COVID-19 at-home testing kits can make returning to work safer
As many begin to return to the workplace, both employers and employees are fearful of bringing the COVID-19 virus into the workplace. A company has produced an at-home testing kit for those returning to work. Read this blog post to learn more.
While access to wide-spread coronavirus testing is still a barrier for millions of Americans, computer software company Appian is partnering with Everlywell, a digital health company, to offer COVID-19 at-home testing kits for employees returning to the workplace.
“Everlywell was founded to give people access to high-quality lab tests that can be taken at home,” said Julia Cheek, founder and CEO of Everlywell. “We are proud to support Appian’s customers in providing FDA-authorized COVID-19 testing to help keep them safe.”
Since March, more than 50 million coronavirus tests have been reported to the CDC, of which 5 million were positive. But as states reopen their economies and infection rates increase, there are growing concerns about supply chain problems, according to Politico. Reopening has increased demand for testing, causing samples to pile up faster than labs can analyze them, which is lengthening turnaround times for results — complicating efforts to contain the virus.
Everlywell’s at-home lab tests seek to streamline the process of testing for their employer clients. The COVID-19 test will be integrated within the Appian Workforce Safety solution. Through the partnership, people using Appian’s return-to-site solutions will be able to request home delivery of Everlywell’s COVID-19 testing kit by taking a screening questionnaire based on CDC guidelines. Each test request will be reviewed by an independent physician from Everlywell’s third-party telehealth partner. Test results can be delivered to the test-taker’s mobile device in 24-48 hours after the sample arrives at an authorized lab.
The lab tests have received emergency use authorization from the Food and Drug Administration. The testing used by the company and its lab partners meet the FDA’s performance criteria for COVID-19 test accuracy, and telehealth consultations are included for those who test positive.
“How much you know as an organization is how much you can protect the members of your organization,” says Matt Calkins, CEO of Appian. “This is the fastest way to get information on infection. We've seen that high amounts of testing can help minimize COVID-19. Knowledge is power, so we're trying to get [employers] as much knowledge as possible, as quickly as possible, and provide them with another tool to keep their employees safe.”
As employers make their strategies for returning to work, workplace safety is of top concern. Antibody screening, thermal cameras and on-site nurses are all methods being considered to help employees stay safe. Digital health is playing a major role in helping employees self-report their risks, whether that be the employee taking the subway, or living with someone who’s immunosuppressed. It can also help employers scalably monitor and assess people's symptoms on a daily basis, ensuring that sick employees stay at home and quarantine. Workplace changes may also include desks and workstations being spread further apart, and stricter limitations on large meetings and gatherings in the office.
Appian’s platform helps employers centralize and automate all the key components needed for safe returns to work. Through the platform, employers can process health screenings, return-to-site authorizations, contact tracing, isolation processing, and now, COVID-19 testing.
“A lot of people would rather work with an employer who goes the extra mile, who’s willing to offer and pay for tests if necessary for their own employees, and to quickly deploy it, where there’s even a suspicion of transmission,” Calkins says. “It’s a responsible gesture and a serious signal that the employer cares about the health of their workforce, and employees are reassured that their colleagues are more likely to be healthy.”
SOURCE: Nedlund, E. (30 July 2020) "COVID-19 at-home testing kits can make returning to work safer" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/covid-19-at-home-testing-kits-can-make-returning-to-work-safer
Giving onsite clinics an engagement booster shot
In efforts to reduce healthcare spend and increase the population's health, many employers are offering a variety of employee wellness services and programs. Read this blog post to learn more about increasing engagement in onsite clinics.
Employers of all sizes and industries are currently offering a variety of wellness services that include preventive, acute, primary, chronic disease and occupational healthcare programs at or near the worksite. These benefits are intended to reduce healthcare spend, increase the population’s health and productivity and positively impact recruitment and retention efforts.
In fact, according to two 2018 studies by the National Association of Worksite Health Centers, more than one-third of all employers and close to 50% of large firms are now operating worksite clinics. But just because employers offer such benefits doesn’t mean employees will take advantage of these services, even when they’re free.
But many employers are frustrated to find that 20% or less of the targeted or covered workers utilizes their programs — with millions of dollars in benefits wasted.
Failure can be caused by lack of promotion, inadequate incentives, poor communications or providers who don’t fit into the culture of the employer. However, one of the most significant problems than can undermine a benefit program, especially a worksite clinic, is when employees don’t trust that their personal health data will be confidential and fear it will be used for employment decisions.
Employers who achieve high benefit utilization build the foundation for success by informing their workforce, prior to a benefit or clinic being available and on an ongoing basis, of the many federal and state confidentiality and privacy laws that dictate who can receive personal and occupational health information and the limitations placed on employers.
Communications, posters, presentations and other marketing vehicles must assure employees that the employer will only see aggregate, not personal data from the offered benefit programs. Emphasize that the program’s or clinic’s medical providers will be the only individuals dealing with this information, and that by law they are legally and ethically obligated to keep this confidential.
Understanding the culture and labor-management dynamics of an organization are also critical to building trust. To increase use, it’s often best to market the program or facility under a new brand name, such as “The Healthy Life” or use the name of the provider who manages the program or clinic, rather than the employer’s name.
The physical design or location of a benefit program or clinic also needs to be kept in mind. Clinical or counseling activities should be separate from business offices or fitness centers where a person taking advantage of the benefit could be seen by their peers, managers and supervisors.
Achieving engagement in a health benefit program or clinic is key to its success, as well as obtaining the resources and support of senior management for its expansion and continuance. The design, marketing and location of benefit programs need to be well-planned so the workforce is confident that the confidentiality of their patient records will be maintained and not used for employment decisions.
SOURCE: Boress, L. (9 July 2019) "Giving onsite clinics an engagement booster shot" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-to-increase-employee-engagement-in-healthcare-benefits
Creating an ‘urgent care first’ mindset for employee benefits
With urgent cares continuing to pop up everywhere, it’s important to guide your employees in adopting an "urgent care first" mentality. Continue reading this blog post to learn more.
Urgent care centers are popping up everywhere, which means getting quick healthcare is easier and more convenient for patients. But these centers could also help employers minimize expensive emergency room claims. That’s why it’s important to guide employees to adopt an “urgent care first” mentality.
The concept of urgent care has been around since the 1970s, but rising healthcare costs, especially for ER care, have spurred an increase in centers across the U.S. over the last decade. In fact, from 2014 through June 2017, the number of urgent care centers rose by nearly 20%.
Urgent care centers provide care for health problems that aren’t life-threatening, but can’t wait for an appointment with a primary care provider. No one wants to suffer with a sore throat all weekend. Many urgent care centers are staffed with doctors and nurses, and provide more advanced capabilities than what’s typically available at a primary care doctor’s office. For example, some urgent care centers give stitches, provide X-rays and even MRIs.
Patients can also get treatment at urgent care for conditions they’d typically see a primary care doctor for, such as the flu or a fever, mild to moderate asthma, skin rashes, sprains and strains, and a severe sore throat or cough — illnesses that produce unnecessary high claims if treated in an ER.
Still, when a severe sore throat and high fever strike on a weekend and the doctor’s office is closed, employees may gravitate to the ER because they’re sick and need help right now. That’s where the urgent care first mindset becomes good medicine. It typically costs the employer (and often the employee) far less if that sore throat is treated in an urgent care facility.
The high cost of ER care is enough to make anyone run a high temp. From 2009 to 2016 (the most recent data available), the average amount that hospitals billed insurance carriers for an emergency room visit more than doubled, from $600 to $1,322. By contrast, urgent care typically costs about $150 per visit. Members often pay a lower copay for urgent care visits, too.
The urgent care first mindset is starting to take hold. New data analysis from Aetna shows that as urgent care centers began to proliferate, ER visits for minor health issues dropped 36%, while the use of urgent care and other non-emergency health settings increased 140%.
However, the same study shows that plans only saw a decrease in ER visits if there were several urgent care centers in the geographic region where their employees lived. Awareness is key.
Fostering an urgent care first mentality
Employers can’t just include urgent care in a benefits plan and expect employees to use it. They need to design the plan to encourage use and follow up with plenty of education.
Education about the benefits of primary care versus urgent care versus the ER should take place during open enrollment and throughout the plan year so members understand the medical necessity and financial implications of each option. Including the closest urgent care centers to employees, as well as a list of services they provide, can help encourage them to adopt an urgent care first mentality.
A word of caution: not every nearby urgent care center is actually in-network. It literally pays for employees to keep a list of nearby in-network centers handy when that inevitable weekend sore throat strikes.
Reminders about urgent care before spring allergies, summer vacations, fall school physicals and flu season can also help encourage their use.
The too-low ER copay
Plan design is another important piece of the puzzle to help steer employees to the right level of care for their needs. It’s not that unusual to see a $100 copay for an emergency department visit. While no one wants to discourage ER visits for true emergencies, it makes sense to adjust the plan design to encourage primary and urgent care visits instead. That may mean a $20 copay for primary care, a $40 copay for urgent care and a $200 to $250 copay for ER visits — which is waived if the plan participant is admitted to the hospital.
For high-deductible health plans paired with a health savings account, the savings can be even more drastic; patients may pay $200 for an urgent care visit versus $1,200 for an ER visit.
The combination of education and plan design can help curb unnecessary ER visits, which could help employers control healthcare increases from plan year to plan year. For health issues that crop up during off hours, the urgent care first mindset is good for both employers and employees, who will ultimately save time and money.
SOURCE: O'Conner, P. (5 July 2019) "Creating an ‘urgent care first’ mindset for employee benefits" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/creating-an-urgent-care-first-mindset-for-employees
Getting employees up to speed with health literacy
Do your employees know how much sugar is in a granola bar or how much radiation is in a CT scan? If not, it's most likely because no one is teaching them. Continue reading to learn more on getting your employees up to speed with health literacy.
Your employees probably don’t know how much sugar is in a granola bar or how much radiation is in a CT scan. They may not even know how to reach your employee assistance program.
That’s because no one is teaching them. Which is what happens when wellness program education ends at eat more fruits and vegetables and avoid added sugar.
Sometimes the advice is even wrong. For example, below is a clipping from a popular health risk assessment. Focus on the lower right quadrant.
It isn’t entirely true that low-fat and nonfat dairy is healthier. In fact, full fat dairy does have health benefits, for example some studies suggest it could help protect against diabetes. By comparison, low-fat or nonfat yogurt could be a significant source of sugar.
This is why employee health literacy is so important. With easy access to mis-information, employees need to learn to sift through the noise to determine what is actually good for them.
Plus, there is plenty to learn. Spanning from everyday health, employee medical education and health benefits literacy. I’ve outlined just a few of the ways to employers can better educate their population.
Everyday health education
Sugar is one place where health education could be more impactful — but it should go beyond just telling workers to avoid added sugars. Education starts at work. Chances are your break room is stocked with granola bars, maybe Clif Bars. The first ingredient in a Clif Bar is organic brown rice syrup. That may sound healthy, but it’s really just sugar. In fact, there are almost 60 different sugars disguised with fancy names like turbinado or malted barley extract.
Another example is sleep. We all want employees to get enough of it, but do they know how? They may not know little bits of information that could help them get more shuteye, like there is a night shift setting on their iPhone or that energy-efficient light bulbs contribute to insomnia.
But teaching everyday health is just the beginning of health literacy. The real impact comes with employee medical education.
Employee medical education
U.S. consumers are voracious purchasers of healthcare services and yet our outcomes remain poor. Americans have about 240 CT scans per 1,000 people. To put that in perspective, only about 1 in 1,000 covered people in your employee population was hospitalized for diabetes last year. So 240 times more employees are getting scans than uncontrolled diabetes.
CT scans have risks. They have about 500 times the radiation of an x-ray and are especially concerning for children because their cells are dividing more rapidly than adults and are more sensitive to radiation exposure. The dye used intravenously also carries a risk.
But many employees don’t know about these risks. So it may be important to educate your workforce about these common medical procedures and how to decide whether or not it is right for them.
Health benefit education
Here’s a wild guess: your employees don’t appreciate the health benefits you provide for them. If so, you’ve got company. Most large organizations face the same issue.
Consider the employee assistance program. Do workers know you offer one? Do they know it’s confidential? They know their emails aren’t confidential, so don’t assume they know this. Do they know the URL, username and password? How many free sessions do they get?
Repeat a similar set of questions for all your benefits. You can’t expect that some memos and a website will implant your benefits firmly in their mind.
SOURCE: Lewis, A. (25 April 2019) "Getting employees up to speed with health literacy" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/educating-employees-through-health-literacy
Digital health revolution: What we’ve learned so far
Digital health devices provide personalized feedback to users, helping improve their health. Continue reading this blog post to learn more about the evolving digital health revolution.
The promise of the digital health revolution is tantalizing: a multitude of connected devices providing personalized feedback to help people improve their health. Yet, some recent studies have called into question the effectiveness of these resources.
While still evolving, many compelling use-cases are starting to emerge for digital health, including a set of best practices that can help guide the maturation of this emerging field. In the near future, many people may gain access to individual health records, a modern medical record that curates information from multiple sources, including electronic health records, pharmacies and medical claims, to help support physicians in care delivery through data sharing and evidence-based guidelines.
As these advances become a reality, here are several digital health strategies employers, employees and healthcare innovators should consider.
Micro-behavior change.
Part of the power of digital health is the ability to provide people with actionable information about their health status and behavior patterns. As part of that, some of the most successful digital health programs are demonstrating an ability to encourage daily “micro-behavior change” that, over time, may contribute to improved health outcomes and lower costs. For instance, wearable device walking programs can remind people to move consistently throughout the day, while offering objective metrics showcasing actual activity patterns and, ideally, reinforcing positive habits to support sustained change. Technology that encourages seemingly small healthy habits — each day — can eventually translate to meaningful improvements.
Clinical interventions.
Big data is a buzz word often associated with digital health, but the use of analytics and technology is only meaningful as part of a holistic approach to care. Through programs that incorporate clinical intervention and support by care providers, the true value of digital health can be unlocked to help make meaningful differences in people’s well-being. For instance, new programs are featuring connected asthma inhalers that use wirelessly enabled sensors to track adherence rates, including frequency and dosage, and relay that information to healthcare professionals. Armed with this tangible data, care providers can counsel patients more effectively on following recommended treatments. Rather than simply giving consumers the latest technologies and sending them along, these innovations can be most effective when integrated with a holistic care plan.
Real-time information.
One key advantage of digital resources, such as apps or websites, is the ability to provide real-time information, both to consumers and healthcare professionals. This can help improve how physicians treat people, enabling for more customized recommendations based on personal health histories and a patient’s specific health plan. For instance, new apps are enabling physicians to know which medications are covered by a person’s health plan and recommend lower-cost alternatives (if available) before the patient actually leaves the office. The ability to access real-time information — and act on it — can be crucial in the effort to use technology to empower healthcare providers and patients.
Financial incentives.
Nearly everyone wants to be healthy, but sometimes people need a nudge to take that first step toward wellness. To help drive that engagement, the use of financial incentives is becoming more widespread by employers and health plans, with targeted and structured rewards proving most effective. From using mobile apps and comparison shopping for healthcare services to encouraging expectant women to use a website to follow recommended prenatal and post-partum appointments, financial incentives can range from nominal amounts (such as gift cards) to hundreds of dollars per year. Coupling digital health resources with financial rewards can be an important step in getting — and keeping — people engaged.
The digital health market will continue to grow, with some studies estimating that the industry will exceed $379 billion by 2024. To make the most of these resources, healthcare innovators will be well served to take note of these initial concepts.
SOURCE: Madsen, R. (14 March 2019) "Digital health revolution: What we’ve learned so far" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/digital-health-revolution-what-weve-learned-so-far?brief=00000152-14a5-d1cc-a5fa-7cff48fe0001
4 questions to ask before adding biometric screenings
According to the Kaiser Family Foundation (KFF), fifty-two percent of large firms that provide employee health benefits offer workers the opportunity to complete a biometric screening. Continue reading this blog post to learn more.
A growing number of employers are adopting workplace wellness programs to improve employee health and subsequently lower their health insurance spend. As they do, benefit managers are tasked with vetting options that will deliver meaningful health and financial results for their companies.
This vetting process typically involves answering questions that range from which types of participation incentives their organization should offer to what type of wellness programs will yield the greatest health-improvement outcomes.
But there’s a problem: Very few benefits managers ask for details about wellness biometric testing, even though most programs are, at least in theory, designed around the information that screening provides. Biometric screening typically involves one or more laboratory tests as well as physical readings, such as blood pressure and body weight, to identify markers of health risks if not an actual disease.
According to the Kaiser Family Foundation, 52% of large firms that provide employee health benefits offer workers the opportunity to complete a biometric screening.
Just as workplace wellness programs are not all the same, biometric screening can vary. Failure to question the specific details of a proposed biometric screening program can lead to suboptimal results.
Before moving forward with biometric screenings as part of a workplace wellness program, benefit managers should pause to ask themselves certain questions. Doing so will enhance the likelihood of favorable outcomes — both for employee wellness and the financial bottom line.
1. Why should we screen?
It sounds simple, but setting clear goals for biometric screening is a step too many benefits managers overlook. This may be because they do not know how to anticipate the kind of actions that will be available to them and their employees given the results.
Based on my experience, the most compelling reason to provide biometric screening as part of a wellness program is to help individuals identify risks for several chronic conditions that, if caught early, may be prevented. With insights from a biometric screening, an individual may be better able to take steps to reduce health risks. Common goals may be to reduce body weight, exercise more or visit a physician for treatment.
Biometric screening often can reveal disease risks an individual may not otherwise know. A study published in the peer-reviewed journal PLoS ONE, for instance, found that one in three first-time participants in a company-sponsored, lab-based wellness program by Quest Diagnostics were not aware they were at risk for a serious medical condition, such as diabetes or heart disease, according to biometric screening results. Many of these individuals were in a health plan, suggesting that healthcare access alone does not guarantee preventive care to identify risk for common chronic health conditions.
Biometric screening also can help an employer identify programs to target at-risk employee segments based on the type of risk with appropriate interventions. Reliable insight into disease risks for a workforce population may also aid the prediction of future healthcare costs.
2. What should we screen for?
Ideally, biometric screening should provide enough information into disease risks for both individuals and the employer in order to take meaningful actions. Here, many employers miss the mark by implementing bare bones biometric screening options. The result is potentially misleading results — and missed opportunities to identify individuals at risk.
Take diabetes screening, for instance. A non-fasting fingerstick glucose screening really doesn’t tell us anything considering the variety of food individuals might have eaten, and how that may have affected their measurement.
A fasting fingerstick glucose test may help identify diabetes risk in some individuals and be less costly to perform than a hemoglobin A1c test, which involves a venipuncture blood draw. However, a study from Quest Diagnostics found that some individuals in a workforce population with normal fasting glucose results were still at higher risk for diabetes, and a glycated hemoglobin (HbA1c) test identified them.
In a similar manner, many employers overlook screening for chronic kidney disease, one of the major causes of kidney transplantation. Eighty-nine percent of participants identified as at risk for chronic kidney disease did not know it, according to the aforementioned PLoS ONE study. The estimated glomerular filtration rate (eGFR) lab test can help identify this condition very cost-effectively, but it’s often absent in biometric screening programs. Other conditions that laboratory tests can help identify include metabolic disorders, thyroid disease, and colorectal cancer, among others.
3. How often should we screen?
Annual biometric screening reinforces the importance of management places on employee wellness. It can also help identify health risks in individuals who are new to the organization. An annual program also provides a regular cadence of engagement that is not too onerous on employees while minimizing the confusion that can occur when screening happens less frequently.
Annual screening has an added benefit of allowing the employee to track her progress over time. Quest provides graphic charts that show changes in an individual’s numbers year over year. This is a powerful motivator for those who have adopted healthful behaviors to stay the course. And longitudinal changes also can reveal patterns, like modest annual weight gain, that the individual may otherwise dismiss until they see the cumulative effect.
4. How can we connect employees to care and intervention?
Screening is just one facet of a successful wellness program. Some individuals who identify health risks may proactively modify their behavior or consult a physician. But not all will. Employers can improve the odds of at-risk employees accessing the care they need following biometric screening.
Most employees in biometric programs receive a personalized report of their screening results. Additionally, many participants can consult over the phone with a third-party administered physician.
At Quest, for instance, we offer programs that help at-risk employees access behavioral change programs. If an individual’s screening results suggest evidence of prediabetes, that employee may participate free of charge in a 16-week, CDC-based diabetes prevention program that includes coaching and lifestyle modification. An individual with a problematic cholesterol result may be able to access a similar program for heart disease prevention.
Biometric screenings can be a powerful facet of an employee wellness program. Understanding the reasons to screen, which methods to use and how often to use them, and the paths to connect employees to care are key. Benefit managers who do this well will be rewarded with a wellness program that results in healthier employees and lower healthcare costs over time.
SOURCE: Goldberg, S. (21 February 2019) "4 questions to ask before adding biometric screenings" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/4-questions-to-ask-before-adding-biometric-screenings