Benefits Column

Staying Above the Fray

In an age of incivility, here are some pointers HR and benefit leaders should keep in mind as they attempt to separate the wheat from the chaff as far as benefits, health and wellness are concerned.

Tuesday, October 22, 2013
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Every one of us experiences, at one time or another, incredible life moments -- both personal and professional.

One of my top three work-related days to remember was Nov. 22, 1999. My employer asked me to fly to Washington to host an event on the last day Congress was in session before the holiday break. Our lobbyists had created a thank-you luncheon for Sen. Ted Stevens (R-Alaska) for his work on behalf of elite athletes with disabilities. In addition to recognizing the senator, I was also requested to congratulate the House and Senate members on their resounding support of the Ticket to Work/Work Incentives Improvement Act of 1999.

We held the reception in a Capitol building conference room and the space quickly filled with famous faces I'd previously only seen in the media. Almost immediately, I found myself entwined in a conversation with the guest of honor and Sens. Daniel Inouye (D-Hawaii) and Ted Kennedy (D-Mass.). While I appreciated the long-standing influence these men exerted on Congress, I was captured by the stories and mutual respect shown among three colleagues who often had divergent viewpoints.

The one part of the conversation that stuck with me hovered around concerns expressed by the senators on the decline of Congressional members "reaching across the aisle." All three men are now deceased, but I'm certain they would have been saddened by the behavior of the current 113th Congress, which is on pace to become the least productive in American history.

What does Congress' behavior have to do with employee benefits?

It seems to me that what I classify as incivility is not limited to the Capitol building and its inhabitants. Over the last several years - particularly, the last six months -- acerbic online commentary and intolerance for different points of view is growing among those who provide employee-benefits consulting, products and/or services. This conduct has expanded to the point that long-time industry expert Ron Goetzel felt compelled to present a webinar entitled Wellness Critics Attack! Understanding What is Fact and Fiction.

My concern is this type of comportment makes the jobs of HR executives more difficult than they already are. Not only are you saddled with trying to sift through the challenges associated with the Affordable Care Act, you now must worry about how to separate the wheat from the chaff when it comes to benefits, health and wellness information you read about and presentations you witness.

So, here's my attempt to outline some pointers I consider when thinking through competing opinions around various employee benefits. Please keep in mind that these are my sentiments based upon the research I've read and applied.

·         First, invest in creating a workplace that focuses on trust, pride and camaraderie. As the Great Place to Work Institute emphasizes, great workplaces are built through the day-to-day relationships that employees experience. The key factor in these relationships is trust. And, as David Whitehouse reminded readers in my last column, ". . . whoever wins the trust game [also] wins the health game."

Employees want to trust the people they work for, have pride in what they do and enjoy the people they work with. When you're reviewing your employee-benefits' design, begin with how well they integrate with your company's culture. Also, consider their variety, originality, inclusiveness and degree of human touch.

·         If you need to maintain or reduce healthcare spending, start with your employees' use of hospitals. The long-time mantra in addressing healthcare costs is to keep employees out of emergency rooms, avoid unnecessary hospital admissions and, if an employee or their dependent is admitted, get them out of the hospital as quickly as possible. The third item is as much a safety issue as it is a cost concern. At any given time, about one in 20 patients has a hospital-acquired infection -- and this results in about 100,000 deaths every year.

A growing number of employers and insurance companies are using different strategies to direct employees to the best care, including concierge and travel medicine, the patient-centered medical home and virtual-physician-diagnostic services for minor medical conditions.

·         If your employees leave the workplace due to an illness or injury, call them.

The first lesson I learned when I was working as a clinician with employees who were out of work was the power of a simple telephone call from a manager to the employee. Time and time again, the No. 1 predictor for when and how quickly workers return to their jobs was this simple act of caring.

·         Understand how, why and when to use wellness, prevention and screening programs.

Start by doing no harm. According to the Tufts-New England Medical Center's comparative effectiveness database, fewer than 20 percent of prevention strategies produce cost savings and 10 percent do harm. HR leaders need to make certain they do not promote initiatives that may cause their employees or retirees adverse effects that are worse than not having a test. Two of the best current examples are the promotion of mammograms and PSA testing, especially outside of the recognized guidelines.

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Start any wellness initiative with a focus on acute prevention. Profit centers can be found around acute prevention -- in other words, an intervention, that produces an almost-immediate savings.

If your workforce turns over every three years, you can't focus on chronic-prevention initiatives that may reduce risk 20 years from now. HR executives need to focus on the time window of effectiveness. Acute prevention yields the best ROI when it's focused on challenges such as seasonal-allergy management, and accident and injury prevention. In fact, there's a connection between seasonal allergies and the rate of accidents.

Said even more succinctly, accidents go up during the allergy season. Employees may take a sedating over-the-counter medication such as Benadryl, which can be the equivalent of having three alcoholic beverages. Making certain that workers use non-sedating medications by including them in your pharmacy-benefit formulary is a direct method to cut down on the accident rate.

Use publicly available data to make annual decisions about targeted health and wellness programs.

Flu-shot programs are often brought up as a sure-fire way to achieve a return on investment. There is good data available about flu shots. Employers can make a clean decision about whether to offer a worksite-based program and pretty quickly determine whether the initiative had an impact afterward by following the accident and sickness rates during the flu season.

Don't let healthcare costs and the ACA distract you from other benefits and services your workers desire. Employees generally want more lifestyle-related benefits, such as pet insurance, unlimited paid-time-off (a personal favorite benefit of mine for exempt employees) and discounted child care, as opposed to what the experts say they need -- such as disability insurance. Some corporate cultures even support employee-perk programs and beer available at the workplace.

The focal points I just described are certainly the tip of the iceberg. It's difficult to go through any employee-benefits publication today without also coming across cost-saving ideas such as private exchanges, centers-of-excellence and narrow networks. My advice is to keep in mind that many of these approaches are in the early stages of prototype and experimentation.

In this time of potential incivility as far as employee-benefits discussions are concerned, keep in mind how your decisions will impact your company's culture and your employees' desires for trust, pride and camaraderie in the workplace. Once again, HR executives may lead the way to re-establishing decorum at work.

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.

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