http://www.hreonline.com/HRE/images/CarolHarnett106x106.jpgAt a Healthcare Crossroads

Some employers - those that understand today's health-and-benefits model isn't working -- are beginning to take a new approach, one that goes beyond insurance products and under-utilized programs to offer workers the real-life help they need, right when they need it.

By Carol Harnett

This column marks my fifth anniversary as the benefits columnist for Human Resource Executive ®. Anniversaries are often points of reflection for me and, as I put this 65th edition to bed, I can't help but ponder the past and speculate on the future.

If I took a traditional approach to writing about this hallmark, I'd give you my take on five product-related trends to watch. In fact, that was my original intent. I was going to wax on about the growth of private exchanges and voluntary benefits, the explosion of consumer interest in mindfulness, the ongoing debate around the effectiveness of wellness programs and the allure of wearable devices.

But further consideration made me realize these topics are merely symptoms of causal trends, including the impact of software on consumer-buying patterns and expectations, the possibilities next-generation wearables will bring to benefits design and - most importantly to me - the messy reality of people's lives. I'll focus on the last observation first and then give you a little food for thought on the other trends afterward.

I often draw fodder for my columns from my life experiences, and, in that vein, I received the most reader response from the piece I wrote about my mother's death. While people were sympathetic to my loss, the avalanche of emails, tweets, phone calls and handwritten notes I collected told story after story about the impact caregiving had on people's work and home lives.

Having been immersed in this topic already, it felt like a validation to talk with Alexandra Drane, co-founder of the Eliza Corp. and EngageWithGrace.org, about what she's called "The Unmentionables" - five life obstacles that make employees more vulnerable to certain health conditions and, in turn, spend as much as five times more on healthcare.

What are these life challenges? Well, there's a reason they're called the unmentionables. They are real-life issues that begin with caregiving, financial difficulties and relationship issues, and end with two topics that make employers very uncomfortable: workplace stress and an unhealthy sex life.

Employees' vulnerability to these life stressors are magnified or buffered by two sets of coping factors. Negative coping factors (or magnifiers) are sleep difficulties, substance use and feeling sad or worried. Positive coping factors (or buffers) include strong peer support, a sense of spirituality and exercise. Too many magnifiers coupled with too few buffers makes the best employees more vulnerable to the unmentionables.

How worried should you be about your employees and the unmentionables? The Eliza Corp.'s survey conducted with the Altarum Institute pointed out that 94.4 percent of respondents were experiencing at least one negative life issue.

Drane isn't the only one to cite non-medical causes of employees' self-perception of health and healthcare utilization. Aetna Inc. published a study in August 2012 on the non-medical drivers of disability and found many of the same factors, which the company headlined as the physical, mental, emotional and financial demands of work, childcare and eldercare. And, in 2010, Cigna's review of family medical-leave claims found employees who use FML to care for a family member are 50 percent more likely to eventually submit a behavioral-health-related short-term disability claim.

I believe we're at a crossroads when it comes to our employees. Either we develop solutions and benefits that give them the help they need at the time they need it, or we accept that employee health and productivity will increasingly be challenged. As Drane said in a recent Health 2.0 presentation, "Empathy is [our] single biggest missing ingredient."

There are employers that are taking on this challenge. Shawn Leavitt, senior vice president of global benefits at Comcast, shifted the company's wellness focus to financial health after he noted the debt ratio in many employees' 401(k) plans. Twitter's benefits program manager, James Sumortin Jr., placed an on-site "guru" on the campus so employees can access someone they've come to know and trust easily when problems arise. And Nate Randall, Tesla Motor's senior manager of global benefits and employee experience, makes a concierge available to employees to help with anything they need, including the light-hearted challenge of planning a party.

Other employers are quietly experimenting with providing immediate solutions for employees. I know two employers that either deliver high-quality groceries to people's homes or send a chef to cook a week's worth of meals for employees who are in the throes of caregiving and working. Some Hawaii-based companies provide healthcare professionals who attend physician appointments with employees' parents. As a result, the worker has one less caregiving-related task to perform and also benefits from a health adviser's expertise in navigating the healthcare system.

The good news is it seems we're at the beginning of a new approach in employee benefits; one that goes beyond insurance products and under-utilized employee-assistance programs to immediately assist employees with life issues.

So what else do we need to keep our eyes on? I'll leave you with two relatively new ideas.

In August 2011, Marc Andreesen, co-founder of Netscape as well as the venture capital firm Andreessen-Horowitz, wrote a Wall Street Journal essay entitled Why Software is Eating the World. In the post, Andreesen predicted companies in every industry needed to assume a software revolution was coming. Three years later, the insurance industry may have encountered its first upheaval.

Policy Genius is a web-based, direct-to-consumer platform that sells insurance products. Its twist is a "Got five minutes?" approach that makes the buying process easy, painless and understandable. Consumers who complete the "insurance checkup" have to input some personal information, but the output - a tailored recommendation of insurance products you need and can afford - is worth it.

Today, Policy Genius is in the process of beta testing the platform with small employers (50 to 100 employees). The company is not a group broker, so Policy Genius' emphasis in the pilot is to provide easy-to-understand education about employee benefits. Employee information can be pre-populated, which allows employees to first work through employer-offered benefits, including health, dental and vision coverage. Then the employees can round out their insurance package, if they desire, with access to Policy Genius' individual insurance platform (currently life, long-term disability, pet and renters insurance). Small employers interested in participating in the free open-enrollment pilot can contact the company directly for more information.

Finally, I was recently intrigued with an idea I heard proposed for a novel way to combine wearable devices and their more advanced cousins (an emerging class of wearable computers that adhere to the skin like temporary tattoos or are ingested). Imagine a mobile app that carries a monthly fee (perhaps $30/month) and provides you with advice related to your personal health goals. This app would integrate with your tracking device(s) and understand how you are lining up against your goals. During the course of your subscription period, if you died or were unable to work, you would be paid a benefit - assuming you've been maintaining your health goals. I find it an interesting way to provide a non-insurance product that acts like insurance.

So, there you have it. After five years of thinking and writing about employee benefits, these are some of the underlying trends I'm tracking. I'll be interested to watch as employers test the waters with new approaches to benefits that give employees what they need. And I'm looking forward to what the next five years will bring.

Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.

Oct 21, 2014
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