Even organizations that are fairly sophisticated
concerning their approach to risk, fail to consider an area that might well be
costing them much more than they dream — the health of their employees. Companies
are aware of employee injuries and work-related issues and the costs attendant
to being lax about worker safety in all its aspects. That is not what I am
talking about. If the organization were to just look a bit beyond work-related
injuries and think about the cost to them, both directly, including lost
productivity and health care costs, (if self-insured) or indirectly (if being
experience-rated by a carrier or plan).
The typical management isn’t aware of what can be saved by
proactive attention to the preventive health of employees. The employer of all
people, other than the employee himself, (and then maybe more), has a reason to
keep an employee healthy, not only the care costs, but the lost productivity
and/or replacement cost for early loss of an employee.
There are two branches of strategy an employer can pay
attention to - primary prevention (prevention before there is any illness), including
being sure the employee is up to date on all recommended immunizations, insisting
on wearing a seat-belt, creating knowledge (free assessments), assurance of
early and proper prenatal care, incentives and enablers for weight control, exercise,
and for a healthy diet.
I was consulting to a large international ministry several
years ago on this subject and suggested several preventive initiatives the
organization could take, including the policy of insisting on the wearing of seat belts. It turned out
that it had a significant number of boomers who did not wear their seat belts.
These folks were located all over the world in places like Rome! And Paris! The CFO (who was over medical
care) asked me in all naivety why they would want to have such policies and
spend that money. He was oblivious to the risks the organization was exposed
to. AND one year later one of their
missionaries who was not wearing his seat-belt had a crash that resulted in
injuries requiring expensive medical care and years of therapy and low
productivity. All would have been prevented if he had been belted in. (The
layman often under-estimates the protection provided by wearing a seat-belt.)
Secondly, early secondary prevention is also valuable.
Catch a developing problem early and correct it — early indications of adult
diabetes, hypertension, bone loss, and other circulatory threats developing.
When a knowledgeable consultant runs the numbers for an organization, usually hundreds of thousands
of lost dollars are preventable. Employers often expect the provider to think
in terms of prevention. Don’t count on it. Providers are not trained in prevention
and do it frequently because someone makes them (unless they are very
progressive and experienced such as Kaiser). Historically, providers were paid
for piece-work and still are in many cases. It was sick patients that made money! Not healthy patients; - talk about perverse incentives working against employee and employer interests! It
is a mental habit hard to break. Furthermore, insurance companies don't take a long view since they do not know how long those employees will be on their rolls. Employers create the incentive for insurers to think short term by re-bidding coverage regularly. Preventive benefits are long term and are likely NOT to be to the current insurer's benefit!Consequently, employers must themselves become proactive with savvy intentionality across the spectrum of their employees' health. They will mutually benefit, often sooner than they think.
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