Looking Ahead Part 2: The Pace of Change Accelerates in 2021

This is the second in a series of four articles in our Looking Ahead Guide to Employee Benefits in 2021. Our goal is to help employers set the stage for new opportunities in their Employee Benefits programs.

In Looking Ahead Part 1, we discussed how employers reviewed their benefit strategies, invested in remote work, and created novel employee communication programs. The silver lining of 2020 was that it taught us to be resilient and continuously adapt to rapid change.

"Be fast, have no regrets... If you need to be right before you move, you will never win."
Mike Ryan, epidemiologist at WHO, March 2020.

Rapid—if not accelerated—change is a key theme for this year, presenting employers with three strategies:

• Prepare for what’s next.
• Embrace here-to-stay trends.
• Double down on what works.

Prepare for What’s Next: Vaccine Management and the Evolution of Remote Working

"Give me six hours to chop down a tree and I will spend the first four sharpening the axe." Abraham Lincoln

Preparation is key for addressing emerging issues. Employers can expect to create new benefit programs as the dust settles, as we all understand more about the long-term effects of the pandemic.

Vaccine Management Programs

Chaos rules the current vaccination program. Limited information, lack of supply, and poor coordination between federal, state, and local agencies fuels the public's already simmering rage. New York City cancelled 23,000 vaccination appointments for lack of supply, while other cities had to discard unused or expired vials. "Vaccination Tourism" may also be emerging, with reports of people flying to Florida just to get a jab in the arm.

As a coordinated vaccination program rolls out across the US, employers will have a crucial role to play in educating employees. Like it or not, employers will need to define their perspective on the issue, deciding if they want to adopt a formalized policy.

Employers can help employees and their families understand what phase of the vaccine roll out they qualify for and set expectations. Directing employees to the right websites and understanding vaccination criteria will be essential to reduce the frustration that employees already feel.

Employers should act early to implement a vaccination management program. Care Validate—a digital health platform that provides employee training, screening, testing, and tracing—may become an integral part of employers' vaccine management program, helping to monitor the health of their entire workforce.

Building education and transparency into your employee awareness program will be an ongoing initiative. Regional cultural norms and beliefs, vaccine availability, and public health knowledge are all subjects that employers will need to address.

Woodruff Sawyer Employee Benefits experts can help you shape the right communication strategy and provide access to sample templates that will save you time in getting accurate and timely information to employees.

Remote Working

Employee communication has never been more important. Not only are employers tasked with communicating about vaccines and changing health regulations, they are challenged with a new working environment as a result of remote work protocols.

Remote working is evolving as employers balance employee safety and business operations. Initially, synonymous with Work-From-Home (WFH), employers are reconfiguring permanent and part-time remote positions, with hybrid office models that include occasional in-office work scenarios. Many employers enjoyed immediate productivity gains, while other corporate leaders believe that innovation has deteriorated with the WFH model.

These new work models are changing the corporate culture, presenting new options for employees that will have a significant impact on employers.

For instance, what happens when your employees relocate? As some positions become permanently remote or have limited need for an office presence, employees are exploring new lifestyle options. Relocating out of high-cost urban areas, either in-state or out-of-state, should be expected. Several states now offer incentives for remote employees to relocate, a tempting offer for people who want a less-stress, lower-cost lifestyle.

Future payroll and benefit plans could be impacted by the exodus of remote workers as they create new living and working options, creating challenging questions for employers. Will your benefit plan support workers in multiple states? How do you create parity in benefit plans if your headquarters is on the West Coast, but several employees live in the Midwest? Are your state regulations still applicable if your employees work in another state, permanently or temporarily? Remote working is creating a decentralized workforce, requiring new employment and benefit strategies.

At Woodruff Sawyer, we are committed to keeping you updated on the impact that remote work will have on your plan design and how you can continue to offer innovative programs that attract and retain your employees, wherever they are.

Here to Stay: Mental Health and Telehealth Benefits

Mental health and improved access to care through telemedicine are two programs that will be permanent parts of every employer benefit program. Here's why.

Mental Health on the Forefront

"It's time to tell everyone who's dealing with a mental health issue that they're not alone, and that getting support and treatment isn't a sign of weakness, it's a sign of strength." Michelle Obama, World Mental Health Day

The pandemic forced people to live, work, and educate from home, creating new household demands and family routines. Financial pressures mounted as unemployment spiked to 14.7% in April, ending the year at 6.7%, an 80% increase over 2019. Over 65% of all children used online learning as parents took on additional responsibility for their home schooling.

The pandemic, economic issues, and family pressures highlighted the critical need for mental health resources for stressed employees. The traditional three-visit EAP benefit is no longer effective for rising depression, addiction, and growing behavioral health issues. Mental health challenges have been an active volcano for years, with COVID-19 being the final seismic shift that blew the top off—forcing everyone to finally recognize it and stop the devastation.

Nationally, we need effective mental health solutions, delivered remotely. Employers are in the perfect position to calm the storm by enhancing current mental health treatment solutions with telehealth and other programs as a core part of their benefit package.

Addressing mental health on a local and national scale is critical and employers play an important role. One Harvard Business Review article indicated that $4 is contributed to the economy for every $1 spent on people with mental health issues.

Woodruff Sawyer has helped our clients evaluate and implement additional behavioral health resources and programs to address gaps in access. In addition to mental health resources we help our clients expand services to include mindfulness training, resilience and stress reduction techniques that help employees during challenging times.

Mental health solutions are part of a larger telehealth approach growing in acceptance and usage. The CDC reported that pre-pandemic, overall telehealth visits increased by over 50% in the first quarter of 2020 as compared to 2019, as patients used for routine visits. As the pandemic spread, overall telehealth usage rose over 150% in April, with some health systems reporting a 4,000% increase from March to April. Mental health visits are an important aspect of telehealth, as adherence to clinical recommendations improved 25%.

Telehealth Increases Access, Lowers Costs

"Our CEO of Mayo has stated all along that we'd like to be doing that type of medicine by 2030. We really did it all in six to eight weeks." Kevin Fitzgerald, MD, chair for outpatient practice at Mayo Clinic Health System in La Crosse (Wis.)

Telehealth improves much-needed access to additional plans, more providers and specialists, and an increased number of visits. While the pandemic drove increased telehealth visits, patients and providers are now adopting it as an essential part of care, allowing patients to see their doctor without risk of virus exposure. Telemedicine saves patients over 100 minutes per appointment, improves compliance for providers, and helps patients take better care of themselves—while reducing copays for employees and costs for employers.

The cost of a telehealth appointment is typically less than that of an in-person visit. Based on a study of over 100,000 telehealth visits (pre-COVID), telehealth visits cost about $40-$50 per visit as opposed to $136-$176 per in-person visit, with approximately 1.3 visits per patient per year. During the pandemic, telehealth can offer substantial savings for routine doctor visits and to monitor potential COVID-related symptoms.

How do patients feel about telehealth versus in-person visits? In general, studies show patient satisfaction with telehealth visits was higher than in-person visits, especially during the pandemic. Lower satisfaction levels are typically associated with new patients or younger patients who appreciate person-to-person interaction. Quicker appointment times, meeting from home (without commuting), and no lost wages are clear advantages.

Employers should examine how telehealth improves care and outcomes for their population and what steps they can take to make these programs more inclusive. Mental health and substance abuse have traditionally been underserved in employer health plans, for instance. Targeted investments in these areas can be beneficial, offering remote treatment in lieu of the stresses of in-person care.

Double Down On: Target Care Programs

"In 14 states, more than half of the excess deaths [during COVID] were attributed to other underlying causes, including heart disease, which is the leading cause of death in the country." Association of American Medical Colleges article, August 2020

While we do not yet know the true cost impact of COVID-related illnesses, we do know that traditionally, the top 5% of people with the most acute illnesses consume 50% of US healthcare spending. Employers—who pay over half of all healthcare premiums—have a vested interest in lowering healthcare costs and improving the health of their employees.

Delayed Treatment for Acute Patients Costs Lives

The American Society of Clinical Oncology recommended that onsite cancer screening be delayed or postponed to “conserve health system resources and reduce patient contact with health care facilities.” In one study, the weekly number of cancer patient visits (across all types of cancer) fell 46.4% in the US, with similar declines in European countries. These delayed visits are expected to result in over 33,000 additional cancer deaths in the US. We can expect a similar increase in illness and deaths due to delayed treatment for heart, kidney, and diabetic related conditions.

Treating COVID-19 has resulted in unmanaged chronic care of other illnesses. While office visits are down significantly, so are ER visits. In the first months of the pandemic, the CDC reported that visits reduced from 2019 levels of 2.1 million visits per week to 1.2 million per week in April 2020, a 42% reduction in visits.

Additional CDC studies from March to May 2020 showed that ER visits for acute conditions also declined, including myocardial infarctions (MI) by 23%, strokes by 20%, and 10% for hyperglycemic crises.

These trends indicate that patients are avoiding the hospital for emergent, chronic, and acute conditions. We expect that employers may experience further surprises as claims go "off the radar" during the pandemic, only to return with excessively high claims for unmanaged conditions.

Alternatives to Emergency Room visits include Target Care programs that focus on treating specific chronic illnesses virtually, providing a convenient way for employers to manage care and avoid unchecked claims. Employees are also ready to adopt this approach as an effective and convenient way to stay on top of their chronic issues with less risk of contracting COVID. Target care opens access to more employees while alleviating worries of being treated.

Employers can now find solutions for heart conditions, diabetes, sleep disorders, and more. Livongo, now part of TeleDoc, helps members manage their diabetes, high blood pressure, weight, and mental wellness. HelloHeart helps manage hypertension, tracking blood pressure and notifying their employee's cardiologist. Target solutions make it easy for patients to receive specialized, integrated care, even during a pandemic.

Target care solutions demonstrate their ability to improve patient health by driving behavior change and tracking metrics, supported by clinical results. For employers, offering and encouraging employees to use target programs can mean the difference between incurring "expensive" versus "catastrophic" costs.

LEARN HOW TO SUPPORT YOUR EMPLOYEES AND THEIR FAMILIES THROUGH
TELEHEALTH >>

Employee Communication is 24/7/365

"I motivate players through communication, being honest with them, having them respect and appreciate your ability and your help." Tommy Lasorda

Communicating your benefit programs is now a 365-day PR campaign. Your employees' health is at risk. Understanding their benefits before they need them has never been more critical. Empowering them with the knowledge and benefits available will help improve their health while lowering your costs, which ultimately increases the value of your employee benefits program.

You can leverage Woodruff Sawyer's expertise to secure the right strategy and prevent future surprises. Contact your benefits consultant to make sure your strategy is on track and how to stay prepared in an uncertain world.

Sign up for our upcoming Benefits webinar, Accelerate Episode II: Showcasing Emerging Solutions >>

In this second Accelerate webinar, we welcome a panel of founders, owners, and entrepreneurs to share their thoughts and expertise on ways to provide innovative benefits that support CPOs and HR executives.