Leave management strategies are making Wellness, disease management, and preventive programs more powerful and effective management strategies.

Business leaders feel the pain when employees are not at work. Workplaces that rely on direct employee contact with consumers exhibit significant loss of productivity and efficiency when an employee isn’t at work. For example, when nurse John Smith isn’t at work, his unit supervisor at the hospital has two choices. She must find a replacement or spread John’s patients across the remaining nurses already carrying a full load. Both options result in higher costs, lower morale as well as a potential negative impact on patient care. Managing absences as a part of the Integrated Healthcare Process saves money and increases productivity.

  1. The first key to reducing absenteeism and improving productivity is to understand why an employee is not at work and address the root cause. A JHA absence management survey reports that 55 percent of employee absences are blamed on disabling injuries and illnesses1. While not all injuries and illnesses are actually work related, according to the Journal of Occupational and Environmental Medicine, the overall annual cost of poor health in the workplace is estimated at $1.8 trillion2.

    The Occupational Safety and Health Act (OSHA, 1970) requires employers to maintain records of serious workplace injuries and illnesses (29 USC section 657c(2)). However, these statistics do not capture episodic injuries. These injuries are largely the result of repetitive activities, occurring over time. They, therefore, often go under-reported and the resulting medical costs and lost productivity remain uncalculated.

    Research by the Integrated Benefits Institute, Ron Loeppke, MD, MPH, (former EVP of Health and Productivity Strategy for Alere and current Vice Chairman of U.S. Preventive Medicine) and Ron Kessler, Ph.D., (Harvard University Medical School) illustrates this through a comparison of the 10 most costly health conditions based solely on medical and pharmacy claim costs. These conditions are cancer [other than skin cancer], back/neck pain, coronary heart disease, chronic pain, high cholesterol, GERD, diabetes, sleeping problems, hypertension and arthritis. Yet when calculations combine productivity losses with direct medical costs those conditions alter to musculoskeletal conditions, depression, fatigue, chronic pain, sleeping problems, high cholesterol, arthritis, hypertension, obesity and anxiety3.

Linking health related absences to specific diagnosis codes provide companies with quantifiable data related to the overall health and productivity of their workforce and its effect on the financial bottom line.
  1. The first warning sign or leading indicator of a potential leave or short-term disability event can be found in employee absences. These warning signs are often overlooked and never considered. This is because most companies rely on healthcare claims to identify trends, even though they are, at best, lagging indicators.
Case Study:

Platinum Inc. company initiated an Absentee Management process. The process consisted of a web portal, call center and mobile phone capabilities for employees to report sick days and corresponding symptoms. Within 3 months, explicit trends elucidated the value of linking the employees and Wellness/DM Health Coaches. The absence data was a leading indicator or barometer of things to come.

John had missed five days of work because he “just didn’t feel well.” John had yet to seek any medical care because he had written it off to his age, weight and generally unhealthy diet.

Using his company’s newly implemented Absentee Management System, John chose from a dropdown list of symptoms, such as ‘Extreme fatigue and Irritability,’ and how often it occurred in the last few weeks. This company’s HR executive insisted on integration of Wellness/DM and the Absence Management System. Therefore, this information triggered a notification to the company’s Wellness/DM provider to contact John.

The Health Coach reviewed John’s overall sick day history (and symptoms), identifies and is alerted to a possible larger problem. Further conversations with John revealed more ongoing symptoms including unusual thirst, extreme hunger and weight loss. The Health Coach helps John make an appointment with his personal physician. It is discovered that John’s physician diagnosed John with Type 1 Diabetes.

The CDC estimates that 23.6 million Americans have diabetes, but roughly 5.7 million of them are undiagnosed. An additional 57 million Americans are estimated to have “pre-diabetes” where their blood glucose levels are high but not enough to be diagnosed as diabetes4. Costs associated with these two groups are estimated to be $18 billion (undiagnosed) and $25 billion (pre-diabetes) respectively5.

Technology helps us to recognize absence data as powerful leading indicators. How many undiagnosed cases of diabetes or other health related issues can be identified through an integrated Leave Management Strategy?

A coordinated effort between internal and external stakeholders can identify employee absentee signals. This allows quick and effect pre-emptive measures providing significant cost savings and maintaining productivity while enhancing the quality of life of the employee which results in added tangible results to the employer.
  1. The third and some would say most important element necessary to reduce absenteeism and improve productivity is a comprehensive Return-to-Work process that incorporates information from the previous two elements to bring the employee safely and efficiently back to work.
Case Study:

Gold Inc. company launched an integrated Return-to-Work process that connected the individual employee, supervisor, HR, Case Management and physician together through effective information management. Within four months, the overall costs associated with lost work days declined. The improved communication of appropriate and allowable information triggered this effective solution.

Phil injured his shoulder while doing yard work over the weekend resulting in an appointment with his personal physician on Monday morning. The doctor concluded that Phil had a minor tear in his left rotator cuff. Unaware of Phil’s complete job description, the doctor directed him to stay home for two weeks to rest his shoulder followed by no lifting of anything heavier than five pounds for the following three weeks.

Phil submitted the Absence Request for time off via his company’s newly implemented Leave Management System, including the medical restrictions ordered by his physician. This company’s HR executive insisted on a comprehensive Return to Work program so the Employee Health case manager contacted Phil’s physician.

The Case Manager provides the physician with a complete analysis of the physical requirements of Phil’s job. After reviewing the specific physical duties of Phil’s everyday job, the doctor provides a more detailed set of instructions for his treatment, recovery and subsequent return to work.

In this situation, Phil sits at a desk 85% of the time with some light lifting and distributing of office supplies for the remaining 15%. Utilizing this information, the doctor adjusts his orders to one week at home to rest, but keeps the original three weeks of not lifting anything heavier than five pounds.

Quick communication on the medical restrictions and essential job functions to all groups involved meant Phil was able to return to work sooner than originally prescribed, thereby reducing the associated lost productivity.

Data integration provides objective measures to show the efficacy of an organization’s health management, Disease Management, Wellness and Preventive Initiatives. Companies now can access a more accurate picture of their actual Return on Investment as it relates to Human Capital.

5 Reasons for integrating Leave management into your Health Management Strategies

  1. Case identification for preventive or care management strategies within minutes of the leave being approved – instead of waiting 120+ days for the medical claim data to be delivered;
  2. Clarity of Health Management Program Value explicitly through Diagnosis-centric Absence Reports;
  3. More accurate outcomes (and recognition for health coaching programs’ impact on Business issues (payroll, overtime, Human Capital);
  4. A higher level of Partnership enabling Health, Wellness, FML, LOA, STD, Work Comp and HRIS data utilization in Strategic Business Setting (C-Suite);
  5. Expanding ROI data from Health Claims to Payroll, Overtime, and Disability savings.

Now more than ever it makes sense to make Absence Management part of your health management strategies. Technology advancement makes it easy to integrate what once were disparate unrelated systems. Leave and health can be one unified strategy improving your employee’s health, your company’s bottom line.

Patrick F. Cua
The author has spent 25 years in the healthcare industry including the last 15 years in Wellness/DM. Mr. Cua led the sales and marketing efforts in for “startups” through large scaled organizations such as C.R. BARD, CorSolutions and Matria Healthcare. Patrick’s previous role was Executive Vice President of Sales & Marketing for Matria Healthcare which was recently acquired by Inverness Medical. Mr. Cua currently serves as Executive Vice President – Sales & Marketing for pihms, Inc.(www.pihms.com)

http://www.linkedin.com/pub/patrick-f-cua/14/543/547

 

  1. Chris Silva, Big-picture benefits: Integrating FMLA and disability claims data helps reduce absenteeism, Employee Benefit News, September 2006. http://ebn.benefitnews.com/news/big-picture-benefits-integrating-fmla-and-disability-39477-1.html
  2. Loeppke R, Taitel M, Haufle V, Parry T, Kessler R, Jinnett K. Health and Productivity as a Business Strategy: A Multiemployer Study. J Occup Environ Med, Vol. 51, No.4, April 2009. http://journals.lww.com/joem/Abstract/2009/04000/Health_and_Productivity_as_a_Business_Strategy__A.4.aspx
  3. Loeppke R, Taitel M, Haufle V, Parry T, Kessler R, Jinnett K. Health and Productivity as a Business Strategy: A Multiemployer Study. J Occup Environ Med, Vol. 51, No.4, April 2009. http://journals.lww.com/joem/Abstract/2009/04000/Health_and_Productivity_as_a_Business_Strategy__A.4.aspx
  4. Centers for Disease Control and Prevention. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf
  5. Dall T, Zhang Y, Chen Y, Quick W, Yang W, Fogli J. The Economic Burden of Diabetes. Health Affairs, 29, no. 2 (2010): 297-303 (Published online 14 January 2010), http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2009.0155