Employers can help employees catch some Z's with new wellness benefit
Employers are starting to offer employee benefits that are focused on a long-ignored but crucial aspect of employee health - sleep. Read this blog post to learn more about this new wellness benefit.
Employers are taking a greater interest in employees’ emotional and physical well-being by offering specialized programs focused on mental health, weight loss, financial health, and now one long-ignored yet crucial aspect of health — sleep.
Beddr, a sleep health technology company, has launched a comprehensive, personalized solution to identify and treat the root causes of chronic sleep issues, though a voluntary benefits platform. The program leverages clinical data captured from Beddr’s app that uses an optical sensor and accelerometer to measure blood oxygen levels, stopped breathing events, heart rate, sleep position and time in bed.
About 45% of the world’s population has chronic sleep issues, according to a study in the Journal of Sleep Research. Poor sleep costs U.S. employers an estimated $411 billion each year, according to a report from Rand.
Employees using the Beddr benefit will have access to an expert-led sleep coaching program and a nationwide network of sleep physicians to provide targeted treatment options to help employees improve their sleep health. The program has the potential to save an employer up to $5,700 per employee, per year in productivity improvements, lower healthcare costs and decrease accident rates, Beddr says.
“Sleep is the foundation to every employee’s mental and physical health. High quality sleep has been shown to both reduce healthcare costs as well as improve productivity, but most employers haven’t found a comprehensive program that addresses the primary root causes of sleep issues and that benefits their entire workforce,” says Michael Kisch, CEO of Beddr. “We have seen a dramatic increase among our users relative to the overall population in their understanding of their sleep health and how their choices impact their overall sleep quality.”
Beddr partners with benefits teams to design a customized program specific to each employer and their employees. The company developed a screening process that makes it easy for an employer to engage their employee base, while providing Beddr the ability to identify employees who are a good match for the program.
In some cases, the company heavily subsidizes the cost of the benefit to employees, while in others it is the full responsibility of the employee. In the latter instance, the company negotiates a discount that is passed on to all participating employees. That discounted price is less than what an employee would pay to purchase the program directly from Beddr.
“Beddr was founded on the belief that the most important thing a person can do to improve their physical and mental health is to get consistent, high-quality sleep,” Kisch says. “We see employers as natural partners in fulfilling this mission because the goals of a company and its management are highly aligned with the goals of our program — to improve the health and productivity of employees. ”
SOURCE: Shiavo, A. (23 October 2019) "Employers can help employees catch some Z's with new wellness benefit" (Web Blog Post). Retrieved from https://www.benefitnews.com/news/beddr-app-helps-employees-get-more-sleep
Key elements to consider when researching financial wellness programs
With financial wellness programs becoming a staple employee benefit, organizations find themselves implementing programs that only offer a few tools or resources. Read the following blog post from Employee Benefit Advisor for key elements to consider when researching financial wellness programs.
Financial wellness programs are becoming a staple in the employee benefit universe. But what should a successful financial wellness program encompass? As a rapidly growing industry, we often lack a consistent definition for financial wellness. This leads to organizations believing they have implemented a financial wellness program, when they may only be offering a few tools like education or counseling.
I define financial wellness as the process by which an individual can efficiently and accurately assess their financial posture, identify personal goals, and be motivated to gain the necessary knowledge and resources to create behavioral change. Behavioral change will result in improved emotional and mental well-being, along with short- and long-term financial stability.
As the administrator of your company’s benefits, you are responsible for bringing the best possible solution to your employees. That’s a tough ask, given the growing number of service providers. So, what is the most efficient and effective way to assess financial wellness services to determine which solution best fits your organizational needs? Ask yourself these questions:
Does the platform offer a personal assessment of each employee’s current financial situation and help them identify their financial goals? If the answer is yes: Does the assessment return quantifiable and qualifiable data unique to each individual employee?
Does the platform address 100% of your employee base, including the least sophisticated employees at various levels of employment? Much of your ROI from a financial wellness program does not come from your top performers. It comes from creating behavioral changes within your employees who need the most financial guidance.
Does the platform integrate the various components to provide a personalized roadmap for each employee? It should connect program elements like personal assessments, educational resources, tools, feedback and solutions to ensure the employee is presented with a cohesive, comprehensive plan to attack and improve their financial situation.
Does the platform offer solutions for short-term financial challenges like cash flow issues, as well as long-term financial challenges associated with saving and planning? A major return on your investment comes from reduced employee stress, which is substantially driven by short-term needs versus long-term objectives. The program must help employees deal with current financial challenges before they can focus on their longer-term vision.
About 78% of U.S. workers live paycheck to paycheck to make ends meet, according to data from CareerBuilder.com. The need for financial wellness is clear, but there are consistent pillars that must be addressed in any successful financial wellness program to affect change: spend, save, borrow and plan. When evaluating financial wellness programs, it’s important that these dots all connect if you are truly going to motivate behavioral change and recognize the ROI of a comprehensive financial wellness program.
SOURCE: Kilby, D. (13 September 2019) "Key elements to consider when researching financial wellness programs" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/key-considerations-for-employee-financial-wellness-programs
The case for expanding wellness beyond the physical
Can addressing mental health, financial wellness and substance abuse in the workplace help employees feel fulfilled both personally and professionally? Newly released data shows that employees who have access to wellness programs that address most or all of the five aspects of well-being are more likely to say their job performance is excellent. Read this blog post to learn more about expanding wellness programs.
Client's wellness programs that only focus on physical fitness may need to rethink their approach.
By expanding wellness offerings to include programs that support workers’ mental and financial wellness, employer clients can increase the overall wellbeing of their workforce. Newly released data from Optum and the National Business Group on Health shows that employees who are offered programs that address most or all of the five aspects of wellbeing — physical, mental, financial, social and community — are significantly more likely to say their job performance is excellent, have a positive impression of their employer, and recommend their company as a place to work.
Over the last decade, workplace wellness initiatives have evolved beyond health risk assessments, physical fitness and nutrition programs. Many programs now include resources to address mental health, financial wellness and substance abuse.
“[Employers] must commit to looking beyond clinical health outcomes,” says Chuck Gillespie, CEO of the National Wellness Institute, speaking at a webcast from the International Foundation of Employee Benefit Plans. “You want employees to be fulfilled both personally and professionally.”
Even though some clients address financial, social and community health, most still focus on physical and mental health.
However, there are benefit trends that address wellness beyond physical fitness. The emergence of financial wellness benefits — such as early pay access, student loan assistance and retirement saving plans — may help employees feel less stressed and more financially secure, which has shown to improve overall health.
But having a good wellness program in place isn’t enough — employers also have to make sure that the offerings are inclusive and personalized, and that the programs have successful participation and engagement rates.
“These programs need to be adapted to who you are,” Gillespie says. “Customization has to be a key factor of what you’re looking at, because everybody is not going to fit inside your box.”
Effective wellness programs use both health and wellness data points and best practices, while keeping an eye on developing trends. Multi-dimensional wellness — looking at aspects such as social and community — can help companies understand the needs of their employees better.
“Employers need to better recognize personal choices, and if the employees are in an environment where they are functioning optimally,” Gillespie says. “Smokers hang out with smokers; the cultural foods that you eat with family may not be nutritious; is there social isolation; do you contribute to your community. [Most benefits] are work-oriented, but for most people, their life is their home life. It’s important to look at the degrees of which you feel positive and enthusiastic about your work and life.”
SOURCE: Nedlund, E. (15 August 2019) "The case for expanding wellness beyond the physical" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/the-case-for-expanding-wellness-beyond-the-physical
It’s time to incorporate cancer screenings into your wellness program
The National Cancer Institute reported that newer FDA-approved novel immunotherapies have shown to be beneficial responses to colorectal cancer but can cost upwards of $400,000 per year. This post from Employee Benefit News discusses incorporating cancer screenings into corporate wellness programs.
Scott Wilson, an employee at brewing company Molson Coors in Denver, was diagnosed with stage four metastatic colorectal cancer in 2016 — a disease that would cost him upward of $1.3 million to date, with significant dollars paid out for non-covered medical expenses.
As a consequence of a later-stage diagnosis, colon and liver resections were necessary coupled with aggressive treatment using chemotherapy and Vectobix — a newer and costly immunotherapy that is priced at $8,000 per week. On average, more than 40,000 people undergo treatment for metastatic colorectal cancer each year and the cost of treatment varies depending on the stage at diagnosis, treatment response and plan.
The availability of newer FDA-approved novel immunotherapies have shown to be beneficial responses to this deadly cancer, but at staggering costs that can be upward of $400,000 per year at market introduction, according to the National Cancer Institute.
Today, about 60% of diagnosed colorectal cases are discovered in later stage disease due to under-screening — a third of the eligible population have never been screened or are not up-to-date with screening guidelines. As a result, about 140,000 Americans are diagnosed with any stage of colorectal cancer and about 51,000 people die of this cancer annually. A recent study examined 1,750 colorectal cancer deaths from 2006 to 2012 in the Kaiser Permanente Health System — 76% of those deaths occurred in patients who were never screened or were not up-to-date with screening.
Cancer screening in the workplace
Last year, the American Cancer Society lowered the colorectal cancer screening age to 45 based on the rising rates of cancer trending in younger age populations — other cancer organization’s recommendations remain at age 50. Employers are in a unique position to reinforce and support these national recommendations among their employees.
Employees between 50 and 65 years of age have the lowest screening rates for colorectal cancer screening, and are typically covered by employer-sponsored health plans. Employers find offering cancer screening programs that reward participation via health and wellness programs are reducing disease risk and financial burdens for themselves and their employees.
The costs for treatment of cancer are more than double the rate of other healthcare expenses. For an employer, the impact of a late versus an early stage diagnosis is significant. National expenditures for treatment and care of colorectal cancer are second only to breast cancer.
In people age 65 and younger, the U.S spends in excess of $7.4 billion for treatment of colorectal cancer. For those employees diagnosed with any stage of colorectal cancer, a large percentage of costs are paid out by company-sponsored health plans despite the implementation of high-deductible health plans.
It would seem prudent to institute a screening initiative to find cancer early in your employee populations, or prevent it altogether by supporting screening for preventable cancers. Employees who test positive are referred by their physician for diagnostic colonoscopy to determine if colorectal cancer is present or to remove precancerous polyps or lesions. The intangible costs associated with cancer is the time off of work for treatment and lost productivity.
Most companies administer a wellness program for employees and families, like Molson Coors, but only about 20% offer colorectal cancer screening. Incorporating a blood test as a preventive cancer screening strategy alongside workplace wellness programs can get employees up-to-date with screening recommendations. Employers who are interested in instituting a colorectal cancer screening program in the office should consider the following suggestions.
Incorporate CRC screening into wellness programs. Screenings provide the opportunity to identify risks early and can bridge the gap between doctor office visits for employees who do not see their providers on a regular or annual basis.
Partner with third-party administrators. Third party administration services can ensure HIPAA regulations are followed for privacy. TPAs also will arrange for the delivery of results.
Create communications campaigns. Target your messaging to those eligible for colorectal cancer screening and make sure to cite the correct statistics for benefits and risk.
Reward participation. Participation is shown to increase when incentives are provided to reward participation. Decide what incentives work for your employees – PTO, financial rewards, gym memberships, coupons or gift cards.
Follow up. Plan for next steps based on employee screenings. Results should be provided in a timely manner to enable employees.
Wilson, the Molson Coors employee, remains in remission for nearly 20 months. He’s since devoted his time to advocate for access to colorectal cancer screening, especially in the workplace. Wilson recently joined the Colorectal Cancer Alliance organization as a board member, a non-profit dedicated to reducing the incidence of colorectal cancer through their many efforts aimed at prevention and awareness. He also wrote a book, “Through the Window: A Photographic Tale of Cancer Recovery” for the alliance. Wilson has been an advocate for the vital need for employee access and employer support for CRC screening in the workplace.
SOURCE: Childers, P. (27 June 2019) "It’s time to incorporate cancer screenings into your wellness program" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/add-cancer-screenings-to-wellness-programs
Here’s how to get the best ROI on a wellness program
How many hours do your employees work per year? According to the International Labour Organization, Americans work nearly 500 more hours per year than French workers and 260 more hours per year than British workers. Continue reading to learn how employers can get the best ROI on a wellness program.
U.S. employees are working harder than ever and need more support from their employers as a result.
In fact, according to the International Labour Organization, Americans work 137 more hours per year than Japanese workers, 260 more hours per year than British workers, and nearly 500 more hours per year than French workers.
With that growing burden — along with more individuals of all ages recognizing how important their health is — comes an increased need for companies to invest in well-designed health and wellness programs. Rolling out these programs can lead to better employee morale and engagement, a healthier and more inclusive culture and fewer absences due to illness, according to research — all of which are especially important in today’s fast-paced work atmosphere.
In addition, the rise of social media means that businesses are being held accountable by their employees in a way that was not the case for previous generations. According to the British Standards Institution, employees trusting their employers’ commitments is now an increased focus. Health and well-being are becoming a significant part of that workforce trust agenda.
With these points in mind, it’s important to recognize that your organization needs to make and keep commitments to investing in and executing successful health and wellness programs for your workforce. These programs must keep trust momentum going to ensure healthier and happier workers, and it is proven that happier and healthier workers are more productive. This can lead to overall company success.
For example, a recent employee wellness study from the U.S. Chamber of Commerce showed that effective wellness programs have good return on investment of $1.50 to $3.00 per wellness dollar spent over a two to nine year timeframe. Another study from the Australian-based Black Dog Institute concluded that thriving and healthy workforces typically perform more than two times above average, compared with organizations that do not invest at all in their employees’ health and well-being.
BSI recommends a three-pronged approach for successfully investing in your employees’ health and wellness. First, it’s important to define your health and well-being initiative and what it means for your company. While there are many definitions, BSI recommends considering one that recognizes the need to manage workplace occupational health and safety, in addition to the promotion and support of managing healthy behavior, such as stress management, work-life balance and an ever-changing work environment.
Next, employers should define what their health and wellness program for workers should include. In particular, BSI suggests a good model to follow: the U.S. federal government’s recommended approach for workplace health and well-being programs. Created by the Center for Disease Control’s National Institute for Occupational Safety and Health, the program is called Total Worker Health.
TWH is a holistic approach to occupational health and safety and worker well-being. It recognizes that work has an important function in the social determinants for health and is defined as “policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being.”
However, this program also goes much further than other wellness programs and reflects the nature and challenges of the changing workplace, from new forms of employment to new technologies. It also reflects that non-work-related illness and stress can be adversely impacted by work, can have health and safety implications within the workplace, and the way an organization manages absence and rehabilitation policies can have hugely positive or negative impacts on the individual and the business.
Once you know what health and well-being means to your business and what kind of program your organization wants to execute, it’s time to move forward. For step three, BSI recommends companies review and implement ISO 45001, the new global management system standard on occupational health and safety. This standard has physical, mental and cognitive well-being and health at its core, while continuing to drive high safety standards for companies.
ISO 45001 also recognizes that the most successful and productive organizations take a holistic approach and therefore, good occupational health and safety management can be integrated with employee well-being initiatives. Related to this, holistic employee wellness programs can be used as a recruitment tool. Evidence from WhenIWork.com suggests that employees want their employers to take an active role in their health, so if you can show potential employees that you are invested in their well-being, you will gain an advantage over companies offering only bare-bones benefits.
As a global standard, ISO 45001 also enables a consistent worldwide approach. With its focus on culture and employee participation, it also provides businesses a best practice model for developing an effective health and well-being program. And employee participation will happen. For example, experts from the Johns Hopkins Bloomberg School of Public Health recently analyzed surveys to determine the overall perceptions of wellness programs from employee and employer perspectives. Its data analysis revealed that nearly 60% of employees think employers should attempt to improve the health of their workers.
Overall, seeking accredited certification of the standard not only builds trust within the organization, but also provides external assurance to customers, shareholders and the wider community. Investing in employee health and wellness programs increases healthy behavior and curbs the risk of lifestyle-related disease, leading to happier workers, more productivity and overall company success.
SOURCE: Field, K. (4 June 2019) "Here’s how to get the best ROI on a wellness program: (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/how-to-get-the-best-roi-for-your-wellness-program
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
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
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
How employers can take advantage of the best-kept wellness secret
How can you take advantage of insurance companies’ best-kept secret? Some insurance carries pay wellness dollars to companies who implement wellness programs. Read on to learn more.
Did you know some insurance carriers pay companies to implement wellness programs? It’s called wellness dollars, and it is insurance companies’ best-kept secret.
Wellness dollars are a percentage of a company’s premiums that can be used to cover wellness-related purchases. The healthier employees are, the fewer dollars insurance carriers need to pay out for a policy. Many insurers have incentives like wellness dollars for employers to improve the well-being of their workers.
The benefits of adding a wellness program are plenty. These programs typically generate a positive return on investment for companies. Research done by three Harvard professors found that overall medical costs decline $3.27 for every dollar spent on wellness programs. Costs from absenteeism fall about $2.73 for each dollar. Well-designed programs can improve employees’ overall wellbeing and life satisfaction, according to a report from the U.S. Chamber of Commerce.
It’s a new year, and group health insurance plans are starting fresh. Here’s how employers can take advantage of wellness dollars.
Get in touch with your carrier. The first step is to get in touch with your insurance carrier to find out if your self-insured or fully-insured plan covers participatory or health-contingent programs. If you don’t have wellness dollars, it’s still early in the year, and it’s worth negotiating to see if you can include them in your company’s current package.
You will work with your insurance carrier to determine how your wellness dollars can be spent, based on an agreed-upon contract. The amount of wellness dollars that you receive depends on the number of employees and profitability.
Every company is different, so the range of services varies and could include wellness programs, gym memberships, nutrition programs, massages and more. Sometimes incentives for wellness activities can be used; sometimes it can’t. Ask your carrier for a complete list of covered expenses. This will help you as you shop around to find the right offerings. Save receipts and records for reimbursements.
Determine the best use. There are a few ways to determine what offerings you should use for your company. Before making any decisions, ask your employees and the leadership team what type of program they would be most likely to engage in. Gallup named the five elements that affect business outcomes: purpose, social, community, physical and financial. Look for a comprehensive program that includes these five elements, instead of coordinating with multiple vendors. If only a portion of your expenses will be reimbursed, it’s still worth getting a wellness program. They have cost-savings on an individual and team level.
Wellness programs are all about building culture, and with unemployment at a record low, it’s a sticking point to keep employees invested in your company. A few examples of wellness offerings include fitness classes, preventive screenings, on-site yoga, financial wellness workshops, healthy living educational workshops, and health tracking apps.
Once you’ve implemented wellness offerings in your workplace, keep track of your company’s progress. Create a wellness task force, a healthy workplace social group, or conduct monthly survey check-ins to make sure employees are staying engaged. Some wellness programs utilize technology to track participation, integrate with wearables, and report other analytics. Ask your insurance carrier if wellness dollars have flexibility in adding or changing the services throughout the year, based on engagement.
SOURCE: Cohn, J. (14 February 2019) "How employers can take advantage of the best-kept wellness secret" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-employers-can-take-advantage-of-the-best-kept-wellness-secret