A: An employer must have one of these to avoid running afoul of discrimination laws when an employee is out on a medical leave of absence.

Q: What is an open-ended leave of absence policy?

Two employers recently learned this lesson the hard way, care of the Equal Employment Opportunity Commission.

  • Family HealthCare Network will pay $1.75 million to resolve disability and pregnancy discrimination claims stemming from its use of “rigid leave policies and practices to deny reasonable accommodations to its disabled and/or pregnant employees, refusing to accommodate them with additional leave and firing them when they were unable to return to work at the end of their leave.”
  • The Cato Corporation will pay $3.5 million, also to resolve claims that it “denied reasonable accommodations to certain pregnant employees or those with disabilities, made certain employees take unpaid leaves of  absence, and/or terminated them because of their disabilities.”

Says Melissa Barrios, director of EEOC’s Fresno, California, Local Office, “The EEOC continues to see cases in which employers have a rigid leave policy that discriminates against individuals with disabilities or pregnant employees.”

These issues very much remain on the EEOC’s radar. Unless you want to risk being on the receiving end of an expensive enforcement lawsuit, take these lessons to heart and ensure that your leave of absence policies, both in writing and in practice, permit for extended unpaid leaves as reasonable accommodations for disabled and pregnant employees.

The post I’ll Take Leave of Absence Policies for $5.25 Million, Alex appeared first on Workforce.


I’m looking forward to the holiday break after spending this month working on a 5,000-word article and finishing up my final assignments of 2018.

The end of the month for me will mean tons of family time with my parents, sisters and a very cute pit bull. I’m excited for simple pleasures like watching episodes of “Jeopardy!” by the fireplace, sipping coffee with my sisters and playing fetch with the puppy in my parents’ backyard.

I’ve also been thinking about the HR/business topics that have really stuck with me this past year. Looking toward 2019, I’ll be interested to see what changes happen in these environments.

The #MeToo Movement Moving Forward

A lot of us have been thinking a lot about sexual harassment this past year. It’s been hard not to. And for as much more work there is to do, it’s frustrating when people suggest that #MeToo has gone too far in “ruining” men’s lives or that men can’t even feel comfortable talking to/mentoring/hiring a woman anymore.

There’s one Quartz story I haven’t been able to shake these past few months about headhunters having trouble recruiting people in the era of #MeToo. An excerpt:

” … But in the last year, search firms also have had to consider host of other qualities about prospective candidates. Are they abusive to employees? Do they have a problem keeping their hands to themselves? Are they likely to engage in inappropriate behavior? Are they jerks? … ”

The fact that apparently headhunters did not have to consider if a candidate has been abusive or inappropriate to employees, while not surprising, is disgusting. There’s no reason that type of behavior shouldn’t be considered. In this environment, this is a great time to finally hold people accountable for their abusive/harassing actions instead of letting them hop from job to job to repeat the same patterns.

Hearing things like this makes me wonder about how many serial harassers can constantly get away with doing the same actions at different companies under the guise of getting a second chance.

I wonder what direction the #MeToo movement will go in next year. I hope it doesn’t lose steam when there’s still so much more that needs to change.

One thing I think to look out for is how much companies are actually trying to change versus just trying to do something that makes them look good. On the surface, certain developments may seem like wins, but it’s still necessary to dig deeper in the surface.

For example, Wired published an article in November about the limitations of revised sexual harassment policies. The gist of this story is that changes arrive too late for many women, as companies like Google, YouTube and Uber continue to try to force arbitration on ongoing claims that missed the cutoff for the new policy. Statistic: Forced arbitration is so common now that about half of all U.S. workers in the private sector (who don’t belong to unions) have waived their right to go to trial.

My major takeaway was that while progress is good, there’s a lot to be done here. Let’s not take every little win as the ultimate win or as a reason to stop caring about this topic. If we look deeper in ways companies are trying to improve, there could be limitations.

We should be able to give organizations a pat on the back for going in the right direction while also feeling free to give constructive criticism where there’s still work to be done. That’s not being ungrateful; that’s being logical.

Other 2018 articles on this topic:

Health Data and Data Privacy

Sometimes it seems like companies are giving fitness trackers away like candy. But what’s the actual cost of these supposedly free devices?

One annoyance I have in the employer health-care space is about the lack of transparency in certain areas, resulting in employees not getting all the necessary facts they need to make an informed decision. For example, life insurance companies can deny coverage based off an applicant’s genetic test results. Do employees know that when they take advantage of an employer’s genetic testing benefit?

Add this new one to the list, also relating to life insurance: John Hancock announced in September that it “will stop underwriting traditional life insurance and instead sell only interactive policies that track fitness and health data through wearable devices and smartphones.”

Excerpt from the Vox article: “The insurance companies can use this data to potentially weed out bad health-risk customers. A John Hancock representative told CNN it may use the data to try to sell customers other products like retirement plans. And it already charges less for people who are healthier. While the insurance market is heavily regulated, we’ve already seen what can happen when insurance premiums are left up to the whims of a free market … .”

None of this is to single out John Hancock, but it’s an example of one company’s practices.

A different article this year pointed out just how common fitness trackers have become for employers. Compared to 2 million workers in 2016, 6 million workers worldwide will receive fitness trackers through their employer by the end of 2018, reported NPR in November. Also, annual financial incentives for participating in voluntary wellness programs that may mean having to wear one of these trackers range from $100 to more than $2,000, depending on the company. That’s a lot of money for employees to give up by not participating.

An excerpt from the NPR article provides some insight into the potential meaning of too-large incentives:

[Andrew Boyd, an assistant professor of biometrics and health information at the University of Illinois at Chicago and the associate chief health information officer for innovation and research at the University of Illinois Hospital] is cautious but confident that some of the ongoing studies will show positive benefits for patient health. But he urges taking care before trading data for dollars. It’s important to know the type of information your tracker is revealing about your health, he says, and to know exactly how it will be used. Your incentives could offer a clue.

“If [your insurance company is] offering you two or three times the amount of money that every other insurance company’s offering you, there’s something else they value in the data that they’re giving you that cash for,” he says.

For instance, he says, if Congress ever repeals the Affordable Care Act, insurers could use the fitness data they’re collecting today to deny you coverage based on a medical condition that your tracker detects.

What do you think? What topics are you following closely now, and what are you curious to follow next year?

The post Hot Topics for 2019: #MeToo and Data Privacy appeared first on Workforce.


More than 114,000 Americans are on the organ transplant list and about 20 people die each day waiting for a transplant. Expanding the pool to allow organs to be transplanted that were previously discarded can reduce suffering, save lives and, in many cases, reduce high disease-related medical costs for self-insured employers, insurers and patients.Organ Transplant Innovations

One way the pool is beginning to expand is by allowing organs to be transplanted from donors with hepatitis C. Thankfully, the same medications that offer a cure for those affected by chronic hepatitis are also being utilized to help patients eagerly awaiting organ transplants.

At first blush, this may seem like a dangerous idea, but if proper protocols are followed it can be safe and help save lives. Receiving an organ from a donor with hepatitis C allows the patient to live a healthier life. It also saves both them and their health plan the significant cost of ongoing disease treatment (such as dialysis) while they wait for a transplant.

But it’s up to patients, their physicians, the stop-loss carrier and health plan administrators to work together proactively to determine if this course of action is right for them. Brokers and consultants can help by educating employers about this treatment opportunity.

Why Infected Organs Can Now Be Donated

In the past, organs from donors with hepatitis C (called HCV-infected) were discarded. But advances in drug development mean that antiviral drugs can cure those with hepatitis C — including transplant recipients. Organs from HCV-infected patients are also becoming more readily available for transplant because of the growing number of deaths associated with the opioid crisis.

A patient can now receive an organ from an HCV-infected patient, and if they show signs of hepatitis C, they can be treated with antiviral medications for eight to 12 weeks following the transplant. Before undergoing the transplant, recipients must be able to tolerate the hepatitis C medication, which is usually tested pre-operatively.

One Cost-Saving Example: The High Cost of Kidney Disease

More than 102,000 people on the transplant waiting list need kidneys. The total cost of a kidney transplant is significantly lower than the $350,000 to $700,000 a plan sponsor or health plan pays annually to care for individuals on dialysis. More importantly, in many cases, using organs from HCV-infected patients is a lifesaving procedure for those on the waiting list who otherwise would not have survived long enough to receive a donated kidney. The average wait time for a kidney from a non-HCV-infected patient is more than two years, while the wait for a kidney from an HCV-infected patient is just eight months.

Also read: 4 Tips on How to Conduct a Voluntary Benefits Checkup

Kidneys from HCV-infected donors can extend life and improve quality for more organ recipients. It’s one example of how innovative practice and revolutionary pharmacology have eradicated the HCV infection, making the reality of transplant available to so many more people.

Transplant Success Stories

Medical teams and patients have seen success transplanting organs from patients infected with hepatitis C. The University of Pennsylvania has successfully transplanted 20 kidneys from HCV-infected patients since 2016, and all patients who received these organs are free of hepatitis C.

Medical teams have seen success with other organs, too. Vanderbilt Transplant Center has transplanted 44 hearts from HCV-infected patients, the largest number done by any transplant center to date. Of 37,795 total organs transplanted in 2017, 1,491 tested positive for a hepatitis C infection. In the first half of 2018, 803 transplanted organs tested HCV positive.

What Brokers and Employers Should Know

With treatment for hepatitis C widely available, an increasing number of health plans are supporting the transplantation of organs from hepatitis C-infected donors to those who are not infected. Just as they would for a typical transplant, a health plan medical director and a transplant coordinator review each case individually for medical necessity, patient condition, organ quality, the best course of action and transplantation at a center of excellence. Brokers should educate employers on this development, and whether their specific health plan covers this time- and money-saving procedure.

For now, it’s up to employees or health plan administrators to work with physicians to determine if it’s an appropriate solution. In many cases, a transplant with an organ from an HCV-infected patient is better for the recipient and better for the health plan.

The post Organ Transplant Innovations Can Save Health Care Dollars appeared first on Workforce.


California HR professionals had to deal with quite a few changes in 2018. This year’s most-read SHRM Online articles covered marijuana legalization, pay equity, background investigations and more.

In my experience, self-improvement is a day-to-day task. It’s a culmination of hard work that over time is accomplished by small but constant steps.

With the new year comes a good number of people whose New Year’s resolution is to get healthy. Given that people spend a good amount of time at the workplace, I’ve spoken with workplace wellness experts and others about well-being tips employees should keep in mind on a day-to-day basis in 2019. Some of them have also explained the employer’s role is in accomplishing these basic tasks.

Keep track of your achievements: Sometimes we can get caught up in the fast pace at work, getting bogged down by problems and difficulties and failing to appreciate our successes along the way, said Rick Hughes, head of service at the University of Aberdeen’s Counseling Service and a co-author of the book “The Wellbeing Workout,” along with Andrew Kinder and Cary L. Cooper. This can lead to anxiety, tension and stress.

“Toward the end of each work day, list three ‘achievements’ of the day in your diary,” Hughes suggested, adding that they don’t need to be major accomplishments. They can be as simple as “I had a good meeting with my colleague” or “I got appreciation from a customer.”

“At the end of the week you’ll have 15 achievements,” he said. “Sit back, applaud yourself and look forward to building on this further the following week.”

Work on your composure: This is a way to keep your sense of well-being strong on a daily basis, said Joyce Young, managing director for the High Health Network.

“Believe it or not, being composed is a skill,” Young said. “When you’re composed you have more control, more optimism, you make better decisions, and those decisions you make, because they’re better, help you stay in balance.”

She suggested three ways in which people can hone this skill.

  1. Connect with something personally meaningful. “If you stop every so often and say, what is meaningful to me? It resets the idea that I’m not just wandering here. There are things in my life that matter to me, and you basically are connecting with them. If we don’t connect and reflect, then these important points in our lives get away from us,” Young said. She added that if someone spends a couple minutes reflecting on what’s personally meaningful to them, the example might not be something positive. It could be something that’s causing negative thoughts or emotions. That’s still valuable, though, since it gives people a sense of centering and takes them away from the trivial things that can take up one’s day-to-day life.
  2. Nap. Studies have shown that even a three-minute nap can be refreshing, Joyce said. Personally, she enjoys taking 20-minute naps many days. Short naps can help someone feel more refreshed and composed.
  3. Connect with nature. This can help with something called “attention fatigue,” Joyce said. One’s sense of attention gets tired, much like a muscle, and experiencing nature can help restore that attention, for example by looking out the window at the office at the park across the street or keeping plants at the desk.

HR has a role in this, too. First, if decision makers in the HR community actually engage in the practices, they get the benefit of the practices, Young said. Also, if they engage in practices like this then it’s easier and more apparent to them what specific things they could do to help support their employees in similar endeavors.

Get fresh air: Expanding on Young’s “connect with nature” idea further, Tracy Hultgren, the creator of the blog Trail Tracing, advocates that people take a little time out of their day to get fresh air and take a walk. Hultgren spoke with Workforce earlier this year, and his ideas are worth revisiting.

For one, his notion to walk outside every day is simple and applicable to most geographies, from the middle of a city to a suburb close to local parks. Walking is a simple form of exercise that most people can do, Hultgren said. While many people have an “all-or-nothing” approach to working out — an attitude like, “If I’m not going to run a marathon, I’m not going to run at all” — allowing oneself a short, stress-free daily workout like walking lets them have a little time every day to take care of themselves in a low-key and not stressful way.

An employer’s role in this is simple. Basically, they just have to be open to allowing employees a short amount of time each day to leave their desk.

Scrap the resolutions: This one is coming from me. A while ago, a friend suggested that having a “goal” for the year was better than having the traditional resolution. So instead of telling yourself to go to yoga once a week, make a theme like “tranquility.”

It’s something more flexible, realistic and creative, because instead of doing one specific task every so often, you have a general vibe you’re striving for, and a lot of different activities fit in it. You might to yoga to calm down and feel more at peace, but you could also go on a long walk, spend a little time pampering yourself, or cook yourself a dinner that makes your apartment smell good.

This is also something realistic to fit in your everyday life, I believe.

Any other wellness tips you find valuable in your workplace? Comment below or reach out to me on Twitter @Andie_Burjek. I’ll add them to this list post-publication.

The post Daily Wellness and Motivation Tips appeared first on Workforce.


There is a savings crisis in America. Eight out of 10 workers are living paycheck to paycheck, and though many employers have started to prioritize financial wellness in recent years, they are doing little to prepare employees for financial emergencies that could end up affecting their performance in the workplace.employee rainy day savings

While it’s true that a lot of companies offer 401(k)s to help employees save for retirement, they aren’t a feasible option for many U.S. workers, regardless of employer contributions. The Federal Reserve Board’s 2018 “Report on the Economic Well-Being of U.S. Households” shows that 40 percent of people can’t even afford a $400 emergency, much less afford to set money aside for retirement.

401(k)s have their place in financial wellness, but that place is not savings for events prior to retirement. There are substantial fees associated with withdrawing funds before retirement.

These fees impact a lot of people: 44 percent of Americans report having to tap into their retirement before they hit age 59 and a half for things like grad school, debt reduction and unexpected hospital visits.

There is a 10 percent penalty for early withdrawals. On top of that, employees must also pay income tax on the money they withdraw, making these accounts even less useful for unexpected expenses prior to retirement.

Financial Worry Hurts the Bottom Line

But early withdrawal fees are just one symptom of the larger problem of ongoing financial stress. Last year, nearly 60 percent of people surveyed said they were anxious about their future financial state. And even more concerning, more than 30 percent reported being worried about how they’ll make ends meet in the present.

Also read: What Ails Financial Wellness Plans

This financial stress leads to big problems in the workplace. For example in 2017, financial worry caused employees to miss an average of 3.4 work days, and nearly a third of financially stressed employees say their money concerns carry over into their job, affecting their productivity and focus.

SafetyNet asked thousands of workers what they would like from their companies, and most noted they wanted help saving money, especially for unexpected emergencies. But few employers are offering help when it comes to rainy day savings.

Also read: Assessing the Value of Financial Wellness for Your Employees

Employers Can Help by Offering Short-term Savings Programs

The good news is that improving employees’ financial security is solvable.

Some companies, like Aetna, have started using incentive-based financial programs to educate employees on basic money management. Still, only 17 percent of large companies offer these types of programs and employees want financial tools in addition to education.

Prudential Financial is throwing their hat in the ring by helping employees set up an after-tax savings option within their 401(k)s. This model enables employees to gather after-tax contributions from their paycheck and have a lower withdrawal fee than the pre-tax contributions do, making these funds easier to use as emergency savings if needed.

One option becoming popular for employers is a short-term savings program, which holds funds that people can access at any time.

Different from traditional savings accounts, these programs (sometimes called “rainy day funds”) are typically sponsored by employers. They work by stowing funds in dedicated savings accounts. A few varieties already exist.

CookieJar, for example, is an employer-sponsored savings account that rounds up spare change from employees’ debit card purchases and gives companies the option to match those contributions. This type of program is low-cost — far below those of a 401(k) for the employer, and free to the employee.

And with Congress attempting to make it easier for employers to set up these types of programs, you can expect to see more in the future.

Given the amount of time and energy currently lost to financial stress, these programs could have a major impact on the well-being — and the bottom line — of your company.

The post Help Workers Save for Rainy Days, Not Just Golden Years appeared first on Workforce.


Employers are offering new benefits to meet workers’ changing demands, this animated slideshow highlights. Elder care resource services, disaster relief funds and advancement initiatives for women are among the benefits more employers offered in 2018.

The Hyman clan carried out our annual holiday tradition of watching “Elf.”

Since much of the story took place in and around various workplaces, this year I decided to watch with an eye toward shareable employment law lessons.

Early in the story, Buddy learns the harsh reality that he is not actually an elf but a human. He learns this lesson after falling 985 Etch A Sketches short of his production expectations and being transferred to Jack-in-the-Box testing (the job reserved for “special” elves).

Assuming that Buddy’s height is a disability in the North Pole (and if the ADA protects dwarfs down south, it’s safe to assume the North Pole’s disability discrimination laws would similarly protect Buddy’s heightened height up north), what ADA lessons does this parable teach us?

1. Reasonable production standards.

The ADA does not require an employer to lower production standards — whether qualitative or quantitative — that it applies uniformly to employees with and without disabilities. An employer may, however, have to provide reasonable accommodation to enable an employee with a disability to meet the production standard.

Thus, if Santa requires 1,000 Etch A Sketches per day, then Buddy is required to make 1,000 Etch A Sketches per day, disability or no disability. Santa may, however, have to offer Buddy a reasonable accommodation (if available) to meet that quota. Santa may also choose to lower or waive the production standard,  but he is not required to do so. Keep in mind, however, that if one waives or lowers the requirement for one employee, it makes it difficult to argue for future employees that the production requirement is truly essential, or that altering it is not a reasonable accommodation.

2. Transfer as reasonable accommodation.

The ADA specifically lists “reassignment to a vacant position” as a form of reasonable accommodation. An employer must consider this type of reasonable accommodation for an employee who, because of a disability, can no longer perform the essential functions of their current position, with or without reasonable accommodation. Reassignment is the reasonable accommodation of last resort and is required only after it has been determined that: (1) there are no effective accommodations that will enable the employee to perform the essential functions of his/her current position, or (2) all other reasonable accommodations would impose an undue hardship.

There are, however, several caveats.

The employee must be “qualified” for the new position, both by satisfying the requisite skill, experience, education, and other job-related requirements of the position, and by being able to perform the essential functions of the new position, with or without reasonable accommodation. An employer is under no obligation to assist the employee is becoming qualified, such as by providing training to enable the employee to obtain necessary skills for the job.

“Vacant” means that the position is available when the employee asks for reasonable accommodation, or that the employer knows that it will become available within a reasonable amount of time.

The reassignment must be to a position equal in pay, status, or other relevant factors (such as benefits or geographical location). If there is no vacant equivalent position, the employer should reassign to a vacant lower level position for which the individual is qualified and which is closest to the employee’s current position in terms of pay, status, etc.

For Buddy, that position was Jack-in-the-Box tester, an open position for which he was qualified.

There you have it. ADA lessons from “Elf.” Happy holidays.

The post What Can the Holiday Movie ‘Elf’ Teach Us About the ADA? appeared first on Workforce.


The Northeast Business Group on Health recently released a new guide, the first of its kind. “Genomic Medicine and Employers: Separating the Hope and the Hype” seeks to educate employers on what’s occurring in this field, and it’s the result of a roundtable of many stakeholders including employers, clinical experts, benefits consultants and genomic vendors.

It was a pretty fascinating read on a topic that will only become more relevant over time. As this report pointed out, a May 2018 Health Affairs report stated that there are some 75,000 genetic tests on the market — such as Illumina, 23andMe, Abbott Molecular Inc. and Blueprint Genetics — with about 10 new tests entering the market daily. Meanwhile, there’s been a large spike in direct-to-consumer advertising. So, even if employers aren’t communicating with their employees about these tests, odds are that these employees are hearing about them somewhere else.

It’s great that a group of people, experts in different sides of this issue, could get together and talk about genomic medicine/genetic testing. [For reference: the term genomic medicine refers to “an emerging medical discipline that uses genomic information about an individual for diagnostic or therapeutic decision making,” according to the National Human Genome Research Institute. Genetic testing refers to a test that “identifies changes or mutations in chromosomes or genes. It can confirm or rule out a suspected genetic condition.” So, in a nutshell, genetic testing informs genomic medicine.]

“All of the genomic medicine topics we covered were fascinating. The innovations taking place in oncology diagnosis and treatment — gene therapy that actually can modify someone’s genes in order to treat or cure cancer, for example — are groundbreaking,” said Candice Sherman, CEO of Northeast Business Group on Health.

One area that she and NEBGH’s members are interested in is mental health. An issue for many employers and employees is when people need to cycle though different depression or anxiety medication before they finally find one that will work, she said. Although there’s still work to be done in this area, the prospect of being able to use genomic testing to identify what a person’s response would be to particular medication is exciting.

The major takeaways of the roundtable are mentioned in the report, but one important topic that the roundtable highlighted was the need for employers to approach health plans and benefit consultants and be “armed with questions about policies, outcomes data and cost when it comes to genomic medicine,” Sherman said.

Digging deeper into the report, it did bring up many solid ideas and questions for employers. Genetic testing benefits and where genetic tests belong in a health plan are not easy concepts to grasp for employers.

A cost-benefit analysis of genomic medicine brought forth some important questions, including:

  • “Do tests provide enough meaningful data to make them clinically actionable? Are they specific and sensitive enough? Some vendors lack scientific data to prove their genomic tests have clinical value.”
  • “Interpreting the results of gene sequencing is art as well as science. Interpretations can vary, which in turn can generate different treatment paths.”
  • “Predictive genomics can help evaluate the risk of a disease developing in an individual. But whether such testing is worthwhile depends on several factors, such as whether the disease has a high genetic correlation and to what extent environmental factors play a role. Environmental and lifestyle factors in conditions like cancer and many chronic diseases can be more significant than a slightly increased predisposition to those conditions.”

There are some very real ethical challenges for employers in the genomic medicine arena, Sherman said. Employers may need to make difficult decisions on what they will and won’t cover. She gave an example of a dependent who has terminal cancer and who discovers a new type of gene therapy that costs hundreds of thousands of dollars. What if an employee were to ask an employer to cover this?

Genomic Medicine Employers
A May 2018 Health Affairs report stated that there are some 75,000 genetic tests on the market, with about 10 new tests entering the market daily.

A situation like this would bring up many overwhelming, ethical questions that are in no way easy to answer, said Sherman, such as: Who decides what value to place on extending life by several months? Does it make a difference whether the dependent is young or elderly?  What if the initial data is promising, but no long-term data is available?

One last element I found interesting about this roundtable is that I found one important stakeholder to be missing: employees (the patients) or patient advocacy groups. Having any discussion about health care, which is specifically meant to treat patients, should include somebody fully representing the voice of the patient.

Sherman pointed out that privacy concerns would be a hindrance to including patients in a discussion like this. That made sense to me, considering how sensitive individual health data is for patients.

I’d hope employers would have the interests of their employees in mind for any discussion about a topic like this, especially when it comes to genetic privacy and discrimination. As I like to point out any time I write about genetic testing, it is not illegal to discriminate against a person based on results of a genetic test in areas like life insurance. Any employee considering genetic testing for any reason should be aware of that.

I’ve written about this before, and of course seeking genomic tests for cancer treatments is different than doing it just to check for general risk factors, but I think it’s important to stress. I have a good friend this past year who was so enthusiastic about getting a genetic test done, but once I mentioned the life insurance discrimination fact, she did more research to decide if the test was worth it.

Genomic medicine is a truly fascinating topic for anyone looking toward the future of health care delivery, and of course it’s possible to go much deeper on this topic. For the time being, this guide was an interesting source of information for employers beginning to think about where genomic testing belongs in their workplace. I hope you find it valuable as well!

For the time being, here are a couple more articles related to the topic I found in my research, if you’d like to read about this area further:

The post Employer Roundtable Explores Hype and Hope in Genomic Medicine appeared first on Workforce.

As I prepare to write an in-depth article on health care costs for Workforce’s March-April issue, one of the topics that has come up regularly is health care navigation among employees. That’s what I found the Deloitte “2018 Survey of US Health Care Consumers” to be interesting.

health care navigation
People navigate the health care system like Homesteaders, Trailblazers, Prospectors and Bystanders, according to the Deloitte report.

The survey broke down the types of consumers in the health care market as “Wild West” tropes and gave suggestions for how different stakeholders could appeal to these consumer segments. Corny? Sure. But corny little bits like this, at least to me, make it way more fun to write about health care navigation, which can be a pretty dry topic. Personally, I would have gone with the space theme, since my roommate and I have been rewatching the early 2000s futuristic space western drama “Firefly” recently, but the historical Wild West works, too.

Health care navigation is a term that refers to helping patients navigate their way through the often complex health system by giving them as much information as possible to make their own decision and guiding you to the most appropriate health professional. Different patients navigate different ways.

Their four categories Deloitte highlighted were: Homesteaders, who are reserved, cautious and traditionalist; Prospectors, who rely on recommendations from family and friends, find their health care providers to be trusted advisers and are willing to use technology; Trailblazers, who are tech-savvy, engaged in wellness and willing to share data; and Bystanders, who are unengaged, tech-reluctant and resistant to change.

The report compared these groups in several different categories, but the two that stood out to me were shopping behavior and willingness to share health information/data.

Let’s start with health data. The older, poorer groups (bystanders and homesteaders) were least likely to share tracked health information with a doctor or to use technology (like wearables) to monitor fitness. The younger, richer groups (trailblazers and prospectors) had the opposite tendencies toward health data.

Now, I know health companies and employers love have their own incentives to get health data, but, from the point of view of an employee, I would just like to point out that not everyone needs to be reliant on technology to keep track of their health. It’s not how everybody functions best, and trying to push wearables or health apps on someone who’s perfectly content in a more manual workout routine is silly.

Also, the data privacy laws in the U.S. aren’t necessarily promising for consumers yet. People should be able to feel like they have control of what happens with their own personal health data.

Not to say that patients/employees shouldn’t be open with their doctors. But, as I’ve written about before, although it’s great if a company genuinely wants to create a program that will improve the well-being of its employees, it should stay voluntary, and people who don’t participate shouldn’t be shamed, penalized or seen as backward or stubborn.

Shopping behavior is the other area of comparison, and this is the meaty part because it gets to the inherent differences in people and who they trust for advice on something as personal as health — and something as complicated and not-necessarily straightforward as choosing a doctor.

It also taps into the reality of how people in different socioeconomic situations make these decisions. Bystanders, the group with the lowest incomes, consider out-of-pocket costs and convenient hours when choosing a doctor and are less likely to change doctors or health plans even if they’re dissatisfied. Compare them to Trailblazers, the highest income group, who are the most likely to do their research on physicians, hospitals and health insurance companies and are the most likely to change doctors if they’re dissatisfied.

Using basic logic, this makes sense. Having a higher paying job with reliable hours and access to paid time off would make it much simpler to make health care provider changes. Meanwhile, if you’re living paycheck to paycheck and have a busy schedule, basing your medical off out-of-pocket costs and hours is perfectly rational.

The report also gave employers and other stakeholders like health systems and insurers suggestions on how to engage employees/patients in each segment.

Employers can begin to engage the tech-savvy, wellness-engaged Trailblazers by offering virtual health visits and creating a seamless technology experience. For those employees who rely on family, friends and trusted doctors for medical advice, employers can push online patient forums and patient advocacy groups.

I was most interested in stakeholder strategies for the two less tech-centric groups, mostly because those segments seem more like a challenge for employers. Connecting with these people and getting them engaged with health care can happen a number of ways, depending on what their barriers are.

  • A patient who makes health care decisions based off convenience of hours and location could benefit from having access to a physician or health system that offers off-hour appointments.
  • A patient who is open to trying tech solutions but still intimidated by it could benefit by having a nurse or clinician spend a few minutes at the end of a doctor’s visit and help set up a virtual appointment, as well as answer any questions about how virtual appoints work, how to access them, etc.
  • For a patient who isn’t likely to engage with the health care system on their own, stakeholders can address this by involving a caregiver, if applicable, who can encourage this person to get the care they need.
  • For the least engaged patients, what could also help is if community organizations like their local grocery store or place of worship encourages healthy behaviors. For example, a church could hold a healthy food potluck.

Now, none of these are employer-based actions, but I still think they hold some value to employers. For example, employers may have an employee with a chronic condition whose spouse and kids act as a caregiver; maybe they could consider how to engage spouses and children in chronic-condition care in their health plan. Also, employers could offer healthy good in the office, where employees spend a large chunk of their time, and think about partnering with health systems that offer appointments off-hours.

What do you think? What does your organization do to appeal to employees/patients with different preferences?

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