Wellness programs have become more common in the workplace, and the benefits of having these programs make sense. However, they are not being offered everywhere—and even where they are, Canadians are still missing work.
According to a 2010 Statistics Canada study, work time lost for personal reasons averaged approximately 9.1 days per worker, up from an average of 8.0 days just 10 years ago. The numbers are also significant for short- and long-term absences. Disability from all sources accounts for anywhere from 4% to 12% of payroll costs in Canada.
The disconnect between an increase in workplace wellness initiatives and continued high rates of absenteeism and disability can be attributed—at least in part—to how we implement these programs and integrate them with existing functions such as case management. As a result, employers are turning from traditional disability management to workforce management, with an emphasis on prevention and intervention.
A successful approach to effective wellness and disability planning is to think of its development as a group of building blocks. When these blocks are combined, they provide a solid, integrated and focused approach to effective workforce management that addresses wellness and disability at all levels. There are five main building blocks: foundation; prevention; accommodation/mitigation; support for recovery; and integrated supports.
1. Foundation
As with any major business investment, workforce management initiatives should be tied to the organization’s strategic goals. Prevention and intervention strategies are most effective if they target the key issues facing the organization.
Yet, according to Buck Consultants’ 2010 Working Well: A Global Survey of Health Promotion and Workplace Wellness Strategies, fewer than one in four wellness programs in Canada has a strategy with multi-year goals and a documented approach to evaluating results.
Service providers need to work closely with organizations to ensure that claims reports are not just focused on tracking the finances of a benefits program. By identifying trends in the types of drugs or extended health benefits that employees are seeking, the provider can identify an organization’s leading health issues and provide strategic recommendations aimed at improving health and lowering costs.
For example, a provider reported to Bell Aliant Regional Communications that there was a growing trend in the number of claims submitted for diabetes drugs and supplies. This trend prompted the provider, in partnership with Bell Aliant, to implement a targeted awareness campaign for individuals who submitted claims for diabetic medications and supplies. The campaign included an information package on diabetes management, community resources and, more specifically, supports for Bell Aliant employees. An incentive for claimants to purchase cost-effective blood glucose test strips was also included in the package. (Self-monitoring of blood glucose is a common method for people with all types of diabetes to assess their sugar levels.)
Once an employer is aware of a particular trend in its population, it can set a clear goal. In Bell Aliant’s case, the goal was to improve employee health, help plan members better manage their diabetes and manage plan costs associated with this chronic condition.
2. Prevention
Proactively identifying current and potential employee health issues and risks can be a great asset to both employees and the organization. An increase in chronic diseases—such as type 2 diabetes, for example—can result in serious long-term effects. According to 2011 research from the Public Health Agency of Canada, three out of five Canadians older than 20 years of age have a chronic disease, and four out of five people are at risk. However, it doesn’t have to be this way: most chronic diseases are preventable, and early identification of risk factors can help to mitigate future increases in these health conditions.
Health risk assessment (HRA) tools, for example, invite employees to complete a health assessment—usually online—including individual health risk profiles and guidance on how to improve their health. Behind the scenes, providers can present employers with comprehensive aggregate reporting to assist in developing a health strategy and to measure the progress of initiatives over time.
In one case, one organization used an HRA to identify risks for stress and weight gain among its employees. To address these issues, the provider worked with the organization on a strategy that included promotion of health services available through the plan, a focus on personal work/life counselling and targeted workplace wellness seminars. This approach resulted in a decrease in the number of employees considered high risk and an increase in awareness of the available health programs.
3. Accommodation/mitigation
Despite increasing efforts by employers to prevent illness, health-related costs continue to rise. This is one of many areas where case management can add value, enabling employers and service providers to take action in preventing lost work time.
By modifying or adjusting a job and/or work environment for ill or injured employees so that they can keep working, employers can avoid the costly alternatives of hiring and/or training a replacement worker or the decreased productivity if a replacement is not found. Workplace accommodation also works to control costs associated with disability leaves and contributes to overall employee morale. Accommodations can be physical (e.g., adjusting the height of a desk) or administrative (e.g., providing an alternate work schedule).
4. Support for recovery
While three-quarters of workers return to work following an absence of 12 weeks or less, only 20% return after a one-year absence, according to the Treasury Board of Canada Secretariat’s 2011 Managing for Wellness.
There is a clear link between how long employees are off work and their eventual return, making managing short-term absenteeism a key component of reducing the long-term effects on an organization. As a result, employers are looking for solutions to help employees return to work as quickly and safely as possible.
To support this objective, rehabilitation services need to be a strong component of a workforce management solution. Employers can accomplish this by using external rehabilitation consultants to complete initial assessments and then identify specific outcome-focused action plans. Rehabilitation consultants and disability claims specialists need to work collaboratively to regularly assess the progress of the claim and the cost benefit for continued rehabilitation services. This approach helps employees get back to work faster and also helps employers to avoid extended disability claim costs.
5. Integrated supports
Over the long term, a combination of prevention and intervention supports—along with a focused strategy—contributes to effective wellness and disability management.
Integration is important and can be accomplished through a suite of complementary services and programs, including HRAs, employee and family assistance programs, attendance management and additional targeted treatment benefits. These solutions offer diverse outcomes that complement one another to improve awareness and employee well-being, as well as addressing a variety of wellness and HR issues.
While service providers are gaining ground in workforce management, there is still an industry-wide gap in methods to measure success.
Research initiatives such as the Conference Board of Canada’s Making the Business Case for Investments in Workplace Health and Wellness could potentially result in the development of a series of standardized tools and metrics that organizations could use to measure the return on their investment.
Over the past few years, there has also been a growing movement by employers to follow provincial and federal healthcare strategies, such as paying for lower-priced drugs first and turning to more expensive treatments only after less-expensive medications have been tried. Benefits providers can offer similar drug management solutions for private plans, based on a tiered formulary. They can then encourage employers to reinvest the cost savings into prevention and intervention supports, which could ultimately compound the savings over the long term.
The demand for wellness and disability solutions—and for prevention and intervention strategies—will continue. But while employers are beginning to recognize the benefits of integrated wellness management, the challenge lies in implementing, using and evaluating these approaches effectively.
Historically, case management took on a greater role once an employee was off for a period of time. Today, we recognize the importance of placing a stronger focus on these case management initiatives much earlier to reduce the number of days off, ultimately reducing longer-term disability claims and costs. With the right integrated approach to wellness—and the right structure—organizational and employee health is a reachable goal for all employers.
Rebecca Smith is director, case management services, with Medavie Blue Cross.
rebecca.smith@medavie.bluecross.ca
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