Integrated Absence Management: The Employer’s Role in Total Employee Health

By Adam Seidner, MD, MPH, CIC

Chief Medical Officer
The Hartford

Integrated absence management is more than just a process to coordinate or integrate employee benefits. Truly helping employees prevent disability, stay at work, or return to work (RTW) requires an understanding of the forces impacting an individual’s health or illness.

As the North American workforce ages, the burden of chronic disease in the population is rising. Episodes of prolonged disability due to depression, lower back pain, and other common conditions are becoming more frequent. Although the incidence of work-related injuries and illnesses has fallen steadily for the last several decades, the duration of disability following work-related injury has climbed, along with medical services and their costs.

Interventions

Although many large employers have applied significant resources to promote general health in the workforce, the results have not been uniformly successful.¹

To understand the health of the employee population, a number of medical data points should be analyzed regularly through health risk assessments, pharmacy utilization data, and other tools. Knowing the primary medical conditions responsible for disability as well as associated comorbidities and employee demographics can help determine which intervention programs will have the greatest impact on employee health and effective utilization of disability benefits.

Healthy employees cost less in medical and pharmacy claims, and have lower rates of short-term and long-term disability, absenteeism, and workers’ compensation incidents.² Well-being programs operate on an implicit assumption that health behaviors drive health outcomes, so interventions that change behaviors can also affect health outcomes.

Medical evidence overwhelmingly supports certain behavior patterns that positively influence health: smoking avoidance, regular exercise, getting enough sleep, and limiting alcohol consumption are well-known behaviors that can have a positive effect on health outcomes.³

Several other important areas affecting employee health and health behaviors include social support network characteristics, demographics, stress level, access to resources and healthcare services, attitudes toward healthcare, knowledge about disease, and perception of disease threat.⁴

In addition to providing tools and education to aid employees in managing their health behaviors, employers can also develop a bridging program to help employees return to work  during or after treatment. It should include partnering with stakeholders to identify chemically-impaired employees and support their return, and providing information about the employee’s work environment and the organization’s ability to provide accommodation to the worker’s healthcare providers so providers can more fully support the stay-at-work and RTW processes.

Conclusion

Total employee health begins with understanding employees and what motivates them. Employers should create partnerships with vendors and insurers who can help them understand their data and identify opportunities to decrease disability durations and increase productivity.

Providing evidence-based knowledge and practical assistance to all stakeholders can help build partnerships to develop successful, sustainable policies and procedures to ensure the success of the employer’s most valuable asset — the employee.

References

1. Safeer R, W Bowen, Z Maung, M Lucik. Using the CDC Worksite Health Scorecard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine. Journal of Occupational and Environmental Medicine. 60(2):e98-e105. 2018.
2. S Sagy. Moderating Factors Explaining Stress Reactions: Comparing Chronic-Without-Acute-Stress and Chronic-With-Acute-Stress Situations. Journal of Psychology. 136(4):407-419. 2002.
3. Conner-Smith JK, BE Compas. Coping as a Moderator of Relations Between Reactivity to Interpersonal Stress, Health Status, and Internalizing Problems. Cognitive Therapy and Research. 28(3):347-368. 2004.
4. Abraham C, M Conner, F Jones, D O’Connor. Health Psychology, 2nd ed. London: Routledge. 2016.