Flu Season Is Right Around the Corner

By James Davis | HR Daily Advisor

It’s hard to imagine, but flu season is almost upon us once again. Today we are joined by Jocelyn Sivalingam, M.D., F.A.C.P., and Medical Director at West’s Health Advocate Solutions to discuss the flu.

HR Daily Advisor: Last year we heard a lot about the flu. There were imperfect vaccinations, some shortages, and rampant flu cases. Did that influence how people vaccinated?

Sivalingam: Last year was a very bad flu season for everyone, in retrospect with a lower than usual estimated vaccine effectiveness because of the strain H3N2. Low vaccination rates did not help.

Source: https://www.cdc.gov/flu/fluvaxview/nifs-estimates-nov2017.htm

Determining whether there was a direct impact of this specific flu season on the rate of vaccinations would be complicated, but anecdotally I can tell you that people often put off getting their flu shot when issues with efficacy are reported.

Source: https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a4.htm?s_cid=mm6722a4_w

HR Daily Advisor: What is the most common reason you hear that people don’t vaccinate? What would you say to them?

Sivalingam: In my opinion, there are two main reasons people don’t get vaccinated. First, they do not believe they are at risk or that getting sick would only be a minor inconvenience. While older people, young children and those with chronic diseases are at a higher risk of flu-related complications, it is important to remember that even healthy people can get very sick or even die. Plus, catching the flu often results in multiple days out of work, the cost of doctor’s visits and treatment, as well as the risk of making family and co-workers sick. The flu is not a minor inconvenience.

The second is that they may think the vaccine does not work or can cause the flu.

Currently, the flu vaccine’s effectiveness may vary from 10-60 percent from season to season, however, it is still the best single preventive measure that we have against this disease. (Researchers are working to develop a “universal” flu shot, but it is still in the early stages of development.) It is important to remember that the flu vaccine is manufactured from components of the virus and does not contain actual viral particles, so it cannot cause the flu.

Source: https://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm

HR Daily Advisor: Some companies might not see the value in paying for vaccinations onsite, how do the costs of paying for employees’ vaccines compare against productivity loss due to sick employees?

Sivalingam: Consider that the cost of lost productivity due to a bout with the flu is approximately $1,000 per employee on average. This does not include the direct medical costs associated with being sick, including doctor’s visits, medication and more. Alternatively, the flu shot costs an average of $32 per person. While the flu shot may not prevent everyone from getting sick (the flu shot reduces the risk of getting sick by up to 60 percent), it can significantly reduce individuals’ risk and the overall number of people affected, making the potential cost savings easy to see.

The flu virus is incredibly contagious, so chances are, if one employee becomes sick, it’s only a matter of time before it spreads to others, quickly multiplying the costs.

HR Daily Advisor: A lot of people that I talk to say “I don’t get the flu, so why bother.” How would you convince them?

Sivalingam: The past does not predict the future, and there is no way to guarantee that you will not get sick in a given flu season. Just because someone has not contracted the flu virus previously is not an indicator of future immunity because the virus changes year to year. It only takes walking by a sick person as they cough or sneeze in your general direction to get the flu. It remains important for everyone to take steps to prevent the flu and its spread.

HR Daily Advisor: What are some strategies workplaces can use to reduce flu outbreaks for their employees?

Sivalingam: While the flu shot is the most effective strategy to reducing the risk of getting sick, employers should encourage their workforce to practice basic healthy habits to prevent the spread of bacteria and viruses. These include covering the mouth and nose when coughing or sneezing, regular hand washing (after coughs and sneezes, before meals and after the restroom). Having hand sanitizer available when washing facilities are not easily available is recommended. It is also helpful to spread out workstations and reduce overcrowding where germs can more easily spread. Inform workers about flu and other contagious respiratory disease symptoms. Facilitating appropriate use of sick time and making policies known helps keep those who are contagious from coming to work sick.

HR Daily Advisor: Prevention seems important, but what happens when that doesn’t work?

Sivalingam: There are a number of policies and programs employers can put in place to help those impacted by the flu and help reduce the spread. First, having a sick leave policy in place that ensures people are able to stay home when sick and prevents them from bringing their germs into the workplace. Equally important is providing access to appropriate care; timely antiviral treatment can reduce the length and severity of the illness, ensuring employees get healthy and back to work sooner. As part of this, ensure health benefits cover flu treatment – if employees are required to pay out of pocket for their care, they may not get the help they need in time.

HR Daily Advisor: What is something most people don’t know about the flu?

Sivalingam: We often hear that the flu vaccine needs to be reformulated each year. This is because several strains circulate around the world 365 days a year, and these strains also change over time. Influenza viruses circulate in other animals as well, recombining and evolving as they pass within and between species. Because of this, the influenza viruses constantly morph, creating the need to develop an updated version of the vaccine each year.

HR Daily Advisor: What is something you wish everyone knew about the flu?

Sivalingam: Prevention is critical because you can pass along the flu virus before you show signs or symptoms. Once you develop the chills or a sore throat, you’ve likely been contagious for 24 hours, and you will be contagious until 5-7 days afterward. So, it is important to always practice good hygiene, because you never know when you might be spreading germs to others (and vice versa!).

Source: https://www.cdc.gov/flu/about/disease/spread.htm

Dr. Sivalingam is a board certified Infectious Disease specialist with more than 20 years of clinical and administrative experience. Prior to joining Health Advocate in 2009, Dr. Sivalingam operated an infectious disease consultative practice and served as an instructor in the Division of Infectious Disease at Thomas Jefferson University Hospital, where she also completed her internal medicine residency and infectious diseases fellowship.

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By Raffi Terzian, M.D., M.P.H., FACEP
Senior Medical Director,
Senior Vice President of Clinical Operations

Musculoskeletal disorders (MSDs) can have a significant impact on workplace productivity, absenteeism and healthcare costs. A 2017 analysis by the Kaiser Family Foundation, which explored trends in the cost of treating diseases, found that musculoskeletal diseases were ranked among the leading contributors to overall health services spending growth.

In terms of the workplace, according to data from the Bureau of Labor Statistics (2015), of those injuries and illnesses causing days away from work, MSDs accounted for thirty-one percent of the total cases for all workers. The Occupational Safety and Health Administration also notes that work-related MSDs are among the most frequently reported causes of lost or restricted work time. Examples of common MSDs include carpal tunnel syndrome, low back pain and back injuries, and arthritis.

Employees working across different industries such as transportation, construction, agriculture and manufacturing as well as service industries (police, fire, EMS) are at risk for developing MSDs. Occupational risk factors include heavy lifting, bending, awkward postures, reaching overhead, pushing and pulling heavy loads, and repetitive tasks.

Developing proactive strategies to prevent or mitigate MSDs in the workplace, and promoting workplace health, should be an important focus for employers. Assessing ergonomic factors and hazards in the workplace and developing a comprehensive program to address them is a central element in the reduction and prevention of MSDs, and it is valuable to involve employees in this process. In terms of programs, the Centers for Disease Control and Prevention (CDC) identifies a number of work-related programs and interventions to address MSDs. They include providing workplace lifestyle health promotion programs and training to management and workers regarding workplace risk for MSDs, and identifying community education programs on arthritis self-management. The CDC also identifies policy strategies to promote workplace health and well-being including implementing policies to demonstrate employer commitment to safety and disability management and return-to-work policies to support employees.

It is also important that employees with MSDs receive the appropriate care. Employees should proactively report symptoms and seek treatment early to prevent worsening of a condition. It may also be valuable to engage with an occupational health provider who can provide expertise oriented toward workplace illnesses and injuries. For employees who may require more complex or specialized surgical care, employers may opt to establish a relationship with a Center of Excellence for a given condition.

Musculoskeletal disorders are a significant cost driver for employers in terms of both direct and indirect costs. Developing a comprehensive strategy to prevent and reduce them — and promoting overall workplace health — is beneficial to employers and employees alike.

Health Advocate can help employees with MSDs, by helping them understand their treatment options and locating the right providers, so they get the right care and treatment to maintain their health and productivity. Contact us to learn more.


Next Story >> Product Spotlight: Health Advocacy

By Raffi Terzian, M.D., M.P.H., FACEP
Senior Medical Director,
Senior Vice President of Clinical Operations

For many healthcare consumers, the complexity of the system is an unnecessary barrier to understanding their treatment options and receiving quality, affordable care.

The goal, then, is to help employees get to the right care at the right time, so they can return to a normal routine in a reasonable amount of time. It begins with having a clear support system in place to help employees navigate the healthcare system so they can make the right choices for themselves and their family members.

By providing ongoing access to someone with clinical expertise who can answer their questions and explain their options, through clinical decision support, employees can make care decisions with more confidence.

The discussion can also include a review of the impact their condition or treatment may have on recovery time or return to work, clarifying benefits and understanding out-of-pocket costs – considerations that may be overlooked when faced with a serious health issue.

Turning anxiety into action

Facing a complex diagnosis or circumstances where an employee is uncertain about their care plan or next steps can leave them feeling vulnerable. Coordinating care and making treatment decisions, including knowing the right questions to ask, can be challenging tasks.

Empowering employees and offering resources to help them get the answers they need before care decisions are made alleviates uncertainty and helps prevent concern about their (or a family member’s) health from affecting their productivity or disrupting their lives. Having an additional layer of support is key during these times of high stress and anxiety.

Expert support to find the right doctors

In addition to helping to coordinate care and providing decision support to assist with understanding treatment options, another key element of clinical advocacy is helping to locate high-quality providers, including specialists and facilities, to meet employees’ individual needs. The focus on quality (such as leading academic centers and Centers of Excellence), can result in better outcomes and lower costs.

The process begins with a thorough clinical intake, followed by a comprehensive search to identify leading in-network providers. Making proactive outreach to provider offices to assess experience, confirm availability and help with scheduling appointments and transferring medical records are also key elements of the process. These personalized services help ensure that employees get to the right care quickly and efficiently. All of these services are augmented by an ongoing relationship with an advocate who can assist with any additional needs that may arise.

Research shows that organizations who integrate clinical advocacy into their benefits offering experience improved health and productivity and lower medical costs. It’s a practical, winning solution for everyone involved.

Contact us to learn more about clinical advocacy and the many ways we can help your employees and organization.


Next Story >> Clinical Corner: Impact of Musculoskeletal Disorders to Productivity, Costs

Here’s how to clear up inaccurate charges and get the reimbursement you’re owed

By Nellie Huang | Kiplinger

This professional can sort through your care options or sort out medical or insurance snafus.

When Richard Crestani had eye surgery three years ago, an error in the medical billing code for the operation resulted in $18,500 in bills his insurance company refused to pay. After trying to correct the error for six months with no luck, Crestani, who lives in Boca Raton, Fla., called Kenneth Klein, a local patient advocate. Klein helps clients negotiate medical bills and resolve billing errors, and he was able to convince the hospital that the medical billing code was incorrect. In the end, the insurance company paid its share, reducing the bill by nearly $15,000. “He was very tenacious and knew just who to contact,” says Crestani.

A growing number of patient advocates like Klein can help you untangle medical bills or insurance coverage snags or assist with care-related questions, such as helping you decide whether to have heart surgery in your hometown or at a specialty hospital in another state. Patient advocates, also known as care managers or patient navigators, are often doctors or nurses, or they may be former employees of insurance companies, doctor’s offices, hospitals or other care facilities. That gives them an insider’s understanding of how the system works and how best to sort out medical snafus.

How to Find One

Patient advocates help you navigate the system, but they don’t provide medical care or make treatment decisions, says Trisha Torrey, executive director of AdvoConnection Directory, a database of independent patient advocates. Rather, they help patients make informed decisions. “Patients often don’t know what questions to ask,” says Torrey. “The advocates do.”

Many Americans already have access to these services through an employee benefits program. Health Advocate Solutions, for instance, works with 11,500 large companies and institutions worldwide, offering advocacy services to 12.5 million employees and their families. “Health care is confusing and difficult for the average person to figure out,” says Abbie Leibowitz, a founder of Health Advocate Solutions. “We help people who have any problem in health care.”

If your employer doesn’t offer a benefit like this, you’ll likely have to pay out of pocket for an independent advocate. Such professionals typically charge between $75 and $450 an hour, depending on the type of service required and your location, says Torrey. Some advocates who focus solely on billing issues charge a commission on the amount of money they save you instead of an hourly rate (or, in some instances, on top of an hourly fee). Leibowitz says the average case at his firm takes roughly two hours, spread over days or weeks.

The nonprofit Patient Advocate Foundation offers its services free. “We help patients with their entire case,” says outreach director Caitlin Donovan. Although the group deals mostly with lower-income households, anyone can call for help. “It can be hard to get through on the phone lines, but keep calling,” she says. The foundation works in tandem with many other groups, too, such as cancer and diabetes organizations.

One caveat: Patient advocates aren’t licensed, credentialed or regulated in any state. A group called the Patient Advocate Certification Board is developing certification criteria and an exam, which may launch in early 2018. In the meantime, if you’re thinking about hiring an advocate, ask your primary-care doctor for a referral, says Linda Adler, a patient advocate in San Mateo, Calif. Then interview the advocate. Ask for personal references, says Leibowitz. Find out what kinds of cases the advocate is used to handling to see whether he or she has experience with cases like yours. And if the advocate tries to sell you something, Leibowitz adds, find another candidate.