Tag Archives: wellbeing

Bridging Health and Productivity at Work

The wellbeing of our workforces is vitally important because it affects both the top- and bottom-line performance of an organization. Programs that focus equally on the personal health of employees and their professional productivity needs are becoming essential to help companies attract and retain talent. This was the subject of a recent “Out Front Ideas with Kimberly and Mark” webinar.

Our guests were:

  • Fikry Isaac, MD, MPH, the CEO of WellWorld Consulting and the retired chief medical officer, VP global health at Johnson & Johnson.
  • Andrew R. Gold, Pitney Bowes, VP, total rewards and HR technology
  • Alanna Fincke, SVP, director of content, meQuilibrium
  • Brad Smith PhD, VP, analytics and reporting, meQuilibrium

Why It Is Important

Wellbeing benefits individual workers as well as entire organizations and communities. It is a holistic approach that includes the mental, emotional, physical and financial health of the person.

First, wellbeing is a way to engage employees with one another and management within the company. Activities such as walking and fitness programs allow groups to come together in a fun way that helps build trust and camaraderie.

Wellbeing programs also can help employees become healthier by teaching them new habits and helping them get treatment for chronic conditions that they may not be aware they have. A screening, for example, can uncover risk factors for certain illnesses and help workers get the right medical care they need. The employee gets healthier and can continue working and earning a living. From the company’s standpoint, this helps improve productivity and controls the cost of medical care, so it is a win-win for everyone.

From a broader perspective, the environmental factors within and outside of the workplace also affect the overall wellbeing of the individual and should be addressed. The boundaries between work and home life have become blurred, putting added stress on workers. Wellbeing programs need to take into consideration many aspects of the person’s work and home life. They need to help the worker become resilient to be able to handle the demands and pressures of both.

Creating a culture of health within the workforce is paramount to the success of a wellbeing program. Any program or service within a company has to be ingrained in the culture for it to be successful. A wellbeing program needs to be part of the fabric of the business mindset so all employees – especially leaders – embrace the idea of a culture of health.

Resiliency

Resiliency is a newer concept that is gaining attention in workers’ compensation and on the benefit side. It is an important component in workplace wellbeing.

Today’s business climate is more stressful than ever. The pace of work makes it difficult to keep up. The work-life merger adds to it. All of this takes a toll on employees.

The latest trends show:

  • 60% of employees report high stress.
  • The annual cost of stress is $300 billion.
  • One million workers are absent from work every day.
  • 30% of the population has undiagnosed mental health issues.

Resilience teaches employees how to adapt to the changes and stresses of today’s work. While we cannot change the things that happen at work or in our lives, we can learn to change how we react and manage the stress. It is not something we are born with. There are scientifically based teachable skills to help us be more resilient. We can learn to control our thinking and how we react to pressures.

Evaluating the Need for a Wellbeing Program

Every company is different, and it is important when considering a wellbeing program to assess the organization’s needs against the value and impact of any given program. Some companies develop their own internal systems while others use commercial measures. Johnson & Johnson for example, surveys workers annually to determine where each person is on the health spectrum and how satisfied they are with the programs and services offered. The company also has a value system of management to assess the performance and engagement levels of leaders in the various business units.

See also: Wellness Programs Lack Health Literacy  

There are also a variety of tools available on the market to assess the need for wellbeing programs.

  • The Gallup-Sharecare WellBeing Index looks at the key factors that drive greater wellbeing for individuals and populations. It is the world’s largest data set on wellbeing.
  • Employee engagement surveys assess the level of employee engagement in their organizations and their perceptions of management’s involvement.
  • The Centers for Disease Control and Prevention Worksite Health Scorecard designed to assess whether companies have implemented science-based health promotion and protection interventions.
  • The Health Enhancement Research Organization (HERO) Scorecard is designed to focus on best practices for promoting workplace health and wellbeing. It shows what may be missing, the need and what employers can do to build a solid wellbeing program.

Pitney Bowes assesses the needs of its employees by talking to them directly and looking at various data. Feedback sessions, surveys and discussions with various department heads can reveal trends in a company that can be addressed through wellbeing programs. An important point in evaluating the workforce is to look at it holistically, not just a specific injury.

Solutions for Employers

Providing access for employees and their families to well-defined services can be effective in improving the wellbeing of a workforce. For larger corporations, onsite health clinics are ideal for quick issue resolution. They can also provide opportunities for preventive services and access to educational programs.

Access to services for mental and emotional support is another very important service, whether it is through an Employee Assistance Program or an online tool.

Energy management is an up-and-coming area to help with resilience. Companies that utilize it assess the energy level of their employees and provide training to increase their energy.

The number and types of programs that are available can seem overwhelming, but not all programs work for all companies. Employers need to identify those that fit the needs and culture of their own workforce.

One solution that companies are using is called meQuilibrium. Two of our panelists were from the firm, which uses behavioral psychology and neuroscience to help people manage stress. We typically do not include specific vendors in our webinars, but this is one instance where we thought it would be worthwhile.

meQuliibirum is a digital tool powered by data-driven insights that measure and benchmark. It is a skills-based learning product that begins with an assessment to determine how the worker reacts in certain situations, connects with his community, his level of sleep and a host of other issues. The user is then given tools to help him become more resilient.

Measuring Outcomes

Measuring the success of a wellbeing program should take into consideration both the effects on workers and the return on investment for the company. One technique is to look at the four Es: enrollment, engagement, efficacy and experience.

  • Enrollment is first and foremost because a program can’t have a significant impact on the bottom line if only a few employees are involved. Companies that have successful wellbeing enrollment use grassroots methods to spread the word, starting with senior management.
  • Engagement. Once you get workers in the door, keeping them involved is equally important. The percentage of people enrolled in any given month will tell you the level of engagement, as will how long they stay involved. It’s also important to know what elements of the program they are using.
  • Efficacy speaks to the effectiveness of the wellbeing program. Does it deliver what is promised? The best way to measure that is with an employer’s own data. For example, lower use of employee leaves suggests there is an improvement in employees’ resilience.
  • Experience refers to whether and how the program is helping employees. Is it changing their lives? Would they recommend it to their families or friends? Do they have stories about life-changing events due to the program? Those can show the success of the program.

The four Es are also applicable to the workers’ compensation program. Enrollment, for example, could pertain to whether and to what extent an injured worker is engaged with case management. Efficacy is also important because we often do not look at the return on investment (ROI) holistically in workers’ compensation across expense, medical and indemnity buckets. A Net Promoter Score (NPS) in workers’ compensation could be extremely valuable. There is an opportunity to use measurements from the benefits side of an organization to help an employer incorporate them into workers’ compensation so vendors and suppliers have a more consistent way of reporting metrics on the company.

HERO is another excellent way to measure success. This national non-profit organization is focused solely on identifying best practices of workplace and wellbeing to improve the lives of employees and their families. The HERO Scorecard can provide an instant assessment of a company’s wellbeing program compared to others in its database.

From an employer perspective, measuring the ROI of a wellbeing program can be difficult. All the various elements work together to drive improvement for workers, so it is hard to see the overall ROI, but you can look at various metrics. Some numbers may not look significant, but are important. An Employee Assistance Program may only have 3% to 6% of employees involved at any given time, but it is important to those workers using it, so it is important to understand benchmarks.

Other metrics that can be considered are things such as weight loss or other changes that measure benefits of the program. Additional metrics may also help, such as the data for care utilization, claims analysis, participation in wellness programs and lifestyle modification outcomes. There really is no one-size-fits-all way to measure the ROI of these programs, but the more details you can get, the better.

Another way to measure the success of a wellbeing program is to look at its return on value; how much workers are engaged in their work based on their perceptions of the company’s support in helping them be healthy and take care of their families.

The financial success of companies that have invested in health and wellbeing can be measured and is sometimes available in various publications. The American College of Occupational and Environmental Medicine, for example, has published studies showing the stock market performance of companies over time to see if there are differences after wellbeing programs have been implemented.

See also: Employee Wellness Plans’ Code of Conduct  

Challenges to Implementation

Putting a wellbeing program in place can be challenging, but taking a few extra steps will help.

  • Due diligence up front. Especially if you are using a third party, you need to really know what you are implementing. For example, if data is to be exchanged, what data and in what format?
  • Communication. One of the biggest challenges is getting the word out to the people who can benefit from the program. Some companies use various marketing tools such as behavioral economics to spread the word. There should also be some way to motivate people to participate. Monetary incentives are one method.
  • Effectiveness. It is important to monitor and see what is or is not working within the program and be willing to find a different approach, if needed.

Lessons Learned

Despite a company’s best efforts, not every piece of a wellbeing program will meet expectations. You want to make sure you carefully assess whatever you put in place. Something might be perfect for one organization but not work well for another.

Johnson & Johnson had to abandon a nurse line for employees because it just did not work. Pitney Bowes brought biometrics to company sites to make it more convenient for employees to get their blood drawn and get immediate results. But it turned out that method did not lead workers to take action. Instead, the company now pays employees to see a physician to get the same information. The physician can then persuade them to take action.

You have to look at the data and utilization to see if a particular program is valuable or not and be prepared to make adjustments, or even pull the plug entirely on a service, based on those results.

Impact on Mental Health in Work Comp

According to the World Health Organization, mental health is described as: “a state of well-being in which every individual realizes his or her own potential, can cope with the normal stress of life, can work productively and fruitfully and is able to make a contribution to his or her community.” But the World Health Organization’s definition applies only to part of the population.

At any given time, one in five American adults suffers with a mental health condition that affects their daily lives. Stress, anxiety and depression are among the most prevalent for injured workers. Left untreated, they can render a seemingly straightforward claim nearly unmanageable, resulting in poor outcomes and exorbitant costs.

Increasingly, many in our industry are recognizing the need to do all we can to address this critical issue. We must openly discuss and gain a deep understanding of a subject that, until now, has been taboo.

Four prominent workers’ compensation experts helped us advance the conversation on mental health in the workers’ compensation system during a recent webinar. They were:

  • Bryon Bass, Senior Vice President for Disability, Absence and Compliance at Sedgwick
  • Denise Zoe Algire, Director of Managed Care and Disability for Albertsons Companies
  • Maggie Alvarez-Miller, Director of Business and Product Development at Aptus Risk Solutions
  • Brian Downs, Vice President of Quality and Provider Relations at the Workers’ Compensation Trust

Why It Matters

Mental health conditions are the most expensive health challenges in the nation, behind cancer and heart disease. They are the leading cause of disabilities in high-income countries, accounting for one third of new disability claims in Western countries. These claims are growing 10% annually.

In addition to the direct costs to employers are indirect expenses, such as lost productivity, absenteeism and presenteeism. Combined with substance abuse, mental health disorders cost employers between $80 billion and $100 billion in these indirect costs.

In the workers’ compensation system, mental health conditions have a significant impact on claim duration. As we heard from our speakers, these workers typically have poor coping skills and rely on treating physicians to help them find the pain generator, leading to overuse of treatments and medications.

See also: Top 10 Ways to Nurture Mental Health 

More than 50% of injured workers experience clinically related depressive symptoms at some point, especially during the first month after the injury. In addition to the injured worker himself, family members are three times more likely to be hospitalized three months after the person’s injury. Many speculate that the distraction of a family member leads the injured worker to engage in unsafe behaviors.

Mental health problems can affect any employee at any time, and the reasons they develop are varied. Genetics, adverse childhood experiences and environmental stimuli may be the cause.

The stress of having an occupational injury can be a trigger for anxiety or depression. These issues can develop unexpectedly and typically result in a creeping catastrophic claim.

One of our speakers relayed the story of a claim that seemed on track for an easy resolution, only to go off the rails a year after the injury. The injured worker in this case was a counselor who had lost an eye after being stabbed with a pen by a client. Despite his physical recovery, the injured worker began to struggle emotionally when he finally realized that for the rest of his life he would be blind in one eye. Because his mental health concerns were raised one year after the injury, there were some questions about whether he might be trying to game the system.

Such stories are more commonplace than many realize. They point out the importance of staying in constant contact with the injured worker to detect risk factors for mental health challenges.

Challenges

Mental health conditions — also called biopsychosocial or behavioral health — often surprise the person himself. Depression can develop over time, and the person is not clued in until he finds himself struggling. As one speaker explained, the once clear and distinct lines of coping, confidence and perspective start to become blurred.

In a workers’ compensation claim, it can become the elephant in the room that nobody wants to touch, talk about or address. Organizations willing to look at and address these issues can see quicker recoveries. But there are several obstacles to be overcome.

Stigma is one of the biggest challenges. People who realize they have a problem are often hesitant to come forward, fearing negative reactions from their co-workers and others.

Depictions of people suffering from behavioral health issues in mass media are often negative, but are believed by the general public. Many people incorrectly think mental health conditions render a person incompetent and dangerous; that all such conditions are alike and severe; and that treatment causes more harm than good.

As we learned in the webinar, treatment does work, and many people with mental health conditions do recover and lead healthy, productive lives. Avoiding the use of negative words or actions can help erase the stigma.

Cultural differences also affect the ability to identify and address mental health challenges. The perception of pain varies among cultures, for example. In the Hispanic community, the culture mandates being stoic and often avoiding medications that could help.

Perceptions of medical providers or employers as authority figures can deter recovery. Family dynamics can play a role, as some cultures rely on all family members to participate when an injured worker is recovering. Claims professionals and nurses need training to understand the cultural issues that may be at play in a claim, so they do not miss the opportunity to help the injured worker.

Another hurdle to addressing psychosocial issues in the workers’ compensation system is the focus on compliance, regulations and legal management. We are concerned about timelines and documentation, sometimes to the extent that we don’t think about potential mental health challenges, even when there is clearly a non-medical problem.

Claims professionals are taught to get each claim to resolution as quickly and easily as possible. Medical providers — especially specialists — are accustomed to working from tests and images within their own worlds, not on feelings and emotional well-being. Mental health issues, when they are present, do not jump off the page. It takes understanding and processes, which have not been the norm in the industry.

Another challenge is that the number of behavioral health specialists in the country is low, especially in the workers’ compensation system. Projections suggest that the demand will exceed the supply of such providers in the next decade. Our speakers explained that, with time and commitment, organizations can persuade these specialists to become involved.

Jurisdictions vary in terms of how or whether they allow mental health-related claims to be covered by workers’ compensation. Some states allow for physical/mental claims, where the injury is said to cause a mental health condition — such as depression.

Less common are mental/physical claims, where a mental stimulus leads to an injury. An example is workplace stress related to a heart attack.

See also: New Approach to Mental Health  

“Mental/mental claims” mean a mental stimulus causes a mental injury. Even among states that allow for these claims, there is wide variation. The decision typically hinges on whether an “unusual and extraordinary” incident occurred that resulted in a mental disability. A number of states have or are considering coverage for post-traumatic stress among first responders. The issue is controversial, as some argue that the nature of the job is, itself, unusual and extraordinary and that these workers should not be given benefits. Others say extreme situations, such as a school shooting, are unusual enough to warrant coverage.

What Can Employers Do

Despite the challenges, there are actions employers and payers are successfully taking to identify and address psychosocial conditions.

For example, Albertsons has a pilot program to identify and intervene with injured workers at risk of mental health issues that is showing promise. The workers are told about a voluntary, confidential pain screening questionnaire. Those who score high (i.e., are more at risk for delayed recoveries) are asked to participate in a cognitive behavioral health coaching program.

A team approach is used, with the claims examiner, nurse, treating physician and treating psychologist involved. The focus is on recovery and skill acquisition. A letter and packet of information is given to the treating physician by a nurse who educates the physician about the program. The physician is then asked to refer the injured worker to the program, to reduce suspicion and demonstrate the physician’s support.

Training and educating claims professionals is a tactic some organizations are taking to better address psychosocial issues among injured workers. The Connecticut-based Workers’ Compensation Trust also holds educational sessions for its staff with nationally known experts as speakers. Articles and newsletters are sent to members to solicit their help in identifying at-risk injured workers.

Continuing communication injured workers is vital. Asking how they are doing, whether they have spoken to their employer, when they see themselves returning to work reveal underlying psychosocial issues. Nurse case managers can also be a great source of information and intervention with at-risk injured workers.

Changing the workplace culture is something many employers and other organizations can do. Our environments highly influence our mental health. With the increased stress to be more productive and do more with less, it is important for employers to make their workplaces as stress free as possible.

Providing the resources to allow employees to do their jobs and feel valued within the organization helps create a sense of control, empowerment and belonging. Helping workers balance their work loads and lives also creates a more supportive environment, as does providing a safe and appealing work space. And being willing to openly discuss and provide support for those with mental health conditions can ensure workers get the treatment they need as soon as possible.

As one speaker said, “By offering support from the employer, we can reduce the duration and severity of mental health issues and enhance recovery. Realize employees with good mental health will perform better.”

To listen to the full webinar on this topic, click here.