How to keep sickness away from your vacation

With the school year over and warm weather here, vacation season is coming. Whether you’re seeing new places or revisiting a familiar favorite, disconnecting from work and spending time with friends and family allows most people to come back to work feeling fresher and more productive.

And it’s important to take that time. According to a 2016 Harvard Business Review article, a U.S. Travel Association study found that 95 percent of people surveyed claimed using their paid time off was very important. And yet more than half of Americans (55 percent) left vacation days unused, which equates to 658 million unused vacation days.

But even if you take your vacation, what happens if you spend the time sick?

Smart Business spoke with Melinda L. Schriver, senior director of Telehealth Strategic Solutions at UPMC Health Plan, about staying healthy on your vacation.

How can people avoid getting sick on vacation time?

No one wants to get sick during vacation, but it happens. Here’s what you need to know to prevent or minimize the impact of a medical issue on your precious time off:

  • If you take medication, make sure to bring enough to last the entire trip. Pack medications in your purse or carry-on bag; do not put them in checked luggage.
  • If any of your medications are controlled or injectable substances, carry a letter from the prescribing physician on official letterhead.
  • If you wear glasses, pack a spare pair. You may also want to take a copy of the lens prescription just in case.
  • Pack a travel health kit that includes pain relief, such as ibuprofen or naproxen, Band-Aids, antiseptic cream, and drugs for an upset stomach and motion sickness. For international travel, research what you should and should not eat and drink. You may need to stick to bottled water and avoid foods that haven’t been cooked or peeled.
  • Don’t forget sunscreen (with an SPF of at least 30) and insect repellant (if you’ll need them).
  • To prevent catching a cold while airborne, bring your own disinfecting wipes and wipe off the tray and armrests. Wash your hands often and stay hydrated. Get up and move around every hour or two.
  • If you’re driving to your destination, make sure you’re well rested. According to the National Highway Traffic Safety Commission, driving while drowsy is a contributing factor in 72,000 accidents annually. Switch drivers, if possible, every few hours.

How does the stress of getting ready impact your immune system?

If you worked late hours tying up loose ends before a trip, that stress can shift your immune system into high gear. Once your stress levels drop, your immune system may also downshift and leave you exposed to pathogens. Try to keep everything in perspective. A recent University of Chicago study found that people experienced similar levels of enjoyment on their vacation regardless of whether they completed all their work first.

What if you do get sick?

Food poisoning, sunburn and sinus infections can happen despite the most careful planning. If someone you’re traveling with needs treatment for a nonemergency medical condition, telemedicine providers can address some of the most common issues through a virtual visit via smartphone, tablet or computer. Providers can even prescribe medicine when necessary. Plus, telemedicine services mean you won’t waste time trying to find an urgent care clinic or an emergency room when you’re in unfamiliar surroundings.

Many insurance companies cover telemedicine. The cost is often less than an urgent care or emergency room visit. Be sure to find out the details of your plan’s coverage before you go. For example, UPMC Health Plan covers its members when traveling through nationwide virtual urgent care visits, a large national urgent care network, a robust extended network, emergency care coverage and a growing telemedicine program.

Insights Health Care is brought to you by UPMC Health Plan

Integrating utilization and case management for optimal results

Medical management programs are typically comprised of multiple services designed to help control health care costs and ensure optimal health outcomes for employees.

“While these sorts of programs can be used individually, they are really intended to work together to provide an integrated approach to managing an employee’s total health,” says Amy Cleveland, HealthLink director of Medical Management.

Employers who don’t have a complete understanding of medical management programs may be missing out on the many advantages of an integrated approach by “carving out” or removing certain programs and services.

“When employers leave even one medical management service out of their plan, the program does not work as intended, which can put the good health of their employees and their spending at risk,” Cleveland says.

Smart Business spoke with Cleveland about integrating medical management.

What is utilization management?

Utilization management (UM) consists of multiple programs designed to encourage appropriate use and performance of medical services in accordance with evidence-based guidelines. Typically, UM consists of pre-certification reviews for hospital admissions, certain medications and high-tech imaging services, such as MRIs and CAT scans, as well as continued stay review, discharge planning, proactive screening for case management (CM) and more. These services can ensure employees get the right level of care at the right time, and that their treatment meets the health plan’s standards.

How should CM work?

CM nurses are responsible for developing individualized care plans for employees identified as at-risk for high utilization and/or high dollar claims. These plans assist employees with complex care needs, improve their experience, promote safe and timely transitions in care and encourage efficient delivery of services and cost savings. The CM team’s goal is to assist in an employee’s recovery to help them navigate the health care system and offer added support.

What are the advantages of integrating these programs?

When UM and CM are fully integrated, it allows for a comprehensive approach to managing employees’ health. Employees can be proactively screened during the UM process and clinical reviews to see if they are a candidate for CM. These high-risk employees can then be engaged much sooner, which leads to better health outcomes. This sort of integration gives CM teams the ability to engage employees in real time, rather than using past claims data to determine eligibility. It also allows for regular communication and coordination between the UM and CM nurses to ensure care plans are as customized and patient-focused as possible. This elevates a medical management program to real-time engagement in the quality of care.

What are the downfalls of carving one of these services out?

When one program is carved out, the other cannot work as effectively. If an employer chooses CM services, but not UM, employees can no longer be pre-screened and engaged in real time. In this instance, utilization and spending reports would be the only tool used to attempt to identify high-risk employees. Often, these employees don’t need services anymore. The opportunity to help employees and contain costs is missed.

How can employers decide if integrated medical management is right for them?

For many employers, cost containment is a driving factor for considering a medical management program. Unfortunately, most employers don’t fully understand the major advantages to employee health and cost containment opportunities that a complete, fully-integrated program offers.

Employers who are considering a medical management program should talk to their broker, third party administrator, network partner or carrier to be fully educated about the impact a medical management program can have on their health plan.

Insights Health Care is brought to you by HealthLink

How clinical intervention can improve the health of those at highest risk

The high-risk top 5 percent typically drive more than 50 percent of overall health care spending when absenteeism, disability and workers’ compensation are included.

Predictive analytics that weigh workers’ compensation, disability, incidental absence, and medical and pharmaceutical claims can be combined to create a risk index that provides early identification of individuals who will soon be both high-risk and high-cost. Clinical intervention can then be offered to those who need it most.

Smart Business spoke with Justin Schaneman, MS, vice president of Data Analytics, and Rene Sims, MSN, vice president of Clinical Services at HCMS Group, a WorkPartners affiliate, about how to create a holistic clinical prevention model, the second of two articles on leveraging integrated data and applying it to clinical interventions.

How does a holistic clinical prevention program work?

Individuals identified through predictive analytics should be invited to enroll in a clinical prevention program, based on the employer’s cultural preferences. This model uses a holistic approach beyond conventional disease management, which is typically triggered by specific conditions such as diabetes or cancer. The data for high-risk individuals consistently shows that costs associated with multiple conditions often produce a cascading effect. Addressing all the conditions, including work, family and social issues helps individuals navigate the health care system and make better decisions about their treatment, leading to fewer relapses and a more sustainable recovery.

Individuals can be invited through a series of outreach calls and letters. Enrollment rates are typically high because these individuals often feel desperately lost in the fragmented health care system and welcome the additional resources.

In this model, a nurse serves as the primary point of contact and continually evaluates the individual’s needs while adjusting the action plan to address those needs. Medications are reviewed by a pharmacist to assist with issues, such as a need for lower-cost options, negative side-effects and the risk of interactions between multiple medications. A medical research librarian provides information to help members take control of their health and make health care decisions that lead to improved outcomes.

What kinds of results can be expected?

In our experience, within a year of enrolling, about half of participants see significant improvement in health, risk and utilization metrics. It may take longer for participants with more complex situations to ‘graduate.’ Measures of success include engagement with a primary care provider; a decrease in the number of prescription drugs, specialists and lost work days; increased productivity at work; and improved quality of life.

HCMS conducted a pre/post enrollment study of 3,864 enrollees who went into a clinical prevention service from 10 companies in 2016. The companies ranged from 500 to 21,000 workers across multiple industry sectors. The most drastic decreases occurred in the number of medical tests, which correlated to a significant decrease in visits to multiple medical providers. The second biggest impact was a reduction in the number of medications. In some cases, the number of diagnoses decreased by the time an individual graduated from the program.

It’s common for people in high-risk groups to experience high-cost events for a matter of months and then begin to recover. Typically, there is a rapid increase in the costs of absence, disability and health care, followed by a rapid decline. However, for individuals enrolled in a clinical prevention model, the decline starts significantly sooner and falls significantly more. This results in tangible cost savings during the first year after intervention.

By providing high-touch clinical support and actionable information across all dimensions, this model empowers individuals to take charge of their health and improve the quality of their life.

As big data opportunities expand in the workforce health arena, advanced analytic and predictive modeling is becoming even more relevant and can improve outcomes for both the employee and employer. The key is to partner this predictive power with a clinical service that can leverage that intelligence effectively, targeting individuals who will benefit from the service.

Insights Health Care is brought to you by UPMC Health Plan

How to leverage data to predict the 5 percent who drive the most health cost

Many employers receive an annual report from health plans listing high-cost claims. Most find themselves looking in the rearview mirror wondering what they could have done to prevent such costly episodes or at least reduce their impact.

This impact goes far beyond the rising costs of health care. A HCMS Group study found the top 5 percent of cases drove over 50 percent of overall spending when absenteeism, disability and workers’ compensation were included. Fortunately, it’s possible to leverage integrated data to predict which individuals are headed toward this top 5 percent, allowing employers to offer uniquely targeted clinical prevention.

But the stakes are high and rising. The HCMS Group’s Research Reference Database, covering 3.8 million members, revealed that the number of cases costing at least $100,000 each year has climbed 16 percent since 2015 and now averages five per 1,000 members. Cases costing $500,000 or more per year have increased 22 percent over the same time period.

High-cost cases happen to high-risk individuals — those with multiple conditions who often deal with family and work issues. They typically consume health care, lost time and disability benefits at a much higher rate. This comes at a price to their health and to their employer’s bottom line. Many individuals stay in the top 5 percent cost range year after year with multiple family members in the top 5 percent at the same time.

Smart Business spoke with Justin Schaneman, MS, vice president of Data Analytics, and Rene Sims, MSN, vice president of Clinical Services at HCMS Group, a WorkPartners affiliate, about how data can predict your top 5 percent, which is the first of two articles on leveraging integrated data and applying it to clinical interventions.

How is data being used to better predict this risk?

Many employers have gained access to data warehouses, hoping to generate actionable insights from mining big data. The value, however, can be limited when only medical and pharmaceutical expenses are included.

Integrating a broader array of data produces more actionable findings. Expanded databases incorporate disability and absence data, which reflect the policies that drive people’s behavior and consumption of benefits. They bring into focus the full cost of burden of disease, illnesses and injuries, allowing employers to better harness the predictive power of their data. Sophisticated employers also include the results of employee performance evaluations, compensation levels, safety violations, training course completions and other person-centric data types.

Once the right data is being collected, how can it be applied to the health plan?

The next step is to fully leverage the value of that broader set of data inputs. An integrated risk index that takes into account compensation and lost time data will dramatically increase the predictive power of the index. This can measure risk related to human capital health and job performance, not just disease. It also provides a leading indicator to flag emerging risk cases early in their trajectory, so interventions can shorten or prevent the period of time when they are both high-risk and high-cost.

Leveraging integrated data on workers’ compensation, disability and incidental absence — in addition to medical and pharmaceutical claims — allows predictive, individual risk indices that enable timely intervention for the high-risk top 5 percent.

This kind of risk index can provide early identification of individuals who will soon be both high-risk and high-cost. Clinical intervention can then be offered to those who need it most.

As big data opportunities continue to expand in the workforce health arena, advanced analytic and predictive modeling approaches are becoming more relevant and can improve outcomes for both the employee and employer. The key is to partner this predictive power with a clinical service that can leverage that intelligence effectively, targeting individuals who will benefit from the service. The next article will discuss how to set up that clinical intervention.

Insights Health Care is brought to you by UPMC Health Plan

Preventive care can help employees avoid medical issues, lower health costs

Preventive health measures and screenings may help prevent 85 percent of illness and disease, according to a 2013 Institute of Health Metrics report. Employees who receive the screenings and vaccines recommended for their age and gender may be able to address potential issues quicker, or avoid them all together. This can help save money for the health plan and the employee.

“Many employees tend to only use their health plan when they’re sick,” says Julie Bukowiec, senior medical policy analyst at Anthem, Inc. “These employees often miss out on advantages of preventive care, which could lead to more serious medical conditions and out-of-pocket spending.”

Smart Business spoke with Bukowiec about how simple education on preventive care can go a long way to helping change the way employees use their health plan.

Why are health screenings important?

Regular health screenings may uncover a potential issue early. For example, glucose screening could reveal pre-diabetes, a precursor to diabetes. At this point, lifestyle changes can prevent progression to type 2 diabetes. Preventive health exams may also reveal previously undetected conditions, such as uncontrolled hypertension, a leading cause of heart disease and stroke.

The Centers for Disease Control (CDC) indicates an estimated 13 million people have undiagnosed and untreated hypertension. In 2015, an estimated 30.3 million Americans were living with diabetes. Approximately 7.2 million of these people were undiagnosed. In both of these conditions, there may be not any signs or symptoms of the disease in the early stages. Early diagnosis and treatment, however, can reduce the associated risks.

What are some recommended screenings and vaccines for adults?

All individuals should undergo an annual comprehensive physical exam that includes height, weight and blood pressure. Some screening recommendations are based on age and gender. Women should receive breast exams every one to three years, up to age 40, and then yearly. Glucose screening for type 2 diabetes should begin by age 40. At age 50, all individuals should be screened for colorectal cancer.

Recommended vaccinations are largely based on age, with the majority of aimed at infants and children. But everyone should receive an influenza shot every year.

How do employees know which preventive care they should receive?

Preventive care recommendations are published by nationally recognized organizations, like the CDC, the United States Preventive Services Task Force and the American Heart Association. These recommendations are available on the sponsoring organization’s websites. Individuals also should talk to their health care provider about what is recommended based upon their circumstances.

What role can employers play in encouraging employees to receive preventive care?

Education is the key to encouraging employees to take advantage of their preventive care benefits. Inform employees that preventive care services aren’t subject to deductible, copayment or co-insurance payments. Some employees may be deterred by a lack of time. Employers can address this by setting up screenings at the office. Finally, attempts to encourage employees to access preventive care benefits should be ongoing, with follow-up reminders, such as emails.

Is there anything else employers should know about preventive care?

Currently preventive services are utilized at approximately half the recommended rate, according to the CDC. (Learn more at www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/preventivehealth.html.) But regular preventive care is vital to improving and maintaining health. In addition to screenings and vaccinations, preventive care consists of counseling and education on topics, such as weight control and smoking cessation. Regular preventive care is the first step toward improving the health of your employees. Preventing disease or treating disease at the early stages can help keep health care costs down, lead to longer, healthier lives and encourage greater workplace productively.

HealthLink is a fully owned subsidiary of Anthem, Inc., one of the nation’s leading health benefits companies.

Insights Health Care is brought to you by HealthLink

Do your employees know how to talk to their doctor?

Health care can be complicated and even confusing. The best way for consumers to avoid being overwhelmed by uncertainty is to become health care literate. This doesn’t just mean learning big words, it also means knowing how to talk to doctors, so you have a better understanding of how to follow recommendations, take medications correctly and take charge of your health.

“When people don’t understand the information given to them by their doctors, they are more likely to be in poor health,” says Danielle Freeman, Network Education Representative at HealthLink. “That is why it is important for everyone to know how to talk to their doctor.”

Consumers who talk openly with their doctor and get the most from their appointments may also save money for their health plan and reduce their out-of-pocket costs. By being engaged and more proactive with their health, your employees can avoid issues that are more complex and the need for additional care.

Smart Business spoke with Freeman about how to help employees take charge of their health, and potentially save you both money.

How can an employee best prepare to talk to their doctors?

Being prepared can make a big difference in the success of an appointment with a doctor. Employees should have a general list of questions that they would like the answers to, such as what should I do to prevent or delay health problems, are there tests or screenings I should have, and am I due for vaccines? Employees should also be prepared to ask questions directly related to the reason for their visit.

In addition, having a list of all prescription and over-the counter medications, other drugs, vitamins and any herbal remedies they currently take can help the doctor get a full picture of their health. They should make note of any nutritional drinks or shakes, herbal teas, energy drinks, coffee and alcohol they drink.

Being prepared will show the doctor the patient is engaged and ready to do his or her part to maintain good health.

What about during an appointment?

During an appointment, employees should ask questions and then listen diligently while the doctor responds. They should feel empowered to ask for clarification if they don’t understand something, repeat the information back to the doctor and even have a piece of paper to take notes.

Before leaving the appointment, employees should know what their main issue is, what they need to do to treat it and why the recommended treatment is important. If they aren’t clear on these three points, they need ask for clarification, or schedule a follow-up appointment.

Employees should also pay close attention to any referrals that the doctor orders. The rule of thumb for referrals is to ask, “Why are we doing this?” Employees need to understand the need for the referral, the expected outcome, and whether or not the doctor or facility they are being referred to is in-network. If they are not in-network, they should ask if an alternative is available. The same is true when being referred for lab tests, imaging or other outpatient services. Employees should understand the need, expected outcome and whether or not these services are being requested diagnostically or if it will help their condition.

When lab, imaging or outpatient services are requested, employees should pay close attention to where they are being referred and shouldn’t be afraid to ask if there are alternatives. Freestanding facilities may have less out-of-pocket costs than services received at the hospital. Employees should always feel comfortable talking to their doctor about their concerns and finding the service provider that is best for them.

What if an employee is diagnosed with a medical condition?

When someone is diagnosed with a health problem, he or she needs to understand, in common language, what the issue is. Again, being prepared, asking questions and really listening while the doctor responds can go a long way in understanding the condition. Some common questions employees should ask about their condition include, what is the name of the condition, how it is spelled, what does it mean, what may have caused it and how long it will last? Employees should also inquire about treatment options and how they can learn more.

Insights Health Care is brought to you by HealthLink

Get the word out about EAPs, which traditionally are underused

Employee Assistance Programs (EAPs) have a long history of success in helping employers and employees tackle complicated and difficult problems. EAPs can trace their beginnings back to 1917, and have been a part of many company benefit programs since the 1960s and 1970s.

And yet, EAPs remain an underused resource for many employees. Employers have to be frustrated when something that could help all employees is not put to best use.

“The reasons for the under use of EAPs are many,” says James Kinville, senior director of LifeSolutions, an EAP that is part of the UPMC Insurance Services Division. “What’s most important is overcoming those reasons and getting the word out to employees that EAPs are a valuable resource that they have available to them.”

Smart Business spoke with Kinville about ways employers can make employees more aware of EAPs and take advantage of their services.

Why do employees resist using an EAP?

Oddly, one of the biggest reasons is that many employees do not believe that EAPs are truly confidential. This comes from a lack of understanding of how EAPs operate. It is imperative that an employer continually educates employees about how an EAP works.

And, of course, the biggest thing is that an EAP is absolutely confidential. EAPs do not report back to the employer after meeting with an employee. Time spent with an EAP is not part of an employee’s work record.

Without that kind of understanding, it is difficult for an employee to look to an EAP as a trusted resource.

What are some other reasons for not using an EAP?

Another misconception still prevalent in the workplace is the stigma attached to reaching out for help in this manner. Men, especially, can struggle with this. What needs to be explained is that everyone at some time or other has had on- and off-the-job problems of a similar nature. Getting help to deal with these kinds of issues is a smart thing to do.

Consider what EAPs handle: financial problems, marital and family issues, cancer, stress-related illnesses, caregiving for parents, substance abuse, workplace conflicts, depression and more. It makes sense to turn to a professional for help with these subjects and it makes sense to realize that some of these problems are bigger than anyone can handle alone. It’s not a stigma to go for help, but rather a wise choice.

Do employees need to go through HR or get permission from their boss to use an EAP’s services?

There is no need for an employee to tell anyone — boss, HR official or work colleague — if he or she wants to partake of EAP services. Companies provide an EAP phone number and an employee can call confidentially and make an appointment.

Because EAPs operate independently of an employer, they are often flexible about when and where they can hold sessions. It could be over the phone, at a therapist’s office or even at the worksite.

What else do employers need to know about EAPs?

Sometimes, employers can be guilty of not fully realizing how EAPs can enhance an organization’s performance, its culture and its business success. EAPs provide value in three ways — by leveraging the value of an organization’s workforce, by addressing the cost of doing business and by helping an organization mitigate its business risks.

It is a key component of an employer strategy to increase employee engagement and improve productivity, morale and workplace harmony.

How does an employer choose an EAP?

Employers need to choose an EAP that can optimize its value to a company’s culture and workforce to ensure the achievement of business objectives.

Employers should weigh an EAP’s experience and expertise in the field, the credentials of the EAP’s staff, the EAP’s level of responsiveness and accessibility, its ability to integrate with other key benefit providers and whether it can tailor a plan design to fit a company’s specific needs.

Insights Health Care is brought to you by UPMC Health Plan

Simple, visible moves help achieve a culture of wellness

Small changes, big results — that’s not always how things work, especially when it comes to health and wellness. But, in terms of the workplace, small changes can often do the most to encourage a culture of wellness.

“You can make a big difference in the lives of employees simply by making the work environment more conducive to wellness,” says Dr. Michael Parkinson, senior medical director of UPMC Health Plan and UPMC WorkPartners. “It doesn’t take major, costly changes to have an impact. Small, simple, but visible moves can communicate that employers are serious about improving the health, safety and well-being of their most precious asset — their employees.”

Smart Business spoke with Parkinson about small changes that can impact wellness.

What are some ways employers can impact employee wellness at the workplace?

One place to start is to encourage employees to walk away from their desks. Cubicles are a mainstay of many workplaces and employees spend much of their time in front of computers. If ‘sitting is the new smoking’ — yes, sedentary lifestyle is a major contributor to death and disease in the U.S. — then getting employees up and moving more needs to be built into each workday.

Leading companies schedule ‘recesses’ throughout the workday, emphasizing stretching, walking meetings and brief walks. Opening an attractive break room or workplace cafeteria encourages employees to not eat at their desks and move at lunchtime.

In early studies, standing workstations have been shown to decrease musculoskeletal strain, improve concentration and increase energy expenditure. Consider introducing one swing activity workstation per group of employees, if the expense for a total office reconfiguration is unaffordable.

Can employers actually increase their employees’ physical activity?

The Centers for Disease Control and Prevention (CDC) has determined that people who get adequate amounts of physical activity have reduced rates of chronic disease, are better able to maintain a healthy weight, can better manage stress and perform better at work.

Employers can help increase physical activity by taking small measures, which make more activity the expectation and default option. For instance, unlocking the stairwells, making them attractive and encouraging all executives and managers to ‘take a hike’ multiple times throughout the day creates an activity culture.

Employers can support employees who bike to work with safe and secure places on-site for bike storage. They can promote active means of transportation, such as mass transit, by providing transit passes. They can encourage running, walking, biking or taking a fitness class during the day with flextime schedules. Even a single wastebasket in a central work area encourages employees to walk in order to dispose of trash.

How can employers promote healthy eating?

Workplace cafeterias are an ideal place to preferentially price and promote fruits, vegetables, whole grains, non-processed foods and sugar-free drinks. Vending machines can offer healthy alternatives to snack food. Sponsoring ‘new fruit and vegetable of the month’ giveaways can expose employees to foods rarely eaten, but loaded with vitamins, disease-fighting antioxidants and micronutrients.

What about stress, mindfulness and well-being?

All employers see direct and indirect costs of anxiety, stress, depression and lack of mental focus in their medical, disability, workers’ compensation and total productivity costs.

Can the office space or workflow be made less stressful? Are there unnecessary noises, interruptions or poor lighting that exacerbates an already challenging work environment? Are there quiet spaces or rooms for taking a break or practicing mindfulness (deep breathing with mental visualization) to relieve stress and re-charge?

Can employers work to decrease tobacco consumption?

The CDC estimates that smokers cost employers about $5,800 more than their nonsmoking co-workers. A smoke-free policy for the workplace and worksite property should be considered. Employers can make tobacco-cessation classes and services available, as well as materials that promote the benefits of living smoke-free.

Insights Health Care is brought to you by UPMC Health Plan

How to help your employees be smart health care consumers

The term “smart health care consumer” has become increasingly popular. Now more than ever, employers are starting to understand the importance of helping their employees make informed health care decisions — but few know how to do it.

“When employees are smart about their health care choices, it has a positive impact on the company health plan, and the employees,” says Bridgette Bock, sales and retention executive at HealthLink. “But most employees won’t get there on their own, that’s where the employer comes in.”

Smart Business spoke with Bock about how to help employees make informed health care decisions.

How can employers help employees become smart health care consumers?

Employers have a unique opportunity to educate their employees on important health care topics. Typically, employers have direct access to employees and can communicate with them in a variety of ways, such as face-to-face meetings, email, a company intranet site or message boards. Plus, employees tend to more actively engage with information that comes from their employer rather than a third party, such as an insurance carrier.

The most important thing employers can do is use this opportunity to educate their employees. Sharing information about benefits, the best way to use those benefits, as well as a variety of health and wellness topics can help employees become smart health care consumers.

What should employees be educated about?

A great place for employers to focus their efforts is on the company health plan. Employers should consider educating employees on common health care terms, such as deductible, co-payment and co-insurance. They should also educate employees on the specifics of the health plan(s), including a detailed benefit and cost analysis to help them decide which plan is best for them. Providing a side-by-side plan comparison that highlights the important components, if applicable, can really help employees make educated decisions.

Employees also need to be educated about the best way to use their plan. This includes knowing the importance of staying in-network, how to find an in-network doctor and where to go for emergency care. Employers should talk to their insurance carrier or network partner about the materials available to educate their employees on these topics.

What about after an employee picks their plan? Should the education continue?

After employees select their health plan, employers should switch their focus to sharing information about how to use the plan effectively. Some topics to consider include where to go for care, the importance of shopping around before selecting medical services, and available tools like a provider finder, corporate discounts or telemedicine. These can help employees make informed decisions about using their benefits.

When is the best time to provide education?

It’s always a good time to educate employees. Don’t make the mistake of stopping education after open enrollment. Instead, employers should consider developing a yearly calendar with educational topics. Monthly or even bi-weekly communications is a great schedule for educating employees and reminding them about free tools and extras. It is also important to encourage employees to ask questions, so frequently asked questions or question-and-answer sessions are good topics to consider.

Again, employers should check with their carrier or network partner to see what resources are available, as many offer pre-developed educational materials and timelines. This can help employers cut down on the time and resources needed to educate their employees throughout the year.

What else can an employer do to help?

In addition to education, employers can incentivize employees to become healthier with company-wide programs such as a ‘know your numbers’ program or offering flu shots. These preventive programs can help employees avoid chronic disease and the need for additional care. Employers can also consider making the workplace healthier through initiatives like refreshing vending machines with better-for-you options or organizing healthy potlucks or fresh fruit and vegetable deliveries.

Insights Health Care is brought to you by HealthLink

How to support employees with alcohol challenges

Though sometimes hard to detect, alcohol abuse and alcoholism can impact the workplace — from absenteeism and lost productivity to missed deadlines, strained relations with co-workers and outright dismissals from work.

It is important for employers to have policies and plans in place, including support for employees who struggle with these challenges, says James Kinville, senior director of LifeSolutions, an employee assistance program (EAP) and part of UPMC WorkPartners’ suite of services.

Smart Business spoke with Kinville about what employers can do to help employees who show signs of alcohol problems.

What can employers do about this problem?

Employers have an obligation to support their employees, but should not base that solely on lost productivity or the company’s bottom line. Rather, employers have a moral obligation to help their employees live healthier, happier, more sober lives. The same goes for employees dealing with family, financial, legal or health problems.

The best way to address these issues is through an EAP. This benefit offering, which is often separate from health insurance, helps employees with personal or work-related problems that impact their job performance. EAPs typically offer short-term counseling, referrals, employer/employee training and education.

How specifically can an EAP help employees with alcohol problems?

Most EAPs offer awareness training so managers can recognize the signs of a problem and know what to do about it. Once a policy is in place, a manager knows that he or she can refer an employee to the program. That’s incredibly helpful and gives a manager peace of mind.

It’s not a supervisor’s job to diagnose alcohol abuse or alcoholism. Even if a manager suspects that alcohol is involved, it’s better to focus on how the suspected alcohol problem is manifesting itself through increased absences, frequent tardiness or a dramatic falloff in work quality. Stick to tangible behaviors, not the alcohol part.

Accusing the employee of having an alcohol problem rarely goes well and it can be very stressful. It’s better to say you have noticed certain ongoing problems, provide the employee with the EAP number and insist that he or she make contact right away.

What about confidentiality? Are some people hesitant to seek help because it could hurt their career if the word gets out?

Whether the employee seeks help on his or her own volition or is referred by a manager, EAPs are extremely confidential. The EAP only divulges to the employer that the employee made contact with the EAP and that there’s a plan in place. No other health or confidential information is shared.

What is the process once the employee makes contact with an EAP?

Most EAPs offer six sessions with a counselor who conducts a comprehensive review and assessment and works with the employee to develop a plan of action. Sometimes, that’s all that’s needed. Other times, the counselor may refer the employee to a therapist or other behavioral health professional covered under the health plan.

What would you tell employers that don’t have an EAP?

Partner with one. EAPs tend to be low cost and even small companies can afford them. It’s a high-value service that employers tend to not need often, but when they do, it makes all the difference.

It’s also important to promote the EAP. Employees need to know about the service and that their organization supports it. EAPs work best when they are promoted internally in a consistent, customized manner, through mailers, lunch and learns, promotional campaigns and worksite presentations.

Any final thoughts on helping employees with alcohol challenges?

You often hear with alcohol or drug addiction that the person with the disease — and these are diseases, not moral weaknesses — has to hit bottom before realizing he or she has to take steps to get better. By utilizing EAPs and other support services, we can raise that bottom so the afflicted person doesn’t have to fall as far. With an EAP, the employee can take action sooner, before a potential crisis hits.

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