Category: Benefits

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How HIPAA-Compliant Are Digital Health Apps?

Andie Burjek, Working Well blog

I recently received a pitch about how Amazon’s Alexa now has a “HIPAA-compliant upgrade” through which people can book appointments, ask health care questions and check on the status of prescription deliveries. The immediate reaction of my editor and me was, “How can this possibly be HIPAA-compliant?”

I bring this up because I’ve also recently read a Washington Post article about a pregnancy tracking app that claims to be HIPAA-compliant. And there was a lot to unpack here. From a patient advocacy perspective, a lot of scary things to unpack.

Before I get into that, a quick anecdote from my high school years. My dad gave me some job advice I’ve never forgotten. Watch out for yourself and if you want to quit, don’t feel guilty about leaving a company you don’t want to be working at anymore. If the tables were turned and the company had to sack a bunch of people, it’d feel no guilt about letting you go. It would make a non-emotional business decision. Employers mostly watch out for themselves, and employees should too. Loyalty can only go so far.

I know that many employers tout a “culture of health” nowadays and make broad claims about how much they care about the health of their employees. As a benefits and health writer, I don’t buy that. Not for nefarious reasons, but because I know that at the end of the day, it’s all about the business. That’s their No. 1 priority. Just like my career should be my No. 1 priority. To believe otherwise is naïve.

Also read: Trendy Digital Health Firms Seek Solutions to Questions It Never Thought to Ask

I’d argue that this self-interest extends to health plans. As this Washington Post article stated, “The real benefit of self-tracking is always the company. People are being asked to do this at a time when they’re incredibly vulnerable and may not have any sense where that data is being passed.”

How can employers benefit from self-tracking? Through digital health apps that employees sign up for, employers could access aggregate data of employee health; the data is “de-identified,” which means it’s stripped of information like name, social security number and email addresses that could be used to identify the patient. Employers who don’t pry into these anonymous identities can still use this data to understand the overall health of its organization and identify issues that afflict many employees, which could help inform and shape its health strategy.

As for sneakier employers, the article notes that it’s “relatively easy” for companies to identify patients (in this case, women using the pregnancy app) “based on information relayed in confidence, particularly in workplaces where few women are pregnant at a time.” Someone could, for example, cross-reference the app’s data with other data. This potentially could impact people’s health care costs or coverage.

An excerpt:

The apps, [health and privacy experts] say, are designed largely not to benefit the women but their employers and insurers, who gain a sweeping new benchmark on which to assess their workers as they consider the next steps for their family and careers. … Experts worry that companies could use the data to bump up the cost or scale back the coverage of health care benefits, or that women’s intimate information could be exposed in data breaches or security risks.

This is why I’m skeptical about digital health apps. I’ve heard arguments on both sides, but if it’s possible for someone’s private medical information to be used against them, how is that OK? Why aren’t there more protections for patients? And how could current patient protection rules be up to date with the digital age?

To quote an informative article from The Verge: “In 1996, the year Congress passed its landmark health privacy law [HIPAA], there was no Apple Watch, no Fitbit, no Facebook support groups or patients tweeting about their medical care. … [It] is still a key piece of legislation protecting our medical privacy, despite being woefully inadequate for dealing with the heath-related data we constantly generate outside the health care system.”

The Post article brought up something else noteworthy: the app’s 6,000 word “terms of use” agreement that women must consent to. A lot of us in the health space have probably heard the statistic of how few people know how to define basic health care terms like “deductible” and “premium,” suggesting low health literacy rates among people. So how is a person supposed to understand the legal and health care jargon in a 6,000-word “terms of use” agreement? Is that realistic? Do people really know what could happen with that data?

Further, according to the article, while a spokeswoman said the company doesn’t sell aggregate data for advertising purposes, the “terms of agreement” tell a different story. The company has a “royalty-free, perpetual, and irrevocable license, throughout the universe” to “utilize and exploit” de-identified personal information for scientific research and “external and internal marketing purposes.”

Digital health companies are a relatively new thing. And in any communications they make — whether it’s a press release, an executive’s quote in the media or the employee they pick to make a statement to the press — they’re marketing themselves. Of course the focus will be on the positive.

That’s why it’s healthy to be critical of these new institutions that have the potential to greatly impact people’s lives, health and security. If nobody pushes forward to seek change that could protect people’s health privacy, then the future health care environment is not going to be a safe place for patients. Patient advocacy groups should have a greater say in how these digital health companies operate. Insurance companies and employers can easily benefit from the wide array of data in these apps, but what about patients?

Candice Sherman
Candice Sherman

One final thought comes from an interview I had about six months ago with Candice Sherman, the CEO of the Northeast Business Group on Health. The NEBGH released a fascinating guide about genomic medicine and employers that came from a roundtable including many key stakeholders, including employers, clinical experts, benefits consultants and genomic vendors. The missing stakeholder was a patient.

Also read: New Wellness Bill HR 1313 Gets Flak for Genetic Privacy Concerns

I asked Sherman about that, and she explained how health privacy concerns would stop patients from participating in a discussion like this. I do understand this, logically — and I am by no means trying to criticize Sherman or the NEBGH roundtable, since I love that they met up to have a discussion on a health-related topic that’s only going to become more prominent.

That said, I think it would be valuable for businesses or business groups to find a way to include the patient stakeholder in conversations like this. Maybe through an advocacy group or an expert who can make sure to represent the patients’ interests without experiencing the same privacy concerns. There are options.

This is a lot of information, but this topic is important now and it’s not going anywhere anytime soon. In summation, de-identified, aggregate data doesn’t always stay anonymous; just because a digital solution is HIPAA-compliant doesn’t mean it’s necessarily harmless to a patient; and patients deserve to have their voice represented in health care conversations.

I understand the power of data for organizations to understand big picture trends, but if this data could easily be used against an employee, it’s not worth it.

Health data privacy is important. I’m curious what discussions we all must have and how laws should be rethought to represent patients — your employees.

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Expanding Employee Access to Mental Health Care

Last week the U.S. Department of Labor announced that it’s launched a new toolkit for employers to help them understand mental health issues and create a supportive work culture.

The EARN Mental Health toolkit — created by the DOL’s Office of Disability Employment Policy and its Employee Assistance and Resource Network on Disability Inclusion, or EARN — includes an educational framework and a list of case studies of successful programs at organizations of various sizes.

The EARN Mental Health Toolkit hinges on “4 A’s”:

  • Awareness: Build awareness and a supportive culture.
  • Accommodation: Provide accommodations to employees.
  • Assistance: Offer employee assistance.
  • Access: Ensure Access to treatment.

I want to focus on access for now, because no matter how much you try to create a disability-friendly culture, if employees can’t access or afford medication, therapy or whatever medical assistance they need to treat their mental illness on a regular basis, then a huge piece of the treatment puzzle is missing.

APA Publishing, a division of the American Psychiatric Association, recently published an informative article on this issue of access. The article covers a February 2019 panel discussion hosted by the New York Academy of Medicine, the New York County Psychiatric Society, and the New York State Psychiatric Association.

There are a lot of points I find valuable in this panel discussion of several people in the medical community. First, one of the panelists noted how Aetna recently settled a lawsuit in Massachusetts after an investigation found that the insurer violated state law with its “inaccurate and deceptive provider directories and inadequate provider networks.” Basically, this means that patients couldn’t access timely behavioral health care because listed providers weren’t accepting new patients or had retired.

This isn’t necessarily an anomaly, the article noted. For example, it cited a very comprehensive report that’s worth a read for anyone interested in this.

The 2017 research report by Milliman Inc. found that compared to medical/surgical care, people seeking behavioral health care more often have to access an out-of-network provider. While in-network care generally has lower co-pays for patients, when they must seek out-of-network care that means more out-of-pocket costs and more expensive behavioral health care.

Also, the report stated, “Some patients may want to avoid the higher costs and delay seeking needed services from behavioral health care providers, which can lead to less effective care.”

The article also stated the employer’s role in this. An excerpt:

Schwartz said that the business community is a strong ally in improving access to behavioral health care given the high cost of not addressing these issues in productivity loss, lower employee retention, high rates of disability, and higher overall employee costs. “While employers are paying for benefits, they are not getting what they paid for when employees cannot access behavioral health care,” he said. “Businesses are well positioned to ask health plans for data on provider networks and to examine disparities to improve accountability.”

Also noteworthy was a list of actionable items that presenters believe could help improve access to care. For example, a suggestion from the National Alliance and the Center for Workplace Mental Health is that “employers obtain quantitative assessments from third-party administrators on how well their employees are accessing mental health and substance use benefits.”

Again, I don’t want to suggest that environmental factors in the workplace don’t impact people’s general well-being. But offering free yoga classes in your building or teaching employees how to use mindfulness to reduce stress are NOT the medical equivalent of seeing a therapist or accessing an outpatient center.

Self-care is not medical care. If your organization has a deluge of trendy perks to help employees de-stress but doesn’t have a sufficient behavioral health provider network, how much of a difference could that really make?

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Sector Report: Wellness Valuable as a Recruiting Tool

corporate wellness

Wellness benefits have officially changed teams. These health-inspired programs and resources are no longer viewed as health care initiatives, but rather as a “new talent value proposition,” said Mike Maniccia, specialist leader for Deloitte in Los Angeles.

“The origins of wellness programs were about saving money by creating a healthier workforce,” he says. But the financial returns on wellness investments have been notoriously difficult to measure, which diminished their value and caused them to lose the backing by cost-conscious execs.

However, in a low unemployment economy where millennials dominate the talent pool, wellness has gained new life as a powerful recruiting tool. Offering on-site yoga classes, healthy food options in the cafeteria, and a suite of physical and emotional wellness apps can help win over hard-to-land new hires. “Appealing to millennials is dominating the wellness conversation,” he said.

Companies like Google, Apple and Patagonia win constant accolades for their innovative wellness efforts, which often include over-the-top offerings like on-site massage therapy, weekly cooking classes, and free outdoor-inspired daycare centers. Maniccia worries a bit that the hype generated by a handful of mission-driven and well-funded wellness programs will make it impossible for others to keep up. “It’s difficult to replicate that kind of culture in manufacturing, retail or a small business,” he said.

However, in reality, companies don’t have to spend a lot of money on wellness to impress talent, as long as they are creative and offer programs that employees actually want. Deloitte’s 2018 “Human Capital Trends” report found that the top two wellness benefits desired by employees are flexible schedules and the option to telecommute, both of which require no real financial investment and can actually cut overhead costs.

Also read the 2018 Sector Report: Is Wellness Just an Employee Perk? 

Also read the 2017 Sector Report: Workplace Wellness Programs Continue Healthy Ascent 

Benefits Come From Within

Beyond flex time, employees are seeking wellness tools that fit their unique needs and interest. That’s has caused an evolution in the types of programs offered and how employees are encouraged to take part, said Linda Natansohn, head of corporate development, meQuilibrium, a resiliency training company in Boston. Most companies have evolved past things like incentives for biometric screenings, in part because of negative publicity that saw incentives as a form of coercion, but also because they didn’t generate the desired results.

corporate wellness

“No amount of extrinsic rewards will drive people to change their behavior,” she said. “Employers have to figure out what is meaningful to their people.”

To connect with these personal drivers, companies have begun curating an assortment of offerings to address employees’ physical, social, emotional and fiscal needs. Many of them come in the form of apps and wearables that encourage healthy behavior and offer intrinsic motivators, like leader boards and positive messages when users hit daily goals.

Though not everyone is motivated by an app, said Steven Noeldner, head of total health management for Mercer. Some employees like self-directed programs, but others will prefer real-time workshops, consulting, or small group classes. “The idea is to have a broad array of services designed for different segments of the population.”

That includes social and emotional wellness programs, which are gaining popularity as companies realize the value of having a happy and well-adjusted workforce, noted Natansohn. These offerings can range from on-site therapists, to meditation apps to “kindness clubs,” where employees work together to create a better and more inclusive culture, she says. “It’s a more holistic approach to well-being.”

Regardless of the scope of offerings, managers and executives have to show their support for using these programs if employees are going to get on board, according to Noeldner. “Organizations with strong leadership support have higher participation and better health outcomes,” he said.

He recently completed work on a joint study between Health Enhancement Research Organization and Mercer that found organizations whose leaders actively participate in health and well-being initiatives reported higher median rates of both employee satisfaction with health and well-being programs (83 percent) and employee perception of organizational support (85 percent) compared to organizations whose leaders did not actively participate (66 percent and 67 percent, respectively).

“The C-suite and management create the climate around wellness,” he said. No matter how carefully companies select their wellness offerings and vendors, leadership support for the program will be critical to their success.

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Vision: The Must-Have Benefit for 2019

Vision care benefits

Vision care benefits have become a mainstay of the employer benefits package.

“Virtually all companies now offer vision,” said Peter DeBellis, head of the total rewards practice for Bersin by Deloitte in Washington, D.C. “It is table stakes, especially for companies of a certain scale.”

Vision care is listed as one of the 10 essential benefits included in the Affordable Care Act, and employees have come to expect it as part of the core employee benefits package. “Health, dental and vision are the benefits triad,” DeBellis said. These programs have a very high rate of participation, which further reinforces the value they bring to employees.

This category of benefits has evolved in recent years in the care options offered and the way these treatments are accessed and paid for. Telemedicine, for example, is a new trend in the vision benefits space, noted Paul Piechnik, senior vice president of group benefits for MetLife. A growing number of organizations now offer basic examinations to check visual acuity and the need for eyewear via do-it-yourself applications or through a physician-led online virtual exam.

“Some are even offering virtual walk-in exams with an optometrist to mirror the same comprehensive examination steps one would encounter at a standard brick-and-mortar optometrist’s office,” he said. The interest in telemedicine is being driven by the digital generation, who prefer self-service for everything, as well as addressing the needs of remote workers. “Telemedicine is just emerging for routine vision care, though it’s too soon to say whether this will become a vision care standard in the future.”

Preventive care

Companies are also offering a broader array of treatment options, including laser surgery, blue light protection on lenses to reduce the impact of light emitted from digital devices, and proactive vision exams to identify risks for glaucoma, hypertension, diabetes and high cholesterol. This last benefit is viewed as a useful preventive care intervention, particularly in an aging workforce. “Vision has a role to play in a lot of chronic health conditions,” DeBellis said. Encouraging employees to have vision exams can help them identify bigger health care risks so they can get prompt treatment.

Vision care benefits

Piechnik suggested that companies offer sunglasses coverage as part of their vision plan as a way to get more employees to take advantage of these wellness visits. MetLife, for example, has a SunCare rider as part of its vision care benefits that allows members who don’t need corrective eyewear to use their frame allowance for non-prescription eyewear. “This encourages them to get their routine ‘wellness’ vision examination and spot those early issues that can become costly medical expenses for the member and employer alike.”

Also read the 2018 Sector Report: The Bright Shine of Dental Benefits 

Also read the 2017 Sector Report: Rising Health Care Costs 

Vision Comes at a Price

The other steady trend in vision care is who’s footing the bill. The rising cost of offering any health care benefits has pushed employers away from supporting fully employer-paid vision care to cost-sharing programs, or providing vision as a fully employee-paid/voluntary benefit. Piechnik said this hasn’t caused outrage among cost conscious workers.

“Employees for the most part see the value in nonmedical benefits such as vision care, so are willing to pick up some or all of the cost of these benefits.”

Regardless of the payment structure, benefits administrators should look for a comprehensive plan that provides annual vision examinations and eyewear benefit levels that employees value.

“With many employers offering vision on a voluntary basis there is no reason not to offer this benefit,” Piechnik said. “It’s a key product for creating a benefits package that truly increases employee satisfaction and loyalty.”

Once the program is in place, benefits administrators should educate employees about what the program covers, and the value of getting annual exams and keeping their glasses up to date. “It’s not just about getting a new pair of readers,” DeBellis added. When employees take care of their vision they are healthier and more productive, which benefits everyone.

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Sabbaticals Help Fight Employee Burnout

sabbatical
PwC’s Beata Zagona on sabbatical in South Africa alongside a rhinoceros.

When executive recruiter Beata Zagona, a self-described city girl, decided to take a fully paid sabbatical from her job, her choice of destination came as a surprise to some. Last summer, she spent a month scooping rhinoceros poop, among other chores, at a rhino sanctuary in South Africa.

“I had worked for the firm for two weeks in South Africa and fell in love with the country,” said Zagona, a manager at PwC in New York. “I had gone on safari in Kenya and became more aware of wildlife poaching and saw the atrocities being committed against these animals. I thought the sabbatical was a great opportunity to do something adventurous and meaningful.”

Many employers would agree that a rested and recharged employee is more engaged and productive and that sabbaticals are a good idea, but PwC requires it for all newly promoted senior managers. The firm offers four weeks off — it pays for three — to give employees a chance to pursue a lifelong goal, volunteer or do nothing at all.

“They can sit and read movie star magazines for all we care, but we do require that they take time off,” said Anne Donovan, U.S. people experience leader at PwC. “We’re adamant. It’s not just a wink and a nod.”

The firm has always allowed individual employees to request a sabbatical but few employees did, according to Donovan. So in 2011, PwC established a formal program that requires senior managers with five years or more of service to take some time off.

About 17 percent of companies offered a sabbatical — either paid or unpaid — in 2017, according to a report from the Society for Human Resource Management. But the need for time off among senior level employees is supported by a number of recent studies showing that job burnout is a costly problem for both workers and employers.

Job burnout accounts for an estimated $125 billion to $190 billion in health care spending each year and has been attributed to type 2 diabetes, coronary heart disease, gastrointestinal issues, high cholesterol and even death for those under the age of 45, according to 2017 article in the Harvard Business Review.

And the number of employees reporting burnout is on the rise, according to a recent Gallup study of nearly 7,500 full-time employees. The study found that 23 percent reported feeling burned out at work very often or always, while an additional 44 percent reported feeling burned out sometimes.

For Zagona, spending weeks waking up at dawn to feed rhinos, clean their enclosures and dig ditches made her feel more resilient. She said that she came back to work more focused.

“The attitude and innovation that comes back to us and to our clients is huge,” said Donovan. “You get an employee that has an appreciation for life and for the firm that’s unmatched.”

Also read: The Disconnected Vacation 

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Employers: Be Bold With Your Benefits

It is an exciting time for employee benefit professionals.

Just a few years ago, we were consumed with legislative challenges and daunting health and retirement issues. Those issues haven’t gone away, of course, but there’s a newfound optimism around the strategic and creative opportunities benefits bring. Several factors are pushing benefits to the forefront of talent strategies and the employee experience.

First, we have an incredibly diverse workforce that needs benefits to solve real problems. It’s marked by a vast range in age — employees from Gen Z (those in their early 20s) to baby boomers (some working well into their 70s) and everyone in between. It also encompasses every definition of family and lifestyle. And it challenges the very definition of “work,” which is evolving as more and more people build careers around part-time and contract roles or take long breaks from full-time employment.

Second, we’re seeing an exciting shift in how we’re designing and talking about benefits. The focus is moving away from traditional benefits like health insurance and retirement plans and toward a more holistic approach to taking care of employees and their families. This change is driven by the understanding that benefits and HR programs can drive greater business results when they’re considered more broadly, with attention to their impact on the mind, body, finances and even sense of purpose.

Third, there’s tremendous innovation in our space as employers and employees demand new programs and new technology (and as venture capitalists have figured out that employee benefits are ripe for disruption). HR technology is starting to keep pace with consumer technology, which means we can now deliver sophisticated benefits to meet those broad needs and create solutions for those very challenging issues we’re still tackling.

On top of all that, people care about their benefits. A lot. For 87 percent of employees surveyed for MetLife’s 15th annual “Employee Benefit Trends” study, having insurance/benefits provides peace of mind for the unexpected. In fact, 83 percent of employees would be willing to take a small pay cut (on average, 3.6 percent) to have a better choice of benefits from their employers.

Finally, consider this: Low unemployment is driving massive competition for talent. Benefits are positioned to be a huge strategic differentiator and a competitive weapon for employers across industries.

The takeaway here is that benefits should be a huge focal point for companies of all sizes. We should be shouting from the rooftops about how amazing benefits are and the tremendous role they play in people’s lives.

And we shouldn’t be shy about the considerable investment employers make in these programs. A significant portion of total compensation goes to benefits, and that percentage is only set to grow.

So, how can you educate employees and position this investment in benefits in a positive light? How do you elevate the significance of benefits in your organization?

One example from this past fall’s annual enrollment stands out. Our client Hitachi Vantara, a tech company recently formed by three industry leaders (Hitachi Data Systems, Hitachi Insight Group and Pentaho) and a leader in cloud-based data solutions.

Hitachi Vantara has made a huge commitment to employee benefits, especially around getting employees engaged in programs and managing costs. Its message during annual enrollment this past fall? “Health care costs are rising. Yours aren’t. For the seventh year in a row, you won’t see an increase in what you pay for your medical plan. Which means your paycheck contributions continue to be significantly less than those at most other companies.”

The company teamed that messaging with a campaign that focused on getting employees to use the programs that are often overlooked, like tuition assistance, virtual doctor visits and fitness reimbursements. And it did so with a bold and definitive point of view on why benefits matter and what they mean to employees.

Susan Ramirez, Hitachi Vantara’s senior director of total rewards, Americas, explains: “Since it really was a ‘good news’ message for our benefits in 2019, we wanted to be sure to share that message with employees. Taking a bold approach not only captured our employees’ attention, it also emphasized that Hitachi Vantara truly cares about them.”

As 2019 unfolds I challenge you to be bold with your benefits. What will you do to make your benefits stand out? And how will you let employees know that you value them by taking care of them?

Read more Benefits Beat!: How HR Benefits By Getting Political

Make Benefits and Internal Communications Inseparable 

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Opioid Treatment Programs Offer Second Chances to Workers Facing Addiction

Opioid Treatment Programs

When a job seeker fails a pre-employment drug test, often the company rescinds the offer and both parties move on.

That scenario wasn’t working for the Belden wire and cable factory in Richmond, Indiana, which in 2016 faced a labor shortage due to a spike in retirements and a dearth in qualified applicants. So they tried something dramatically different.

Belden’s factory, which sits near the Ohio state line and employs more than 400 people, began offering drug treatment to those who failed their drug screening with a promise of a job if they successfully complete the program — all on the company’s dime. The pilot program, called Pathways to Employment, was launched in February 2018 and is believed to be the first of its kind.

“We had many people who were retiring and we needed to fill dozens of positions, but it was getting harder to find candidates because so many were failing their drug test — around 10 percent,” said Dean McKenna, Belden’s senior vice president of human resources. “There was no mechanism to deal with this except to say, ‘Sorry, you can’t work here.’ The CEO and others talked about what would happen if we hired these people. They said, ‘How bad would it be to give them the opportunity to get back in the workplace?’ ”

Also read: Construction Industry Nailing Down Opioid Addiction Woes 

Belden teamed with Richmond-area organizations including Centerstone, a mental health and drug addiction provider, Meridian Health Services, Ivy Tech Community College and employment agency Manpower of Richmond, to manage the program. Participants are referred to a health care provider for evaluation and to develop a treatment plan, according to McKenna. So far, 26 have been through the program.

Opioid Treatment Programs

“The success rate is better than what we could have hoped for,” he said. “My peers probably thought we shouldn’t do this. There are risks of injury and litigation. You need the right level of support from the community.”

While many states are struggling with the opioid epidemic, Indiana is among a handful that is also facing a growing labor shortage, according to research from Indiana University. The economic damage caused by opioid abuse cost the state $4.3 billion in 2018 and will exceed $4 billion again this year, the study showed.

In 2015, nearly a million Americans were not working because of opioid addiction, according to a study by the American Action Forum, a nonprofit advocacy group. Between 1999 and 2015, the decline in labor force participation cost the U.S. economy $702 billion as the result of 12.1 billion worker hours lost, the study found. In some industries, such as construction, trucking or manufacturing, the numbers are even higher.

In neighboring Ohio, which leads the country in drug overdose deaths per capita, opioid addiction, abuse and overdose deaths cost the state anywhere from $6.6 billion to $8.8 billion annually, according to a 2017 report from the C. William Swank Program in Rural-Urban Policy at Ohio State University.

Also read: State Chamber Fights Workplace Addiction With Employer Opioid Toolkit  

In order to help employers improve worker health and safety, the Ohio Bureau of Workers Compensation launched a pilot program in October to reimburse companies for drug testing and to provide training that helps managers deal with workers in recovery.

“In Ohio we are almost at zero unemployment, but we have employers that can’t find candidates who can pass a drug test,” said Dr. Terry Welsh, the bureau’s chief medical officer. “We aim to help employers hire and manage folks in recovery no matter their addiction. Normally, drug testing is an expense that employers bear themselves, but we are incentivizing them to do it by offering reimbursement. We are also providing professional training to folks in management for second chance employees.”

The agency has been a pioneer in tackling the opioid crisis, according Welsh, who pointed to the 2011 overhaul of its pharmacy program to better monitor and reduce addiction to potentially dangerous prescription drugs. In 2016, the agency also created safeguards to hold prescribers accountable if they don’t follow best practices. The agency saw a drop in opioid addiction among injured workers of 59 percent between 2011 and 2017.

The bureau’s Opioid Workplace Safety Program will provide up to $5 million over two years to employers in the state’s hardest-hit counties for expenses related to both pre-employment and random drug testing, manager training and support for workers in recovery.

At Belden in Indiana, the cost to treat a candidate classified as low-risk for relapse is around $16,000 and up to $25,000 for someone who is considered a high risk. McKenna said it’s a small price to pay.

“When you look at the difference in cost between a manufacturing job we can’t fill and a machine we can’t run versus what it costs to help someone get back on their feet, you see that it’s worth it,” he said. “These are people with real illnesses. They aren’t choosing to be in that situation. It’s unfair to discount them from society because of the problems they’ve stumbled into.”

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3 Ways to Help Employees Save Money on Prescriptions

save money on prescriptions

save money on prescriptionsThe escalating cost of prescriptions is a hard pill to swallow for employees. That’s because it’s becoming more common for prescription drug plans to shift the cost to participants. Then there’s the behind-the-scenes double Rx whammy: pharmaceutical companies increase prices and pharmacy benefit managers obscure the true cost of medications, causing more headaches for employees.

Employees also feel blindsided when the PBM adjusts its formulary or the plan sponsor moves participants to a high-deductible health plan. Rx sticker shock is on the rise. Consider the employee whose monthly copay of $20 for a generic drug skyrockets to 10 times that per month under an HDHP.

Employees have a hard time paying for important maintenance medications. As prices keep rising, patients are less likely to fill new prescriptions or continue taking maintenance drugs, which can cause more health issues and cost medical plans even more down the road.

Unfortunately, many employees don’t know that the pharmacy they frequent may not always offer the lowest price for their medications. There are more options for finding low-cost prescription drugs than there were even five years ago, but it doesn’t necessarily follow that employees know they actually can price-shop prescriptions.

Also read: What to Ask Your Pharmacy Benefit Manager to Control Spike in Prescription Spending

Employers can work with their insurance brokers to educate employees about better ways to find reasonably priced prescription medications.

In the meantime, here are three Rx buying tips you can share today with your employees.

  1. Retail Store Discounts

Some large retail stores, including Target, Walmart and many grocery store chains, offer discounts on popular brand name and generic medications at low or no cost without insurance simply to drive traffic to their stores. These loss leaders attract shoppers who are likely to buy a few items when they pick up their medication at the in-store pharmacy. The prices of brand name and generic drugs that are discounted vary from store to store. It pays for employees to investigate where they can get the best deal for their medications.

ShopRite, a grocery store chain in the Northeastern United States, has been dispensing free diabetes medications since 2009. Similarly, grocery chain Publix offers the generic type 2 diabetes drug metformin at no cost. The grocery chain also offers 14-day supplies of several prescribed antibiotics at no cost. Walmart offers several drugs at $4 for a 30-day supply and $10 for a 90-day supply. The key to this strategy is to keep “impulse purchases” to a minimum.

  1. Mobile Apps

Not surprisingly, the web now makes it easier to track down the cheapest generic prescription medications. Two examples are GoodRx and Blink Health, which both provide medication prices and direct customers on buying options.

GoodRx collects drug prices from thousands of pharmacies to show where a specific medication can be purchased at the lowest price. They also aggregate coupons and discount programs from manufacturers. Blink Health partners directly with drug manufacturers and negotiates lower prices for medications. Blink Health conveniently lets consumers pick up medications at a pharmacy or order them by mail. Importantly, coupons on these sites often make the price of a medication lower than the copay through the prescription plan.

  1. Manufacturer’s Coupons

Prescription drug manufacturers often offer discounts and coupons for their drugs. If a medication costs more than $50, for example, the manufacturer may cover part of the balance. To access a coupon, just contact the manufacturer to enroll in the savings card program.

Some manufacturers will cover the balance of the drug cost and contribute the balance toward the employee’s deductible. After just a month or two of a higher-priced prescription drug and a manufacturer’s discount, an employee may satisfy their deductible and pay only the copays for the rest of the plan year.

Educating employees about free and discounted drugs starts during open enrollment, but it shouldn’t end there. Emails, postcards and announcements from the HR team are good reminders for employees. Some HR departments develop targeted communications that list expensive prescription drugs and how to save. Helping employees learn how to shop for the best prescription prices can help to keep them healthy and help you contain costs.

Also read: Contracting a Cure for Prescription Drug Costs

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5 Paid Family Leave Trends to Watch in 2019

paid family leave

In 2018, Microsoft surprised employers and policymakers alike when it announced a new requirement for its vendors: give contract workers at least 12 weeks of paid leave after having a child, or risk losing the tech magnate’s business. For HR managers nationwide, this was just one of many signs that the conversation surrounding paid family leave is growing from a slow burn to a steady fire.

While federal action on paid family leave has been a nonstarter in decades past, large organizations along with state and local legislatures are pushing Washington to reassess its commitment to national paid time off. As an HR manager, understanding the following national trends and local changes surrounding paid family leave will help you better assist both employers and employees in navigating future policies and complex legislation.

Expect vendor-leave mandates to become more common

While only some organizations are currently mandating vendors to implement paid family leave, it’s likely that trends like these will only increase over time. After all, it’s no secret that paid family leave is rapidly growing in popularity. Around 6 in 10 Americans say they have taken or are very likely to take time off from work for family or medical reasons at some point, and around 8 in 10 support paid family leave for new mothers (around 7 in 10 support paid family leave for new fathers). These numbers are expected to grow, with employers seeking to provide additional benefits for high-quality employees in an increasingly competitive talent market.

Watch for paid family leave on the federal agenda in 2019

The midterm elections shifted political balances in many states. With major shifts in both the House and Senate, it’s likely that a reinvigorated version of the FAMILY Act will move forward. The 2017 bill proposed 12 weeks of paid leave for family and personal medical needs, seeking funding through a 0.4 percent payroll tax split between employers and employees. Previous pre-midterm legislation is less likely to gain new life — this includes the Economic Security for New Parents Act and Workflex in the 21st Century Act.

While a divided federal government may make the likelihood of paid family leave reform less likely in the near future, there has been significantly more bipartisan discussion on this topic than in years past. Both Democrats and Republicans in the Senate and House are discussing introducing legislation this year. In addition, longtime congressional veterans, political newcomers and even presidential candidates have made it a core component of their platforms, signaling a renewed interest in moving the needle on this topic.

Look to states for the future of paid family leave

Three states launched or approved paid family leave in 2018:

  • Washington state will launch its paid family and medical leave program on Jan. 1, 2020. The program offers up to 12 weeks of paid family leave, 12 weeks of paid medical leave, or 16 weeks paid leave total. Employers will have to choose between the state-run plan or otherwise submit their own plan.
  • Massachusetts signed paid family and medical leave legislation that will go into effect Jan. 1, 2021. The program will offer up to 12 weeks of paid leave for family member care or caring for a new child, plus 20 weeks of paid leave for personal medical issues.

As the conversation around paid family leave continues, it’s important to take note of these major state-level policies. As of Jan. 1, 2019, 21 states have had a version of a paid family and medical leave bill introduced in either chamber of their state legislature. State legislation will likely serve as a framework for future employers and politicians looking to provide paid family leave in their respective districts.

Expect increased regulation and complexity

While policymakers are responding to the need for paid family leave, complex legislation may make the process of providing leave across state lines a difficult process. It will likely fall to HR managers to sort through the various paid family leave policies that multistate employers face.

Keeping track of individual state legislation and paying attention to national discourse surrounding parental and medical leave trends will help tremendously as paid family leave administration becomes increasingly complex. Additionally, outsourcing help as needed when faced with the prospect of new legislation will free up the valuable time required to study and implement new or revised programs.

Above all, be ready

While each of these trends point to a renewed interest in providing quality paid family leave to millions of Americans this year, the broader message is clear: Leave policies and the administration surrounding them will only become more complex in 2019. As an HR manager, your best frontline defense is a thorough understanding of the local and national trends surrounding leave policy.

Your organization will look to you to make sense of where the conversation is moving — and, when the time comes, they will seek your insights when putting a revised or new paid family leave plan into action. Getting a jump-start on the larger conversation, paying attention and outsourcing as needed are your best tactics for success in 2019. It’s up to you to use them wisely.

 

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Be Wary of What’s Rocking in the Cradle Act

Jon Hyman The Practical Employer

Earlier this week, Republican Sens. Joni Ernst and Mike Lee introduced the Child Rearing and Development Leave Empowerment Act (the CRADLE Act). It is a first step toward providing some measure of paid parental leave to American workers.

Yet, it has some serious flaws.

The Cradle Act would provide up to three months of consecutive paid parental leave benefits to new moms and dads following the birth or legal adoption of a child. It not only applies to biological parents and those that legally adopt children, but also those who intend to maintain the same abode as the child for more than six months of the year following the birth or adoption. Further, its coverage is much broader than the FMLA, applying to any employee that meets certain minimum Social Security contribution requirements.

How are the benefits paid? The Cradle Act would allow workers access some of their Social Security retirement income during the parental leave. For each month that workers access these benefits on the front end, they delay their Social Security eligibility by twice as many months on the back end. In other words, an employee who takes their full entitlement of three months of Cradle Act benefits would delay their later eligibility for Social Security benefits by six months.

In discussing this bill, Sen. Lee said the following:

Working families are the heart and soul of our nation. If young people can’t afford to marry and start a family, then the American dream literally has no future. Unfortunately, the cost of family formation and child-rearing today is higher than ever. …

But in today’s economy of working moms and dual-earner couples, we also need updated social insurance programs that support workers at different times of their lives, rather than just starting at retirement. The Cradle Act is a step in that direction.

He’s 100 percent correct. Yet, the Cradle Act has some serious flaws:

    1. It will stress our already overstressed Social Security system.
    2. It will require employees to delay retirement and work longer.
    3. It offers no job protections for those who take leave. The Cradle Act’s coverage is significantly broader than the FMLA, yet provides no restoration or re-employment guarantees for employees not otherwise protected by the FMLA. Thus, an employee could take Cradle Act leave, yet lose their job.
    4. It provides no protection against retaliation for employees exercising their rights under the Act.
There is no doubt that we need a paid parental leave solution. We are the only industrialized country that does not guarantee paid parental leave to our employees. We should be embarrassed. And while most agree that we need to provide paid parental leave, the rub seems to be how to pay for it. The Cradle Act is not the correct solution. Yet, anything the moves this discussion forward is a debate worth having.