people — especially those with anxiety — from doing just that. A co-worker’s promotion can lead an employee to leap to the conclusion they must be inferior to their colleague. In reality, there’s no way employees can fairly compare themselves to a co-worker. Their experiences, personalities and skills are different. Employees able to avoid that comparison trap might, instead, keep the focus on themselves, evaluating the growth they’ve achieved over the past year and determining how they can continue to improve in the year ahead.

The personalization trap. It’s hard for some employees to recognize not everything is about them. The co-worker who earned the promotion may have gotten the job because they were simply a better fit; that doesn’t diminish the talents and abilities of those who weren’t chosen for the position. Rather than assume the worst of themselves, employees could look at the situation more objectively and recognize that their co-worker may not be better than them, just different.

The overmagnification trap. Blowing things out of proportion is another thinking pattern with a destructive effect. Being passed over for a promotion can expand to a sense of being permanently, hopelessly, bad at one’s job. Instead of being able to parse out the specific reasons why the promotion didn’t go their way, employees who overmagnify convince themselves that they are not only unqualified for the promotion, but they’ll never get a promotion and their career is doomed — so why even try? To keep those overblown feelings at bay, a better approach is to stay focused on the specific and transient nature of what has just happened. Being passed over hurts now, but it won’t hurt forever. Not getting this particular job says nothing about the person’s ability to get other jobs. It may mean that they are missing certain skills or experience, but it doesn’t mean they will always lack them.

Workplace culture and practices can either exacerbate or diminish the self-sabotaging thinking traps that go hand in hand with anxiety. Some effective strategies that can help foster a positive work environment for all employees, but especially those who tend toward anxiety, include:

Create a collaborative workplace. Workplace collaboration helps employees feel valued for their contributions and allows them to see how their skills are important to achieving success for their team or company. It also provides the opportunity to learn from other employees and appreciate what they bring to the table, rather than viewing them as their competition.

Promote transparency. Employees who are kept in the loop, who understand their role, the criteria for what promotions are based on, and understand what they can do to get to the next level are more trusting of their leaders. Be particularly sensitive to what employees may be experiencing during annual performance reviews and make sure to overcommunicate during those times.

Offer tools and services. Providing programs and services to help reduce stress and anxiety can be beneficial for all employees. These can include subsidizing gym memberships, offering yoga classes, encouraging “mind vacation” breaks throughout the day, providing online programs that guide employees through mindful meditations or other well-being exercises.

Model self-care. Employees are more likely to engage in self-care at work if they see their supervisors practicing it, not just encouraging it. If a meditation class is offered in the workplace, employees are more likely to take part if their managers are taking time out of their day to participate as well. Similarly, organization-wide activities, such as a mid-day walk, allow employees to see management promote the message that self-care is a workplace priority.

Given the high number of working Americans with anxiety conditions, easing their anxieties and helping them avoid those thinking traps is good for business. It will improve employees’ overall well-being, workplace satisfaction and professional growth.

SOURCE: Parks, A. (5 March 2019) "3 ways anxiety can hold back your employees’ careers" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/3-ways-anxiety-can-hold-back-your-employees-careers


With the Advent of Remote Work, Is the ‘Sick Day’ Becoming Passé?

With many employees working remotely full time, is the practice of employee sick days becoming out of date? Read this blog post from SHRM to learn more.


Your advertising manager works from home full time. She has a nasty cold. But hey—she only needs to walk a few steps from her bedroom to her desk, can nap when she needs to and won't infect her colleagues. So she doesn't really need to take a sick day, right?

Well, she probably should, but as remote work continues to rise, workplace experts find that those who do their jobs from home are inclined to stay on the clock while soldiering through colds, the flu and other maladies—in part because they don't want to appear to be taking advantage of their work-from-home benefit.

"Remote workers find it hard to integrate work with the rest of their life because it is so easy to overwork and even plow through your work while you are sick," said Jeanne Meister, founding partner of Future Workplace, a New York City-based HR executive network and research firm. "If you are only traveling from your bedroom to your home office, remote workers may rationalize, 'What harm can be done if I work while I am sick? At least I'm not contagious.' "

In addition, the advent of remote working has introduced another trend: managers suggesting that onsite employees work from home when they're sick.

"It's no secret that many [workplaces] have cultures that encourage the 'always-on' mentality," said Erica Denner, head of people and culture at YouEarnedIt/HighGround, an Austin, Texas-based company that focuses on employee recognition, rewards and performance management. "In my experience, I've found that because of this, employees at these organizations can find it difficult to ask for time off when they're sick and are often encouraged to work from home instead."

Circumstances Matter

Thanks to technology that facilitates remote work, there are instances when working during what otherwise would have been a sick day may actually be a win for the employee and employer.

"There are all kinds of reasons to take sick days," said Ellen Galinsky, president of the Families and Work Institute and a senior research advisor for the Society for Human Resource Management. "If employees have a condition that affects their ability to be mobile, like a broken bone or torn tendon, they might have to take a sick day if they work in a traditional workplace because travel to work would be difficult, but they could easily work at home. I can think of other such illnesses, such as having something contagious and not wanting to infect others but feeling good enough to work or being postoperative and being able to work in short spurts. Working at home could be ideal for that."

Consider U.S. Supreme Court Justice Ruth Bader Ginsburg, who recovered from cancer surgery at home but nonetheless heard arguments in a case before the court. A court spokesperson said Ginsburg would participate "on the basis of briefs, filings and transcripts," CNBC reported.

But if working while ill prevents an employee from fully resting and recuperating, this will likely hinder performance—and even future productivity and morale.

"If an employee is really sick, he or she might power through and get a few things done but might not do them well," Galinsky said.

Working through your cold, sore throat or flu not only can lead to a decline in physical well-being but "also can present mental health challenges," Meister said.

Contractors, or so-called gig workers, in particular, may be wary of taking sick time. Lacking job security, they may fear that doing so would make them appear dispensable to their employers.

What Employers Can Do

To discourage employees from avoiding sick days because they're working remotely:

Communicate to employees that you expect them to take time off when they're sick. Or, encourage them to be open about how much work, if any, they feel they can accomplish. "If you can't produce high-quality work, even from the comfort of your own home, when you're under the weather, relay that message to your manager," Denner said. "If they value your contributions and are a good supervisor, they will understand and step in to help until you're feeling better."

At YouEarnedIt/HighGround, workers are asked to make it clear when they are out sick and unavailable. This includes setting up not only the typical out-of-office notification by e-mail but also notifications across productivity platforms the company uses, such as Slack. "It's remarkable how effective turning on the 'out sick' emoji in Slack is in terms of alerting colleagues you need time to recover," Denner said. "When employees are out on a longer-term medical leave, we actually remove their technology access so they can't check e-mails or Slack. This way, the employee doesn't feel guilty or obligated to respond to messages."

Talk about the importance of taking sick days for one's physical and mental well-being. Bring up the topic during all-hands meetings with onsite as well as remote workers. In benefits materials and handouts, address the importance of taking sick days.

Ensure that managers and executives take sick days themselves. When a boss shows up at a meeting sniffling and coughing, she sends the clear message that work is too important to be interrupted by illness. And that only leaves her subordinates feeling guilty if they take sick days.

"We've found that [modeling sick-day behavior] actually goes a long way in not just encouraging our employees to do the same, but also in further solidifying a culture of trust and respect," Denner said.

Encourage remote workers to take time for themselves even when they're healthy—such as taking a midday break—and reinforce how this is important for their well-being and productivity.

SOURCE: Wilkie, D. (6 February 2019) "With the Advent of Remote Work, Is the ‘Sick Day’ Becoming Passé?" (Web Blog Post). Retrieved from https://www.shrm.org/resourcesandtools/hr-topics/employee-relations/pages/remote-workers-and-sick-days-.aspx


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Analytics are key to wellness success. Here’s why

How can benefits managers utilize analytics to maximize their companies’ investments? Continue reading to learn how analytics can help employers optimize their health, wellness and other benefits programs.


What do benefits managers have in common with Walmart? Both have the power to leverage data to create a sustainable competitive advantage.

Like other leading retailers, Walmart mines vast quantities of data and applies predictive analytics to fuel solutions that improve store checkout processes, maximize inventory turnover and optimize product placement. Data analytics also helps the company identify shoppers’ preferences and personalize their shopping experiences. New parents, as identified by prior purchases, might receive digital coupons for infant products, for instance.

Walmart’s data intelligence gives the international retailer the ability to act upon insights quickly. One Halloween, for example, a novelty cookie generated high sales across the United States, but no sales at all in two U.S. stores. The company’s data analytics swiftly ascertained that the cookies were never put on the shelves at those stores. The problem was resolved immediately through high-visibility product placement.

Employee benefits managers have similar opportunities to maximize their companies’ investments. The effective use of disparate data can help employers optimize their health, wellness and other benefits programs, and pinpoint the true value of their total rewards.

A data-driven approach to benefits analytics

Three out of five U.S. employers use health screenings and risk assessments to help employees detect conditions earlier, when treatment might be more effective and costs lower. However, the majority of employers do not measure the impact of these programs.

Those that do assess a program’s impact typically compare the dollars spent on it with the medical claims saved. Forward-thinking benefits managers, however, are examining the total value of investment (VOI) instead. This innovative approach analyzes not only the effect of a wellness initiative on medical costs but also its influence on productivity, absenteeism, disability costs and other factors.

By aggregating and analyzing different types of data — such as claims and non-claims data — benefits managers can determine crucial correlations between preventive screenings, health outcomes and healthcare costs. Thus, they can develop more targeted benefits packages that reduce costs while improving overall employee health and productivity.

Case Study: Implementation of predictive analytics in preventative screenings

One recent initiative undertaken by a state employee health plan demonstrates the power of data analytics to reveal the VOI of preventive cancer screenings.

The state provides medical benefits to around 205,000 employees and dependents. The agency that administers the benefits program wanted to know whether preventive cancer screenings improved health outcomes, and whether the program was cost effective. Analyzing screening and claims data showed that 6% to 8% of those who underwent screenings for breast, colorectal or cervical cancer received a diagnosis of cancer or a related condition. The follow-up and all-important question was: did those members experience different outcomes than members whose cancers were not detected through screenings?

The results indicated a high VOI for members’ preventive cancer screenings:

  • The majority of new cases of breast, colorectal and cervical cancer were detected through preventive screenings.
  • Among members who received preventive screenings, 5% to 11% underwent treatments because of screening results — and not just for cancer. Treatments included removal of benign tumors or polyps.
  • Those diagnosed with breast, colorectal or cervical cancer through the screenings experienced less invasive treatments and had fewer complications than those diagnosed through other means.
  • New cases of breast and cervical cancer diagnosed through the preventive screenings had lower costs, on average, than cases detected through other means.

Positive action through data

This cancer screening example illustrates how data analysis can empower benefits managers to improve employees’ health outcomes while reducing costs. Analytics can help employers invest in more effective care management resources, as well as design benefits packages that provide positive VOI in wellness, screening and preventive care.

With the cost of health benefits continuing to rise, it’s critical to leverage data to determine the total value of wellness investments. Just as retailers use data analytics to improve the retail experience and increase profits, benefits managers should use data analytics to guide the design and evaluation of benefits and other rewards.

SOURCE: Kramer, M. (21 January 2019) "Analytics are key to wellness success. Here’s why" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/analytics-are-key-to-wellness-success-heres-why


It’s peak flu season. Here’s what employers should do now

Employers can expect to see an influx of coughing, sneezing, and germ passing at the office this time of year. Read this blog post to learn what proactive steps employers can take to keep the workplace healthy.


The U.S. is in the height of flu season, which means employers are likely to see an influx of employees coughing, sneezing and spreading germs in the office. Aside from passing a box of tissues, employers may be wondering what they are legally permitted to do when their workers get sick.

One benefit that is becoming increasingly relevant is paid sick leave. Several cities and states — including Arizona, California, Connecticut, Massachusetts, Chicago and others — have paid sick leave laws on the books. But while many companies offer paid sick leave as a benefit, there is no federal paid sick leave law. Paid sick leave laws may remove some incentive for sick workers to report to work, making the illness less likely to spread to the rest of the workforce.

But paid sick leave laws do place limitations on employers. For example, companies cannot make taking a paid sick leave day contingent upon the employee finding someone to cover their shift. Depending on the law, employees don’t always need to give notice of their absence before their shift begins, which could make scheduling difficult. Some laws limit an employer’s ability to ask for a doctor’s note.

Employers do, however, have some latitude when it comes to requiring employees to stay home from work or sending them home if they show signs of illness. Employers just need to be careful not to cross any lines set by the federal Americans with Disabilities Act or a state fair employment statute. This means steering clear of conducting medical examinations or making a disability-related inquiry.

According to the U.S. Equal Employment Opportunity Commission, employers should avoid taking an employee’s temperature. This is considered a medical examination by an employer, which is generally prohibited except in limited circumstances.

They should also avoid asking employees to disclose whether they have a medical condition that could make them especially vulnerable to complications from influenza or other common illnesses. Doing so would likely violate the ADA or state laws, even if the employer is asking with the best of intentions. Employers also cannot require workers to get a flu shot, according to the EEOC.

Employees could have a disability that prevents them from taking the influenza vaccine, which could compel them to disclose an underlying medical condition to their employer to avoid taking the shot. Additionally, some employees may observe religious practices that would prevent them from taking the flu vaccines. Thus, requiring an employee to take a vaccine could lead to a violation of Title VII of the federal Civil Rights Act of 1964 in addition to the ADA.

Beyond these limitations, employers can take these proactive steps to keep the workplace healthy.

Ask employees if they are symptomatic. In determining who should go home or not report to work, employers may ask workers if they are experiencing flu-like symptoms. This would not rise to the level of a medical exam or a disability-related inquiry, according to the EEOC.

Advise workers to go home. Employers can order an employee to go home if they are showing signs of the flu. The EEOC says that advising such workers to go home is not a disability-related action if the illness is like seasonal influenza.

Encourage workers to telecommute as an infection-control strategy. But keep in mind that the company could be establishing a precedent for telecommuting as a reasonable accommodation in other circumstances, such as for an employee recovering from major surgery who cannot come to the workplace.

Encourage flu shots. Employers may encourage — but not require — employees to get flu shots. For example, a company can invite a healthcare professional to the workplace to administer flu shots at a discounted rate or free.

Employers may require its employees to adopt certain infection-control strategies, such as regular hand washing, coughing and sneezing etiquette, proper tissue usage and disposal, and even wearing a mask.

The ADA, Title VII, state fair employment laws and paid sick leave statutes are also incredibly nuanced. Moreover, it’s important to balance the mandates of OSHA, which require employers to maintain a safe working environment. Before taking any significant actions, employers should consult with an employment attorney or HR professional for guidance.

SOURCE: Starkman, J.; Dominguez, R. (4 December 2018) "It’s peak flu season. Here’s what employers should do now" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/its-peak-flu-season-heres-what-employers-should-do-now?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001


Poor employee health costs employers half trillion dollars a year

According to a recent report from the Integrated Benefits Institute, poor employee health costs employers half a trillion dollars each year and almost 1.4 billion in missed work days. Read on to learn more.


Poor employee health is costing employers in a big way — to the tune of half a trillion dollars and nearly 1.4 billion days of missed work each year.

That’s according to a new report from the Integrated Benefits Institute, which finds that employees miss around 893 million days a year from illness and chronic conditions, and another 527 million days because of impaired performance due to those illnesses. Those days add up to $530 billion in lost productivity.

“To put this in further context, the cost of poor health to employers is greater than the combined revenues of Apple, Amazon, Microsoft, Netflix, eBay and Adobe,” says Thomas Parry, president of Integrated Benefits Institute, an independent nonprofit that serves more than 1,250 employers including Amazon, Kroger, McDonald’s and Walmart.

The $530 billion price tag is on top of what employers already spend on healthcare benefits. Employers pay $880 billion in healthcare benefits for their employees and dependents, which means that poor health costs amount to “60 cents for every dollar employers spend on healthcare benefits,” according to the study.

“There’s not a CEO or CFO that can placidly accept their business expending the equivalent of almost two-thirds of their healthcare dollars on lost productivity,” Perry says. “Illness costs this country hundreds of billions of dollars, and we can no longer afford to ignore the health of our workforce.”

Employers invest in healthcare benefits to maintain a productive workforce. But this new study suggests that more needs to be done to keep employees healthy, or strategies need to be put in place to lower spending. Or both.

“It’s critical that employers understand how strategies for managing healthcare spend — such as cost- shifting to employees or ensuring better access and more cost-effective care — can impact the kinds of conditions that drive illness-related lost productivity,” says Brian Gifford, director of research and analytics at IBI.

The study broke down the estimated costs of poor health into several categories:

Wage and benefits (incidental absence due to illness, workers’ compensation and federal family and medical leave): $178 billion.

Impaired performance (attributed to chronic health conditions): $198 billion.

Medical and pharmacy (workers’ compensation, employee group health medical treatments, employee group health pharmacy treatments): $48 billion.

Workers’ compensation other costs (absence due to illness, reduced performance): $25 billion.

Opportunity costs of absence (missed revenues, costs of hiring substitutes, overtime): $82 billion.

For its study, IBI used 2017 data from the U.S. Bureau of Labor Statistics as well as its own benchmarking data from 66,000 U.S. employers.

SOURCE: Paget, S. (20 November 2018) "Poor employee health costs employers half trillion dollars a year" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/poor-employee-health-costs-employers-half-trillion-dollars-a-year?brief=00000152-14a7-d1cc-a5fa-7cffccf00000


HR’s recurring headache: Convincing employees to get a flu shot

According to The National Institute for Occupational Safety and Health, the flu cost U.S. companies billions of dollars in medical fees and lost earnings. Read this blog post to learn how HR departments are convincing their employees to get a flu shot.


Elizabeth Frenzel and her team are the Ford assembly line of flu shots: They can administer about 1,800 flu shots in four hours.

Frenzel is the director of employee health and wellbeing at the University of Texas MD Anderson Cancer Center, and with 20,000 employees, she is no stranger to spearheading large flu shot programs. The center where Frenzel administers flu shots has roughly a 96% employee vaccination rate. Back in 2006, only about 56% of employees got their shots.

“When you run these large clinics, safety is critically important,” she says.

Problems like Frenzel’s are not unique. Every fall, HR departments send mass emails encouraging employees to get vaccinated. The flu affects workforces across the country, costing U.S. companies billions of dollars in medical fees and lost earnings, according toThe National Institute for Occupational Safety and Health. It is not only a cause of absenteeism but a sick employee can put their coworkers at risk. Last year the flu killed roughly 80,000 people, according to the Centers for Disease Control.

Even if an employer offers a flu shot benefit, the push to get employees to sign up for the vaccine can be a two-month slough, with reminder emails going unanswered. Moreover, companies often contend with misconceptions about the shot, such as the popular fallacy that shots will make you sick, running out of the vaccine, and sometimes just plain employee laziness.

In Frenzel’s case, increasing the number of employees who got flu shots weren’t just a good idea, but it was needed to protect the lives of the cancer patients they interact with every day. The most startling fact, she says, was that healthcare workers who interact with patients daily were less likely to get vaccinated.

“So that’s how we started down the path,” she says. “Really targeting these people who had the closest patient contact.”

Frenzel credits the significant increase in employee participation in the flu shot program to several factors. They made the program mandatory — a common move in the healthcare industry — but Frenzel says their improvement also was related to flu shot education. The center made it a priority to explain to staff members exactly why they should get vaccinated. Frenzel made it more convenient, offering the vaccine at different hours of the day, so all employees could fit it into their schedule. They also made it fun, offering stickers for employees to put on their badge once they got a shot. Every year, she says, they pick a new color.

Employers outside of the medical industry are focused on improving their flu shot programs, including Edward Yost, manager of employee relations and development at the Society for Human Resource Management, who helped organize a health fair and flu shot program for 380 employees.

Yost says onsite flu shot programs are more effective than vouchers that allow employees to get vaccinated at a primary care doctor or pharmacy. The more convenient you make the program, he says, the more likely employees will use it.

“There’s no guarantee that those vouchers are going to be used,” he says. “Most people aren’t running out to a Walgreens or a CVS saying, please stab me in the arm.”

Besides the convenience, employees are more likely to sign up for a shot when they see co-workers getting vaccinated, Yost says. If a company decides to offer an onsite program, planning ahead is key. Sometimes employees will not sign up in advance for the vaccine but then decide they want to get one once the vendor arrives onsite. Yost recommends companies order extra vaccines.

“Make sure that you’re building in the expectation that there's going to be at least a handful of folks who are more or less what you call walk-ins in that circumstance,” he says.

Incentivizing employees to get the flu shot is also important, Yost says. Some firms will offer a gym membership or discounted medical premiums if they attend regular checkups and get a biometric screening in addition to a flu shot. He recommends explaining to employees how a vaccine can help reduce the number of sick days they may use.

“Employees need to see that there’s something in it for them,” Yost says. “And quite honestly, being sick is a miserable thing to experience.”

Affiliated Physicians is one of the vendors that can come in and administer flu shots in the office. The company has provided various employers with vaccines for more than 30 years, including SourceMedia, the parent company of Employee Benefit News andEmployee Benefit Adviser. In the past 15 years, Ari Cukier, chief operating officer of the company, says there’s been an increase in the amount of smaller companies signing up for onsite vaccines. HR executives should be aware of the number of employees signing up for vaccinations when scheduling an onsite visit.

“We can’t go onsite for five shots, but 20-25 shots and up, we’ll go,” Cukier says.

Cukier agrees communication between human resources departments and employees is crucial in getting people to sign up for shots. Over the years, he’s noticed that more people tend to sign up for shots based on the severity of the previous flu season.

“Last year, as bad as it was, we have seen a higher participation this year,” he says.

Brett Perkisonassistant professor of occupational medicine at the University of Texas School of Public Health in Houston, says providing a good flu shot program starts from the top down. The company executives, including the CEO and HR executives, should set an example by getting and promoting the shots themselves, he says.

It’s also important to listen to employee concerns. Before implementing a program, if workers are taking issue with the shot, it’s best to hold focus groups to alleviate any worries before the shots are even being administered, he says.

Some employees may even believe misconceptions like the flu shot will make one sick or lead to long-term illnesses, he says. Others may question the effectiveness of the shot. Having open lines of communication with employees to address these concerns will ensure that more will sign up, Perkison says.

Regardless of the type of flu shot program, the most important part is preventing illness, SHRM’s Yost says. While missing work and losing money are important consequences of a flu outbreak, having long-term health issues is even more serious, he says. Plus, no one likes being sick.

“Who’s going to argue about that?” he says.

This article originally appeared in Employee Benefit News.

SOURCE: Hroncich, C (24 October 2018) "HR’s recurring headache: Convincing employees to get a flu shot" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/hrs-recurring-headache-convincing-employees-to-get-a-flu-shot


Taking A Page From Pharma’s Playbook To Fight The Opioid Crisis

From Kaiser Health News, here is the latest: an interview with Dr. Mary Meengs, medical director at the Humboldt Independent Practice Association, on curbing opioid addiction through the reduction of prescription painkillers.


Dr. Mary Meengs remembers the days, a couple of decades ago, when pharmaceutical salespeople would drop into her family practice in Chicago, eager to catch a moment between patients so they could pitch her a new drug.

Now living in Humboldt County, Calif., Meengs is taking a page from the pharmaceutical industry’s playbook with an opposite goal in mind: to reduce the use of prescription painkillers.

Meengs, medical director at the Humboldt Independent Practice Association, is one of 10 California doctors and pharmacists funded by Obama-era federal grants to persuade medical colleagues in Northern California to help curb opioid addiction by altering their prescribing habits.

She committed this past summer to a two-year project consisting of occasional visits to medical providers in California’s most rural areas, where opioid deaths and prescribing rates are high.

“I view it as peer education,” Meengs said. “They don’t have to attend a lecture half an hour away. I’m doing it at [their] convenience.”

This one-on-one, personalized medical education is called “academic detailing” — lifted from the term “pharmaceutical detailing” used by industry salespeople.

Detailing is “like fighting fire with fire,” said Dr. Jerry Avorn, a Harvard Medical School professor who helped develop the concept 38 years ago. “There is some poetic justice in the fact that these programs are using the same kind of marketing approach to disseminate helpful evidence-based information as some [drug] companies were using … to disseminate less helpful and occasionally distorted information.”

Recent lawsuits have alleged that drug companies pushed painkillers too aggressively, laying the groundwork for widespread opioid addiction.

Avorn noted that detailing has also been used to persuade doctors to cut back on unnecessary antibiotics and to discourage the use of expensive Alzheimer’s disease medications that have side effects.

Kaiser Permanente, a large medical system that operates in California, as well as seven other states and Washington, D.C., has used the approach to change the opioid-prescribing methods of its doctors since at least 2013. (Kaiser Health News is not affiliated with Kaiser Permanente.)

In California, detailing is just one of the ways in which state health officials are attempting to curtail opioid addiction. The state is also expanding access to medication-assisted addiction treatment under a different, $90 million grant through the federal 21st Century Cures Act.

The total budget for the detailing project in California is less than $2 million. The state’s Department of Public Health oversees it, but the money comes from the federal Centers for Disease Control and Prevention through a program called “Prevention for States,” which provides funding for 29 states to help combat prescription drug overdoses.

The California doctors and pharmacists who conduct the detailing conversations are focusing on their peers in the three counties hardest hit by opioid addiction: Lake, Shasta and Humboldt.

They arrive armed with binders full of facts and figures from the CDC to help inform their fellow providers about easing patients off prescription painkillers, treating addiction with medication and writing more prescriptions for naloxone, a drug that reverses the toxic effects of an overdose.

“Academic detailing is a sales pitch, an evidence-based … sales pitch,” said Dr. Phillip Coffin, director of substance-use research at San Francisco’s Department of Public Health — the agency hired by the state to train the detailers.

In an earlier effort, Coffin said, his department conducted detailing sessions with 40 San Francisco doctors, who have since increased their prescriptions of naloxone elevenfold.

“One-on-one time with the providers, even if it was just three or four minutes, was hugely beneficial,” Coffin said. He noted that the discussions usually focused on specific patients, which is “way more helpful” than talking generally about prescription practices.

Meengs and her fellow detailers hope to make a dent in the magnitude of addiction in sparsely populated Humboldt County, where the opioid death rate was the second-highest in California last year — almost five times the statewide average. Thirty-three people died of opioid overdoses in Humboldt last year.

One recent afternoon, Meengs paid a visit during the lunch hour to Fortuna Family Medical Group in Fortuna, a town of about 12,000 people in Humboldt County.

“Anybody here ever known somebody, a patient, who passed away from an overdose?” Meengs asked the group — a physician, two nurses and a physician assistant — who gathered around her in the waiting room, which they had temporarily closed to patients.

“I think we all do,” replied the physician, Dr. Ruben Brinckhaus.

Brinckhaus said about half the patients at the practice have a prescription for an opioid, anti-anxiety drug or other controlled substance. Some of them had been introduced to the drugs years ago by other prescribers.

Dr. Ruben Brinckhaus says his small family practice in Fortuna, Calif., has been trying to wean patients off opiates. (Pauline Bartolone/California Healthline)

Meengs’ main goal was to discuss ways in which the Fortuna group could wean its patients off opioids. But she was not there to scold or lecture them. She asked the providers what their challenges were, so she could help them overcome them.

Meengs will keep making office calls until August 2019 in the hope that changes in the prescribing behavior of doctors will eventually help tame the addiction crisis.

“It’s a big ship to turn around,” said Meengs. “It takes time.”

 

Source:
Bartolone P. (14 November 2017). "Taking A Page From Pharma’s Playbook To Fight The Opioid Crisis" [Web blog post]. Retrieved from address https://khn.org/news/taking-a-page-from-pharmas-playbook-to-fight-the-opioid-crisis/

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