A mayor in Ohio has gotten himself in some hot water for his selective use of pre-employment medical examinations for hirees.
How selective? According to WKYC, one woman claims that the mayor required her and other women, but not men, to be examined by his personal doctor. For his part, the mayor denies the allegations as an act of a “fertile imagination” and claims that he sends all city workers, male and female, to the same doctor for pre-employment exams.
Why would her allegations rise to the level of unlawful activity?
Aside from the obvious sex discrimination (an employer cannot apply one set of policies to male employees a different set to female employees), it also violates the ADA’s requirements for pre-employment medical examinations.
The ADA applies a traffic-light approach to employer-mandated medical exams.
Red light(prior to an offer of employment): the ADA prohibits all disability-related inquiries and medical examinations, even those that are job related.
Yellow light(after employment begins): an employer only may make disability-related inquiries and require medical examinations that are job-related and consistent with business necessity.
Green Light(after an applicant is given a conditional job offer, but before s/he starts work): an employer may make any disability-related inquiries and conduct medical examinations, regardless of whether they are related to the job, as long as it does so for all entering employees in the same job category.
Because these exams fall in the “Green Light” category, the city is in the clear, right? Wrong. Pre-employment medical exams are permitted as long as the employer does so for all entering employees in the same job category. This employee alleges the females were singled out. Thus, unless she worked with all women in her job category (another legal red flag), the city violated the ADA by sending some, but not all, employees for pre-employment medical exams.
Also, pay attention to state laws when conducting medical exams. For example, Ohio prohibits an employer from shifting the cost of any pre-employment medical exam to an employee: “No employer shall require any prospective employee or applicant for employment to pay the cost of a medical examination required by the employer as a condition of employment.”
As for this mayor, these allegations are just the tip of his legal iceberg. It’s also alleged that he uses the n-word to refer to African American residents, and sexually harasses female employees by talking about his private parts and how pistachios contribute to his sexual prowess. Sounds like a great place to work.
Providing such care while working a full-time job is both physically and mentally taxing for most employees, and studies even show that burnout from caregiving responsibilities cost companies nearly $13.4 billion each year in health care expenses.
Backup elder care is a benefit some organizations are considering for employees. In general, there are two primary types of elder care benefits:
Dependent care assistance plans. These plans deduct a certain portion of an employee’s paycheck (gross amount before taxes) to pay for elder care costs. According to Forbes, currently, 41 percent of employers offer this benefit.
Respite care. Offered by only 7 percent of companies, this benefit offers short-term care to family members when an employee needs to rest, take time off or go into work.
Flexible work options. These options include allowing caregiver employees to work from home, have flexible hours during the day, or providing paid time off.
Care subsidies. This benefit would help employees with the cost of elder care with subsidies covering either direct costs or backup care.
Support groups. Employers can create onsite caregiver support groups for employees. This will allow them to speak with fellow coworkers dealing with caregiving of senior parents and perhaps find some value in communicating. The employer may also provide online support group resources if onsite isn’t an option.
Respite care is the benefit most commonly referred to as backup elder care, and it is provided through the private insurance companies employers contract with. It is a voluntary benefit, so employees who do not need backup elder care do not have to enroll. If an employee does not know whether they have these benefits, they should speak with a human resources or benefits manager.
The Professional Impact of an Aging Population
According to the U.S. census, nearly 70 million Americans will be over the age of 65 by 2030. This may sound like a shocking statistic to many, but as the baby boomer population ages and exits the workforce, their children and younger relatives might be required to act as caregivers in many situations.
Backup elder care benefits helps employers reduce the amount of stress caregiving employees experience by allowing them to know that their loved ones will be cared for while they are at work.
Studies show that employees prefer to work for companies that offer a reasonable work-life balance. Companies should keep this in mind when deciding whether to provide backup elder care. Caregiving can be exhausting, even for the most dedicated individual and when paired with a demanding work schedule, employees become overwhelmed.
By providing elder care, caregiving employees will have more flexibility. This means limiting the choice of missing a workday or taking care of an infirm parent.
Scheduling Flexibility
According to a 2012 CareerBuilder study, nearly 40 percent of employees who voluntarily left the workplace did so because of a poor work-life balance. Few employees appreciate being called in at the last minute to work abnormal hours, but sometimes it is unavoidable. Most managers and supervisors are aware of this, but if their employees have outside caregiving obligations, they simply will not be able to depend on them to work outside of normal work hours.
Many employees also have difficulty balancing their caregiving responsibilities with regular work hours. Caregivers are more likely than other employees to leave work early and use paid time off to look after loved ones.
This can place a strain on the workplace when a valuable employee is not able to work their normal hours, especially if other workers are forced to pull their weight for them.
Millennials make up 35 percent of the American workforce, and as members of the baby boomer generation age millennials will have to accept the role of family caregiver. As of 2013, nearly 19 percent of caregiving employees were under the age of 40, and this percentage is only expected to increase in coming years. If a company fails to keep such statistics in mind when recruiting younger professionals, it may start to notice its talent pool shrinking because of its perceived lack of concern for its employees who double as caregivers.
Offering Backup Elder Care
As time continues to prove backup elder care should be a benefit offered by an employer, more companies are taking responsibility in offering these benefits. A main provider of backup elder care is Bright Horizons. They offer 24/7 backup elder care to employers. The organization is understanding of both the employer and employee’s needs and even provides an online self-service support for if the employee wants to choose and hire the caregivers themselves. Other providers include Care.com, LifeCare and Town + Country Resources.
Prices vary per provider, with some backup benefit providers estimating a minimum of $15,000 per year to be paid by the employer. The average amount of an employee paying for elder care services is estimated at $4 to $6 per day if the employer subsidizes the cost.
Offering backup elder care is not only beneficial for employees and their loved ones but a company’s bottom line as well. Caregiving employees cost companies millions of dollars in lost hours each year, and by offering backup elder care, you may be able to make up for these losses and retain your most valuable employees who want to work for a company that understands their needs and the importance of family.
EDM Cycling. Surf Set Fitness. Punk Rock Dance Class Aerobic Kickboxing (yes, really!). Hot Yoga. Class Rowing. Barre. Boutique fitness studios and newly fashioned fitness crazes held in small group settings are growing in popularity and helping millions of people get active. Creative instructor-led group classes cater to multiple generations of consumers and are highly effective at engaging members to live an active, healthy and fun lifestyle.
Nick Park, benefits consultant at Corporate Synergies
Access to boutique fitness studios is also becoming an appealing voluntary benefit. Now, some employers are sponsoring access to both small studios and big box gyms with the help of tech-forward companies that aggregate multiple fitness facilities into single-point networks.
The trend toward coached fitness has injected adrenaline into employer-sponsored health and wellness initiatives. That’s because boutique fitness classes appear to engage employees in healthy long-term behaviors. Some progressive HR pros are wondering if they’ve finally found the holy grail of employer-sponsored fitness programs. The answer: maybe.
Wellness programs have changed drastically from the days when employers handed out pedometers at wellness fairs. Today, many businesses provide discounts to traditional, big box gyms. Employees track each visit (often through a gym’s app or their membership system, but sometimes still by hand) and receive monetary reimbursement after visiting a specified number of times in a year — say $150 for 150 visits.
While traditional gym reimbursement is a stride forward, it can still limit engagement to a specific type of self-motivated employee and family member. Big box gyms often offer a limited number of classes that are appealing to the masses.
Boutique fitness studios are becoming increasingly popular because of small class sizes that allow instructors to focus more attention on participants and creative approaches to fitness that engage participants.
Beyond of what most Americans remember from ninth grade Phys Ed class, the vast majority of adults don’t know how to exercise outside of basic running and calisthenics. High-impact exercise on an untrained body can lead to injury, which means that employees need more personal guidance at the start of an exercise regimen that boutique studios can deliver.
Those who are motivated may also miss out on the benefits of a health and wellness program. Employees who would rather cycle for 45 minutes or take part in hot yoga may not get credit from their employer’s wellness program just because they choose to work out at a boutique fitness studio or other instructor-led classes outside of a traditional gym.
Creative instructor-led group classes like barre, cycling, kick-boxing and hot yoga cater to multiple generations of consumers in a wellness program.
Tech-forward fitness companies like ClassPass, Peerfit and Gympass enable employees to pay a monthly subscription fee to attend classes at different boutique fitness studios, as well as traditional gyms. Here’s how it works: An app shows users nearby studios. Employees can register for individual classes, whether it’s cycling, boot camp, yoga or kickboxing. Some apps also use algorithms to recommend new or different fitness classes or fitness trends depending on user behavior.
As more people use the service, the apps compile feedback from users and suggest highly rated classes based on positive experience and popularity.
Boutique fitness studio apps can help make a difference with instruction, coaching, motivation and flexibility:
The apps encourage users to exercise regularly; some also incorporate peer motivation so employees can sign up for classes and encourage their colleagues and friends to join them.
They can help users set goals and stay on track with push notifications and messages (a benefit particularly useful for those just starting their wellness journey).
Some apps include audio coaching for interval running on a treadmill, weight lifting, aerobics and meditation.
When employees travel, they can easily find a participating boutique fitness studio in their area or work out alongside a streaming on-demand video.
Employers that wish to offer this service can often do so at a discount to their employees. The specific pricing structure depends on the app or service chosen; however, they are typically competitively priced.
A boutique fitness studio benefit could be offered as a sole gym membership benefit, or it could be added to a more traditional gym membership reimbursement program to give employees more flexibility in getting and staying fit.
Employers that have established health and wellness programs can also incorporate boutique studio subscriptions into their programs, or build a wellness program around them. The fitness apps provide data to track participation and encourage use. Some vendors will go as so far as to build an application programming interface (API) that will work with a pre-existing wellness technology platform used by an employer. APIs feed participation data to an employer’s wellness platform so employees get credit for it.
Providing boutique fitness studio subscriptions can address two focuses for employers — keeping employees healthy and catering to an increasingly diverse workforce. This type of benefit provides more flexibility to employees, gives them better access to fitness classes (which is a big advantage for teams spread across multiple locations) and has the potential to increase engagement in health and wellness programs.
The first day of school is often compared to the first day of a new job, but the two are more different than they are alike. Sure, a new hire might feel a tinge of excitement and anticipation in advance of their first day with a new company, but more often one feels an overwhelming sense of uncertainty about new processes.
HR leaders can take onboarding tips from the school experience and apply them to the new-hire experience to create excitement rather than angst for the job.
Long before the first day of school, incoming students receive preparatory details lik school supply lists, notification of who their teachers are, and even assignments and materials to read in advance. Larger institutions might send campus maps and directories to incoming students.
When it comes to employee onboarding, don’t wait until a new hire’s first day to introduce him or her to your company. Share details such as directions to the office, where to park and an onboarding checklist of administrative tasks (like setting up payroll and benefits) that the new hire can complete before day one.
Arm each new employee with informative tools such as an org chart, making sure it reflects the new employee’s name and position in the organization and whom to contact for certain needs or questions. A detailed org chart can give new employees interesting and relevant details about their new coworkers, such as where they went to school, what their job responsibilities are and what interests them outside of work. Instead of walking into a room full of strangers, new employees will already feel a connection with their coworkers on the first day.
The First Day: An Assigned Seat
New students usually have an assigned seat and are provided with all needed supplies on their first day. Likewise, it’s critical to ensure that your new hire has a designated space in the office. It sounds simple, but it’s not uncommon for a new team member to show up and find him- or herself without a place to sit. Make sure the right processes are in place so this doesn’t happen.
It’s also important to provide new employees with the equipment they need to do their job well from the start. This usually means a designated desk and chair, a working laptop, and a telephone, at minimum; an employee handbook and background information on the company are also useful. It’s always nice to welcome new team members with a bag of company marketing collateral or “swag,” like a T-shirt, laptop sticker or branded earphones.
On the first day of school, no one wonders where to eat lunch. Students typically walk to the cafeteria together. But for new hires, the lunch routine is not so obvious. Do most employees eat out or bring their own? Do they eat together in a break room or café, or does everyone tend to eat at their own desk? Encourage your new hire’s team to take him or her to lunch on the first day, and communicate this to both the new employee and the team beforehand so there is no confusion.
The Days Ahead: Class Is in Session
Many universities have instituted the smart practice of pairing incoming freshmen with peer mentors during their first semester. These “buddies” are not teachers or leaders, but rather fellow students who have been at the university for a year or two and know the ropes.
This type of “buddy system” can be adopted in the workplace. Assign a new hire a peer — not a manager — who has been at your company for a while and knows how things are done. This buddy can help the new employee find out information that isn’t documented and meet people quickly. This system is also beneficial to the buddy, as it gives him or her a sense of ownership and responsibility.
Another way to help new employees get to know each other is to make a game of the getting-to-know-you process. If your org chart is interactive, use it to create a flash card–type game that makes it easy to put faces to names. You can also incorporate elements like job skills, fun facts, number of years with the company and even Myers-Briggs personality types.
Consider adopting these steps and implementing them in your new hire onboarding. Streamlining the process and making it easy for new employees not only makes their jobs more enjoyable, but also makes your job easier and more strategic.
Bill Boebel is a serial entrepreneur and is the CEO of Pingboard. He previously was CTO of Rackspace Email and also co-founded Capital Factory, which helps entrepreneurs in Austin, Texas, build their companies. Comment below or email editors@workforce.com
Everyone has a health-related vice. It’s more respectful to refer to them as a person and not by their unhealthy habits.
The language you use is important. People are people. Call them what they are.
I say this because of a common phrase I’ve come across occasionally in my health care research. I attended a webinar in which the speaker consistently referred to people as “cost-drivers.” Obese employees were referred to as “cost-drivers;” so were employees with diabetes. What does someone who is obese cost you compared to someone who is not obese, the moderator posed. This is a major pet peeve of mine in health care reporting — both the language used and the idea that a person’s health status could potentially influence a candidate’s perceived hireability for a company.
We’re all in the HR space here. I wouldn’t be surprised if you, too, have come across handfuls of headlines and articles about “putting the ‘human’ back in human resources.” I’d like to argue that when we’re talking about health care and health problems that need medical attention, let’s be careful to keep the “human” in mind, too.
There’s a person behind that health care cost, and you don’t know how much physical, mental or financial stress that health problem is putting on them. Stop acting like people’s health problems are more inconveniences for you than inconveniences for them.
Most people have some sort of cost-driving behavior, whether that’s smoking, not eating healthy enough, not sleeping enough or drinking too much coffee. Even people who work out, do yoga, practice mindfulness and eat healthy participate in some behavior that one might consider unhealthy. Most everyone has a health-related vice.
People should take responsibility for their own health, but adopting the perfect heath behaviors in every aspect of our lives is impossible. Every person, regardless of their health status, drives health care costs.
Yes, of course organizations have the responsibility to try to stay financially healthy, and a continuing, rising cost in many companies are health care expenses. It’s not surprising that businesses want to focus on decreasing health care costs, and it’s not negative that they want to do so.
Referring to employees as rusting machines that require constant maintenance rather than humans whose health problems are realistically more complex than a simple fix rubs me the wrong way. Ultimately, it’s an objectifying way to describe people. It comes across as a way to disregard the human behind the heath behavior.
Not long ago, a pre-existing condition was a valid reason for insurance companies to deny people coverage. And, with the future of health care legislation in the U.S. so uncertain, who knows what the future of this practice will be? Might employers possibly take a similar route and choose the healthiest candidates first, regardless of if they’re the best person for the job, to avoid those pesky, sick “cost drivers”?
There has to be a way to mix financial responsibility and human understanding — at least if you truly do want to “put the ‘human’ back in human resources.”
My take on this: when you refer to a “cost driver,” make sure it’s a something and not a someone. And don’t let their status as a “cost driver” impact the value you place on them as an employee or as human beings.
Andie Burjek is a Workforce associate editor. Comment below or email editors@workforce.com.
Team Horner Group, a pool-supply manufacturing and wholesale distribution company with a nationwide footprint of 480 employees, focuses on employee well-being to the extent that it was one of five companies nationwide to win the 2014 American Psychological Association’s Psychologically Healthy Workplace award.
Jeska Brodbeck, a mindfulness education and performance coach, works with employees of Team Horner as an antidote to stress. Photo by Edison Rumbos
Not surprising, given that the company has offered employees yoga, meditation, financial and life coaching, and personal training at its in-house gym and exercise room, as well as a discounted massage program.
Team Horner has taken it up a notch recently, adding mindfulness education for its employees as an antidote to stress.
“According to the American Institute of Stress, 80 percent of workers feel stress on the job,” said Jeska Brodbeck, a Miami-based mindfulness and performance coach who taught Team Horner employees. “Stress is a tremendous issue at the workplace and is often only addressed minimally. Nearly half say they need help in learning how to manage stress and 42 percent say their co-workers need such help. Two-thirds of doctors office visits are for stress-related conditions.”
While a modest amount of stress in the workplace is normal, sustained levels can be harmful and lead to numerous health issues, affect professional and family relationships, and contribute to poor work performance, said Carol Ann Rydahl, a health strategy consultant with Minnesota-based managed health care company UnitedHealthcare.
A recent UnitedHealthcare survey indicated almost 90 percent of employees report a positive impact from meditation or mindfulness on their overall health and well-being, with 41 percent indicating a significant impact.
Mindfulness may be the answer to help lower employee stress and improve productivity through freeing employees of habitual patterns of thinking, judging, feeling and acting, and may help them perform better, ignore distractions and make better decisions throughout the day, Rydahl said.
Team Horner employees practice mindfulness training. Photo by Edison Rumbos
As such, “Employers also may benefit by experiencing more productivity, with an enhanced sense of culture and connectedness that can drive more creativity and innovation while reducing absenteeism, burnout and turnover,” Rydahl said.
Mindfulness also can boost working memory, reduce emotional reactivity, offer greater cognitive flexibility and reduce rumination, Brodbeck said.
Following a solid body of research on mindfulness by universities and institutions that prove its multiple benefits, mindfulness programs are now offered by some health plans, including UnitedHealthcare, and medical centers, hospitals, schools and businesses, Rydahl said.
Jason Rutz, Cigna health engagement specialist.
“We’ve found that mindfulness is an effective approach for relieving stress and improving focus. We encourage employers and employees to include mindfulness as part of a holistic approach to health and wellness,” said Cigna Health Engagement Specialist Jason Rutz, crediting Brodbeck for helping people recognize opportunities for self-improvement and develop new habits that can reduce stress, increase productivity and improve quality of life.
“Many times, we think of wellness programs as only focusing on nutrition and exercise and not mental health and the different ways of dealing with every day stress,” said Joel Staco, Cigna’s onsite benefits representative for the city of Hollywood, Florida, in its human resources office.
With roots in the corporate world, Brodbeck understands firsthand the challenges employees and executives face in the workplace. She has practiced mindfulness and yoga for more than 14 years, having trained at the U.S. Kripalu Center for Yoga & Health.
She is training in mindfulness-based stress reduction, a program based on the work of Jon Kabat-Zinn, founder of the Stress Reduction Clinic at the University of Massachusetts Medical School, a preeminent meditation-based clinical program.
Through her business, Be Light Consulting, Brodbeck brings her Mindful Performance Training program to C-level private and public-sector executives and employees, teaching them practices such as mindfulness “that can act as triggers for the ‘flow state,’ also known in science as transient hypofrontality or by athletes as being in ‘the zone,’ ” she said.
“When a person is in the zone, they can perform with high levels of creativity, little to no negative stress and complete focus and engagement,” Brodbeck said. “This training creates a paradigm shift in the way employees are working and living so that they can get their work done and also enjoy the process.”
Brodbeck’s science-based course is taught in eight modules that delve into meditation, shifting from stress to calm in under five minutes, reducing emotional reactivity, and moving into the flow against distractions.
Other topics include time management, relaxation techniques, harnessing the power of the mind, and mindful communication.
Brodbeck’s mindfulness lessons bring something different to the table, said Kim Kent, who coordinates the well-being department at Team Horner.
Brodbeck’s course “ties it together like a thread, putting together techniques that are takeaways you can implement in your daily life,” Kent said. “Mindfulness is not just about addressing stress, but also time management, which can be stressful if you don’t manage it well. We learn about mediation, focus and flow.”
Of all of the wellness programs Team Horner has offered, Brodbeck’s has drawn the highest participation percentages from warehouse employees to vice presidents, Kent said.
Kent also favors Brodbeck’s scientific approach, which helps participants not only understand the impact of mindfulness on brain function but why it is important.
“We are so thrilled with what Jeska has done, taking the mystery out of this buzzword ‘mindfulness,’ ” Kent said. “People are embracing how the strategies she’s given us can really help our lives.”
At Team Horner, the course is taught during the lunch hour, with lunch provided by the company.
The wellness programs — especially the mindfulness presentations — have benefited the company, Kent said. Employee surveys indicate positive feedback. Employees also are getting bigger insurance discounts based on annual health risk assessments.
“We see upticks on data like employees’ blood pressure getting better because we’ve been teaching people about stress,” Kent said. “This is an employee-owned company with the understanding that when you invest in your teammates, your teammates feel valued.”
Tracy Duberman, president and CEO of the Leadership Development Group.
Of the city of Hollywood’s 1,300 employees, 25 to 30 voluntarily participated in Brodbeck’s program, Staco said, adding those who have participated in it have offered positive feedback.
As was the case at Team Horner, the driving factor for launching the mindfulness program was to provide a different aspect of wellness for city employees, Staco said.
“We all look forward to that hour respite from our daily work duties,” said Hollywood City Attorney Doug Gonzales. “The skills taught in that short period of time are invaluable and certainly lead to more productive employees, which in turn benefits everyone involved.”
Gonzales sees value for the program for anyone “who can use a relaxing moment to themselves during an otherwise hectic day.”
Health care facilities can be one of the most stressful workplaces and mindfulness can play a key role in stress reduction, said Tracy Duberman, president and CEO of The Leadership Development Group, a global talent development firm that works with health care leaders.
“In our experience coaching leaders, we incorporate mindfulness practices to center our clients as they begin and end a coaching session,” Duberman said. “This allows their minds to focus on the session goals rather than their next work task.
“Leaders begin to see the results of the practice in its ability to promote resiliency and the ability to lead in complex conditions,” she said. “Embedding the practice within an organization takes concerted effort, a conscious focus on personal daily practice and facilitated group-based meditation as part of the organization’s daily practices.”
Carol Brzozowski is a Florida-based independent journalist. Comment below or email editors@workforce.com.
Since I started researching and writing about workplace wellness for Workforce two years ago, there’s been one story that’s consistently creeps up every so often.
I’ve always seen it as one of the many tension points in workplace wellness: return on investment. Do wellness programs work from a financial perspective? Do they actually save plan members and organizations health care dollars?
[Other points of tension I’ve noticed: 1. financial incentives — are they coercive or not? Do they work or not? 2. Responsibility — is employee health and how employees eat, exercise, etc., outside of work an employer’s responsibility? Is that overstepping a line or a legitimate business decision? What areas of debate do you think are most noteworthy or intriguing tension points in workplace wellness?]
There are studies that claim wellness programs have clear financial benefits, and others that find the opposite. I’ve noticed the types of organizations that publish positive results are wellness companies themselves or the organizations that utilize wellness programs. The types of organizations that have published the more constructively critical results have been third party researchers like universities.
That’s why it was interesting to come across this New York Times story, “Workplace Wellness Programs Don’t Work Well. Why Some Studies Show Otherwise.” This story may be a bit dull for people not interested in the details of workplace wellness programs or the nuts and bolts of how different research studies are structured, but I found it enlightening.
The article compared two types of research studies: observational analyses vs. randomized controlled trial. Many of the analyses of wellness programs that show positive results are observational, it stated, and although there are some benefits to observational research, the randomized controlled trial is the “gold standard of medical research.”
You can check out this article’s deeper information on these two methods and what makes them different. I’ll focus on the implications of the methods on workplace wellness studies. An excerpt from the article:
“… Almost all of those analyses are observational, though. They look at programs in a company and compare people who participate with those who don’t. When those who participate do better, we tend to think that wellness programs are associated with better outcomes. Some of us start to believe they’re causing better outcomes.”
“The most common concern with such studies is that those who participate are different from those who don’t in ways unrelated to the program itself. Maybe those people participating were already healthier. Maybe they were richer, or didn’t drink too much, or were younger. All of these things could bias the study in some way.”
“The best of these observational studies try to control for these variables. Even so, we can never be sure that there aren’t unmeasured factors, known as confounders, that are changing the results.”
In June, a group of researchers published the results from the Illinois Workplace Wellness Study. They conducted a randomized control trial and analyzed the data as if it were an observational trial. Here are some of the results:
People who participated in the wellness program went to the gym almost twice as often as those who did not participate, according to the observational analyses. The randomized control trial found that participants and nonparticipants went to the gym roughly the same amount of times a year.
Participants spent $525 and $273 monthly on health care and hospital related costs, respectively, compared to nonparticipants who spent $657 and $387, according to the observational analyses. the randomized controlled trial found that wellness programs had little effect on spending.
I’d strongly recommend this to any benefits or wellness professional interested in the ROI of workplace wellness.
One more thought. A while ago I began hearing from some people or reading that wellness programs aren’t a health-care cost saver, really, but a retention and attraction tool for employees. If that’s true, maybe results like those seen in this Illinois Workplace Wellness Study are irrelevant and employers will continue to offer wellness programs no matter what the cost savings (or lack thereof) are. We’ll have to see what the future of workplace wellness has in store!
Andie Burjek is a Workforce associate editor. Comment below or email editors@workforce.com.
In 2002 Prudential Financial’s employee wellness program had a participation rate that many employers would envy, but when executives examined who was signing up, they discovered that African-Americans were greatly underrepresented.
They developed a new communications strategy to get more African-American workers on board, but another problem emerged. As they looked more closely at the company’s health care data, they found that African-American employees had much higher rates of diabetes and hypertension than those from other racial and ethnic groups, according to Dr. K. Andrew Crighton, chief medical officer at Prudential Financial.
In order to address those disparities, the company created a data warehouse to collect and analyze employee health information by race, ethnicity, gender, age and job levels and to track chronic conditions like diabetes, cardiac disease and asthma. Armed with that information, Prudential launched the Healthy Diabetic program in 2011 to address the disproportionate incidences of the disease among various employee groups.
Prudential is part of a small but growing number of employers that are addressing inequities in the health status of their workforces. Racial and ethnic disparities in health care — whether in access, insurance coverage or quality of care — is typically thought of as a public health concern, but awareness among employers is growing, according to LuAnn Heinen, a vice president at the National Business Group on Health.
“As the U.S. workforce becomes increasingly diverse and company operations globalize, health disparities in the workplace are also becoming more common,” she said in an email. “By addressing health care disparities and health equity, employers are improving the value, quality and effectiveness of the services their employees receive through health care benefits and productivity programs.”
According to the U.S. Centers for Disease Control and Prevention, African-Americans are 60 percent more likely to develop diabetes and 30 percent more likely to die of heart disease than non-Hispanic white people. While insurance coverage and access to care affect health outcomes, disparities exist even among those with insurance. For example, when it comes to cardiac care, insured African-Americans are significantly less likely than white people with health insurance to undergo angiography, which identifies blockages in the heart’s arteries, according to an NBGH report on health care disparities. As a result, African-Americans are less likely to undergo heart bypass surgery and other potentially life-saving procedures.
“Employers are coming to see that this is really critical,” said Ron Goetzel, vice president at Truven Health Analytics, which helped Prudential develop its data warehouse. “Even companies that offer very good health benefits, even those in the Fortune 500, when you begin to analyze the data and look at different racial and ethnic groups, you will see differences in prevalence.
“It doesn’t start when you enter the workforce, it starts way before that. Your childhood, your education, the environment you grew up in, all of those factors come with you into the workplace. To the extent that employers can address those factors, it’s going to benefit the employee and the organization.”
In 2015, Goetzel co-authored a study of racial and ethnic health disparities at 46 large companies and found that even among employees with good health benefits, higher incomes and a safe work environment, disparities existed. The study points out that some differences may be attributed to social, environmental and economic differences that were not measured in the analysis.
At Prudential, on-site nurses provide personalized coaching to help diabetic employees manage their blood glucose levels. First-year results showed declines for all groups with 61 percent of diagnosed employees joining the program. The company also provides cultural competency training for all health and wellness professionals.
Unlike many employers, Prudential eschews outcomes-based wellness incentives like financial rewards for employees who complete weight-loss or fitness challenges because such practices could unfairly discriminate against those with conditions associated with race and ethnicity, according to Crighton, who also co-authored the 2015 study, which was published in the Journal of Occupational and Environmental Medicine.
Employers who are concerned about health care disparities in their workforce must look beyond the physical and take into account factors such as an employee’s social and cultural environment when designing a wellness program, he said.
“It’s about focusing on those nonmedical barriers to health and really sitting down and meeting the person where they are to find the best approach for them,” he said. “It’s not the old medical model of, ‘Here’s what you need to do.’ Even among minority groups there are differences. Not everyone is the same.”
In a job market where a recent survey noted that 1 in 5 employees are determined to land a new job this year, a robust benefits package could go a long way to help retain the worker who’s contemplating a move or entice the ones who are on the hunt for a new opportunity.
Building better benefits offerings will take time, effort, research and good old-fashioned communication. As in, talking to your employees. What do they want? What do they need?
One consideration they likely will want is a comprehensive wellness plan. Wellness is no longer trendy or a fad, but organizations without a wellness plan should analyze whether it’s a fit for its employee population. Some employers are taking preventive steps with nagging health issues such as back pain by offering employees incentives to look at other options before surgery.
This Workforce Roadmap helps encapsulate the themes and ideas of what was written in this special section on developing and maintaining a well workplace.
Plan, Do, Review
Plan
Assess your employees’ needs. Is there literally a lot of heavy lifting involved? Or, is your workforce largely confined to desks? What takes up your largest workers’ compensation claims?
Learn how the Affordable Care Act affects your workforce. By now, you should have a good handle on the effects of Obamacare on your organization. With new forms like the 1095-C and the so-called “Cadillac” tax, the ACA is having a dramatic effect on how health care plans are managed.
What about wellness? If you haven’t implemented a wellness program in your organization, you’re lagging behind your competitors. But that doesn’t mean you are too late. Assess several vendors and consider your options.
Do
Communicate. Then communicate some more. It has been said that people would rather clean their toilet than deal with their benefits. And while this might sound obvious, HR needs to communicate frequently and consistentlywith employees regarding the benefits program. Is there an employee assistance program available and how does it work? What’s the coverage on such things as vision and accidental death? Are there options to include elder care or child care assistance?
Motivate. Then motivate some more. Just because you put apples and bananas in the break room doesn’t mean you’ve set the motivation health machine in motion. Quarterly health fairs, motivational speakers, wellness tips and recipes placed in employee communications are all part of the repetitive drum you must beat to make wellness integral to your workplace.
Schedule an ergonomic overhaul. Look around. When was the last time your organization updated its office furniture? Not only will a room full of new chairs and standing desks improve morale, but also it will modernize the look and feel of the office environment and help boost productivity.
Review
Don’t put all your wellness eggs in one ROI basket. Managers want to see the return on investment. Given that it can be a costly, complicated process with murky results, focus on “VOI,” or value on investment. Did you cut absenteeism? Are there fewer claims among the diabetic population? Tell the story through the progress you’re making on employees’ individual health.
Track your ACA compliance. Federal agencies are stiffening compliance rules with each passing year. Consult your benefits advisers regularly to measure your progress.
Quit fiddling with it. Don’t make changes unless something is actually broken. Employees become suspicious when you constantly revamp a program. If you must make adjustments, change one element at a time and track the impact on the entire program before implementing it.
I had been looking forward to lunch with my friend Kate for some time. During the past few years we’ve bonded over the travails of raising teenagers, the challenges of balancing work and home and the exhausting job of caring for elderly parents. We laugh a lot when we’re together too, but those topics always seem to creep into our conversations—the last one with increasing frequency.
We’ve tried to get together several times in the last year but as any working mom knows, coordinating schedules with friends often means planning so far in advance several holidays can go by before you actually see each other. But this time the planets had aligned and our lunch date was set. I was looking forward to it.
The day before she sent me an email that began with: “Well, things with my parents have gone to hell in a hand basket and I’m heading to Tennessee for a week.” Her mom is struggling with dementia and her father is in failing physical health. Watching their decline has been devastating for Kate and her family.
So it goes with the life of a caregiver. There are good days and there are bad days and there are days when all hell breaks loose. One minute you’re on the phone with your mom planning a trip to the mall and the next minute you’re in the emergency room praying that she didn’t have a stroke or break her hip or catch pneumonia. A million things can go wrong when our bodies start to fail us.
It’s a wild and unpredictable ride and eventually, most of us will climb aboard. Or as Greg Johnson, director of family care giving at New York-based EmblemHealth, Inc. says, “you can’t buy, pray or prescribe your way out of it.” When a parent needs help few of us have much choice other than stepping up and doing the best we can.
And that’s exactly what 65 million people are doing every day — caring for an elderly relative, often while holding down a full-time job. Any many of them are also raising children — the sandwich generation as they are called. I am one of them. I have two amazing teenagers and one loving 86-year-old mother, and all three are at a stage in their lives where they need me more than ever.
Trying to meet their needs while working full time often leaves me feeling drained and in need of some care myself. Luckily, I have understanding editors who allow me to work from home when I need to, but not everyone is so lucky. Just ask the telecommuters at Yahoo!
With people living longer the number of caregivers in the workplace is rising rapidly and that costs companies up to $34 billion a year due to absenteeism and lost productivity. That doesn’t include health care costs, which are higher for caregivers who are more likely to suffer from heart disease, depression and other health issues than noncaregivers. At the same time the number of companies offering elder care programs and services has declined.
That means more employees are using lunch breaks to drive dad to the doctor or sort out medical bills. Employees at companies without elder care referral services or flextime or other supports must navigate the confusing world of Medicare and Medicaid and nursing homes and in-home care alone and during any spare moment, including vacation time. Not surprisingly, burnout and fatigue are higher for caregivers than for other workers.
But there is much that employers can do to help those workers, like offering flextime and resource-and-referral services. Some companies, like Johnson & Johnson in New Jersey, are taking it a few steps further, offering free geriatric care services to its employees. Caregivers work with a case manager who checks in regularly and will even visit nursing homes and other facilities with the family.
While many employers can’t afford such extensive supports, just offering flexible schedules and a little understanding can go a long way in helping workers stay healthy and in boosting retention and loyalty.
The issue of elder care will gain more attention as more workers become family caregivers—a role typically dominated by women. And as more women move into executive positions the problem of caring for mom or dad will become just as pressing as finding good child care.
Johnson of EmblemHealth calls caregivers “the backbone of the world.” But the weight of supporting kids and parents can be crushing. By providing elder care support employers can do a lot to lighten their load.
People should take responsibility for their own health, but adopting the perfect heath behaviors in every aspect of our lives is impossible. Every person, regardless of their health status, drives health care costs.
