The Value of Workplace Screenings

Pam Mortenson and Rich Prall
Corporate Wellness Magazine | October 18, 2016

Workplace screenings are a critical component of corporate wellness initiatives. By measuring key aspects of health, including blood pressure, weight, cholesterol and glucose, among others, these screenings provide valuable insights into the health of employees and help identify potential risk factors early on, enabling employers to implement more targeted health and wellness initiatives and track progress and improvement over time. Screening programs continue to evolve and adapt to meet the needs of employers and employees and offer valuable benefits, including driving engagement, improving health outcomes and reducing costs.

Drive Engagement in Health

Like overall wellness and well-being initiatives, a onesize-fits-all approach to screenings does not work. Customizing screening programs to meet the needs of each unique organization and their workforce can help improve participation. Tailored programs that account for the health needs of employees, provide convenient locations and times, and offer resources to take the next step, are more effective at engaging employees, which can help increase workplace productivity, improve outcomes and reduce overall costs.

There are a number of other ways to encourage participation in screenings in order to reap the benefit of this important tool, including:

  • Incentives – Research, including a 2015 study from the Employee Benefit Research Institute, shows that offering employees a financial or other type of incentive to complete their screening increases participation.
  • Communications – Ongoing communications from employers about upcoming screenings and what to expect are critical to raise awareness and encourage participation. This can include emails, intranet announcements, posters and flyers in common areas, mailers to employees’ homes, and even automated technologies like text messages and phone calls.
  • Convenience – As mentioned above, holding screenings when and where it is convenient for employees will ensure attendance. For example, having screenings in the dining room between shifts at a busy restaurant will make it easy for employees to participate. Programs should be tailored to meet the needs of each organization to ensure maximum participation and benefits.

Further, when coupled with on-site health education and coaching, biometric screenings can help influence positive behavior change, improving the health of employees while helping to control rising healthcare costs. A Health Advocate study published in the Journal of Occupational and Environmental Medicine in 2015 found that employees identified as having hypertension during a workplace screening were twice as likely to be diagnosed with hypertension, or fill a prescription for a hypertension medication, in the month following the event. For many employees, screenings are a first step toward better engagement in their health.

Know Your Numbers

Workplace screenings offer insights into the health of the workforce, as well as the leading drivers of health-related costs, providing both organizations and their employees with a starting point toward their goals.

For employers, aggregate data from screenings helps to create a baseline from which to tailor wellness strategies moving forward. By using this information as a foundation, it is possible to measure year-over-year results and improvements. This is an opportunity to see the progress and value of wellness initiatives as well as adjust programming as needed to meet the needs of an evolving workforce. By understanding what is working and what is not, organizations can avoid wasting money on ineffective programs and invest where it will have an impact for their employees and bottom line.

For employees, having an understanding of their health and potential risks enables and motivates them to take action to improve their health. The Journal of Occupational and Environmental Medicine study referenced previously also found that 68 percent of employees whose hypertension was discovered during a workplace biometric screening had no previous record of diagnosis or treatment. These workplace screenings have the potential to identify undiagnosed conditions like hypertension in employees and lead those employees to seek treatment.

By learning more about the current state of their health through workplace screenings and knowing their numbers, employees can be motivated to set goals based on the results and take necessary next steps toward improving their health. These screening programs can have a big impact in helping employees understand their risk and take action, improving outcomes and reducing healthcare costs for both individual employees and organizations.

Integrate for Maximum Impact

Workplace health screenings and the resulting data from these events can be integrated into existing wellness and benefits programs to maximize and amplify the impact. By connecting screenings with other initiatives, employers can optimize the experience for employees and make it easy to take advantage of more benefits offerings, increasing the effectiveness of the entire program. Plus, the ability to plug data from screenings into other programs like wellness and disease management can help employers identify high-risk individuals and ensure communications and outreach are appropriately targeted.

As an example, because screenings help employees identify areas of risk they’d like to improve, such as high blood pressure, they can then decide to sign up for a walking program and nutrition webinar series to help address this issue. Once they’ve reached their goal, their employer may offer a discounted insurance premium to reward them. This integrated approach combining biometric screenings with wellness provides opportunities for multiple touch points with employees, especially those at high risk, increasing the opportunity for success. When workplace health screenings are integrated with other benefit programs, it’s possible to realize even more value and benefits and maximize the potential outcomes.

Workplace screening programs provide convenient, professional health assessments on-site to help identify employees’ risk for some of the most common chronic conditions, but they provide great value well beyond the initial screenings. By identifying issues sooner, employees can take steps to improve their health, leading to reduced costs for themselves and their organization. Screenings are an integral cornerstone for workplace wellness programs and offer value and benefits to both employers and employees.

Wellness Moves from Bottom Lines to Positive Outcomes

Pam Mortenson
World at Work Benefits & Work-Life Focus | October 10, 2016

Health-care costs have skyrocketed over the past two decades. Employers and workers bear the brunt of this trend. Between 2005 and 2015, employer contributions to health insurance premiums increased by 61%, according to the Kaiser “Employer Health Benefits Survey.”

Naturally, employers are seeking strategies to counter rising health-care costs. One important strategy to consider is to focus on medication adherence. Why? According to the Network for Excellence in Health Innovation, medication non-adherence is a leading driver of high health-care costs, adding up to $290 billion annually. It’s the leading cause of preventable morbidity and mortality, responsible for 30% to 50% of treatment failures and 125,000 deaths annually, says the American College of Preventive Medicine. As the industry scrambles to improve quality and lower costs, non-adherence to medication is a topic that healthcare providers, payers and self-insured employers should address.

The most common contributing factors of medication non-adherence are:

  • Cost
  • Lack of a clear immediate benefit/not understanding the reasons for taking the medication • Confusion about the medication and how to take it
  • Concern about side effects
  • Psychological resistance.

Most of these barriers can be resolved through patient engagement, education and communication. Implementing a program to engage a large patient population effectively — to stay one step ahead of nonadherent behaviors, send patients refill reminders and ensure that patients have the education they need to take medications properly — isn’t easy to do.

That’s where targeted patient engagement solutions come into play. Intelligent, automated communications combined with live support from licensed clinicians enable organizations to proactively help patients take medications as prescribed.

Employers could potentially save hundreds of millions of dollars in employee productivity — not to mention additional savings in reduced health-care costs — by improving patient engagement and driving interventions around medication adherence for employees and dependents covered through their health plans. In particular, employers have an opportunity to save money by engaging those with common, but costly, chronic conditions.

These savings may sound like a pipe dream, but consider these statistics:

  • 3.8 billion prescriptions are written every year, yet more than 50% of them are taken incorrectly or not at all.
  • 75% of patients do not take their medications as prescribed.
  • Patients who don’t take their medications as intended have a higher risk for hospitalization, re-hospitalization and premature death.
  • Poor medication compliance is implicated in more than 125,000 U.S. deaths per year.

According to the Centers for Disease Control and Prevention, as of 2012, about half of all adults in the United States had one or more chronic health conditions. A Georgetown University study estimates that 34% of adults age 18-65 have at least one chronic condition. By 2020, half of the U.S. adult population will have at least one chronic condition.

For the purpose of this article, chronic conditions exclude obesity and include the top eight that require clinical intervention or support: asthma, chronic obstructive pulmonary disease (COPD), coronary artery disease (CAD), congestive heart failure (CHF), depression, diabetes, hypertension and metabolic syndrome/ high cholesterol.

A Cost-Savings Scenario for Medication Adherence

A study in the Journal of Occupational and Environmental Medicine found that employees with chronic conditions who adhere to their prescribed medications had up to seven fewer days away from work annually than those who were not adherent, translating into estimated annual savings of nearly $1,700 per adherent employee.

What does this mean for an employer’s costs in real terms? The average size of the workforce for a Fortune 500 company is approximately 50,000 employees. Based on the most conservative nationwide statistics, we’ll assume that more than one-third of the workforce (adults age 18 to 65) covered by a company’s health plans has at least one chronic disease and 75% in any given year are not on the proper medications. Below is the potential financial impact in a single year:

  • 50,000 covered employees x 30% with at least one chronic condition = 15,000 employees
  • 15,000 employees (with at least one chronic condition) x 75% not taking Rx properly = 11,250 employees
  • 11,250 employees (with at least one chronic condition and not Rx adherent) x $1,700 (amount that could be saved if employee was adherent to meds for their chronic condition) = $19,125,000

Employees’ adherence to medication could save a Fortune 500 employer more than $19 million annually.

Employees who are adherent to their medications also generate savings as the result of fewer emergency department visits and fewer inpatient hospital days. In fact, researchers for CVS/Caremark have found that adherent employees saved the following amounts compared to their non-adherent counterparts for these common chronic conditions:

  • Congestive heart failure patients saved $7,823 per year.
  • High blood pressure patients saved $3,908 per year.
  • High cholesterol patients saved $1,258 per year.
  • Diabetes patients saved $3,756 per year.

Employers seeking to improve the health of their employees and their health-care spend would be wise to consider a medication adherence program. Smart, automated communication solutions are valuable, cost-effective means to make this possible and realize the many benefits of improved medication adherence.

Marc Allan
Indianapolis Business Journal | October 1, 2016

Bruce Smith, director of human resources at Stalcop, a metal-forming specialist in Thorntown, has found one solution to the never-ending battle to hold down health care costs: patient advocates.

For four years, Stalcop has contracted with Milwaukeebased Patient Care, a health care advocacy company that helps its members make informed decisions about health care spending and works on their behalf to resolve claims and billing issues.

To illustrate the savings, Smith likes to tell the story about the spouse of an employee who needed a CT scan. The patient’s doctor recommended getting the procedure done at a facility where the price tag was $2,637. Of that, the patient would be responsible for $1,227; the company would have to shell out $935.

But the patient checked with Patient Care, which issued a “cost and quality report” that compared the doctor-recommended facility with two others in the area, and wound up getting the CT scan for $500. The procedure cost the company health plan nothing, and the patient saved $818 out of pocket.

Smith had used Patient Care at two previous employers and saw how it helped keep costs down. While Stalcop pays about $2.75 per employee per month, he said that if three or four members of the company’s health care plan use the cost-and-quality service and choose the lowest-cost provider for something routine like an MRI or a CT scan, the savings on claims more than pays the entire yearly cost for the service.

The concept is beginning to catch on—albeit slowly in Indiana.

Susan Rider, a consultant at the Indianapolis insurance brokerage Gregory & Appel, said companies began hiring health advocates in earnest nationwide about four years ago, fueled by implementation of the Affordable Care Act and growing public awareness that provider rates and quality can differ greatly.

Rider said the services, which typically charge monthly fees, can unearth dramatic savings. In one case, she said, an advocacy firm found that a screening colonoscopy performed by the same gastroenterologist had a $2,500 cost difference based on where it would be performed. The variance stemmed from a facility charge at one of the sites.

“Today, especially with these high-deductible health plans, consumers have to make a choice,” she said. “So more and more tools are coming to fruition.”

As patient advocacy has taken hold, the Florida-based Alliance of Professional Advocates has seen its membership swell, rising from 30 in 2009 to 650 now, said Trisha Torrey, the trade organization’s founder and director.

The reason for the growth is simple, she said. “The health care system exists with almost no transparency and great frustration on the part of almost everybody who participates—with the exception of those who are making lots of money from it.”

“I’m telling you,” she added, “95 percent of people don’t understand their insurance or what it covers. And until they have a circumstance, they don’t have to. Until they need an MRI and they find out their deductible is $1,500 and that MRI is going to cost them $1,200. And that happens every day. This is part of the rise of private advocates.”

Even the insurance industry acknowledges patient advocates have their place. Clare Krusing, press secretary for America’s Health Insurance Plans, said advocates “have an important role to play. Consumers also have an advocate in their health plans. It’s important that they first connect with their insurance company, just to make sure that they’ve exercised all the options available to them, including appeals. And then, if additional assistance is needed, their plans can recommend a patient-assistance program.”

‘More and more confused’

Kati Adam, vice president of sales for Patient Care, which was founded in 2001, said employees have a saying at the office: “The more confusing health care is getting, the better it is for us.”

“People are becoming more and more confused, and so they need somebody to help them navigate through the health care system,” she said.

Patient Care, which has eight clients in Indiana, helps employees understand their benefits, what’s covered under policies, and which doctors are in-network. The firm also can schedule appointments, help with billing issues and answer pharmacy-related questions.

Adam said that as more companies, especially smaller ones, self-fund their health insurance, they’re becoming more cost-conscious. Employees are too, thanks to the growing use of high-deductible plans that hold down premiums but have higher out-of-pocket costs for procedures.

“So they’re looking for a solution like Patient Care to help employees price out procedures before they have them done,” she said. “We help them understand what their costs will be ahead of time so they can spend less money.”

A competitor, Plymouth Meeting, Pennsylvania-based Health Advocate, started 16 years ago and provides services including advocacy, employee-assistance programs, wellness, disease management and telemedicine for 11,500 clients—85 in Indiana.

“We’re really just making it easier for employees to get the help they need when they need it,” said Joanne O’Toole, assistant vice president of sales.

For many companies, Health Advocate helps short-staffed human resources departments by reducing their administrative burden. And by saving employees from having to take time away from work to untangle insurance claims or find doctors, it helps improve productivity.

“Employees tend to realize quickly that this is a very valuable benefit for them, so it helps in employee retention,” O’Toole said.

Health Advocate has provided services for all U.S. employees of the Chicago-based accounting firm Crowe Horwath since 2012. Autumn Harlow, the total rewards manager in the South Bend office, said that, during the open-enrollment period each fall, Health Advocate staffers walk employees through their options. It also offers legal services, and financial and health counseling.

Health Advocate helped a Crowe Horwath employee save thousands of dollars by renegotiating his bills after he had an extensive back surgery performed by an out-of-network doctor.

“It’s been a great partnership,” Harlow said. “We get great response from our employees. They seem very happy that we offer this service. It really rounds out our benefits and wellness package.”

‘You want to be empowered’

While many patient-advocacy firms have prospered by charging employers flat monthly fees, Leesa Ackermann, the sole proprietor of Fort Wayne-based Advocated Healthcare LLC, has a different approach.

The former registered nurse hung out her shingle in January, and she charges an hourly rate to help clients with medical-related issues—research, attending appointments, reviewing treatment plans, helping people understand options, education, coaching.

“Anything but advising and telling people what to do,” she said.

So far, she’s working to move a client from a nursing home in Georgia to a facility in Indiana, where the woman can be closer to the few distant relatives she has, and she’s negotiating with an insurance company to cover the treatment of a 32-year-old client with brain incapacity. The man ended up in a facility that is not meeting his needs, and his family felt powerless and uninformed.

Ackermann said what she brings to her role is “the allegiance factor.”

“If you’re in medical crisis,” she said, “if you are fighting for reimbursement or preauthorization or understanding or choices, you want to be empowered and you want somebody on your side, somebody who’s going to fight on your behalf.”