 There are costs associated with every aspect of running a business, whether for profit or not. Management gurus, Peter Drucker and Tom Peters, are quoted as saying, "What gets measured, gets done." Yet organizations still struggle to quantify aspects of their business that drain resources like a bucket full of holes.
With stress and anxiety levels increasing and people's decisions about financial, physical and mental health struggling to be a top priority, employers increasingly feel the effects of presenteeism, absenteeism, disability in the workplace. Measuring the cost of chronic conditions in the workplace is a method for understanding the drain, weighing its importance, and giving it the prioritization it requires. What is a chronic condition? By definition, a chronic condition is an illness that continues for a prolonged period (more than one year) and requires ongoing monitoring or treatment. Chronic conditions include high blood pressure, asthma, anemia, diabetes, heart disease, arthritis, mood disorders and cancer. According to the Centers for Disease Control (CDC), there are four major health risk factors that contribute to chronic conditions: 1) lack of exercise; 2) poor nutrition; 3) tobacco use; and 4) excess alcohol consumption. The more employees are educated about these factors, the greater the likelihood that healthcare costs have a chance of being effectively managed. Without awareness and preventive steps, the greater the propensity that chronic conditions and their associated costs will increase. What to measure. While this list is by no means exhaustive, it offers potential quantifiable metrics for employers to measure:
With an aging workforce and the rise of chronic disease prevalence, there has never been a better time to focus on maintaining a productive, healthy and competitive Canadian workforce. Working with a trusted employee benefits advisor can help you measure and manage the healthcare costs associated with chronic conditions. We invite you to contact us to discuss this topic in more detail. As always, we're here to help so that you can focus on what you do best.
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 Image: Shutterstock In the world of benefits, certain issues tend to receive more attention than others. The big ticket items like prescription drugs and paramedical service expenditures tend to hog the cost management discussion limelight. Hiding in the background is a growing problem for both employees and employers -- eldercare. Statistics Canada predicts that our population will continue to age quickly until 2031 and this means that eldercare issues are likely to becomes a much greater concern. Unlike childcare, eldercare becomes more complex and the level of support required tends to increase over time.
What is eldercare? It is unpaid assistance provided to a person 65 years of age or older because of a long-term health condition or physical limitation. For an employee who provides eldercare to an aging parent or loved one there are many issues facing them. The issue for employees. According to a report by CIBC Capital Markets, 30 per cent of workers with parents over age 65 lose 450 hours per year of time off to support eldercare needs. At present, more than 8 million Canadians are caregivers. Eldercare support is provided in all kinds of ways.
Notably, more care is needed for those between the ages of 75 and 85. The predominant conditions caregivers face include:
Employees who provide eldercare may experience stress, anxiety and exhaustion. According to a Met Life study, 16% of respondents said they had to quit their jobs in order to meet the needs of elderly parents. Others said they passed up job promotions, training or career advancing opportunities. They used sick or vacation time to attend to eldercare issue. In so doing, less time or no time remained for self care or attending to their own needs. The issue for employers. According to a report by CIBC Capital Markets, 30 per cent of workers with parents over age 65 lose 450 hours per year of time off to support eldercare needs. Employees providing eldercare experience more partial absenteeism. To accommodate the eldercare demands, they arrive late, take longer lunches, leave early and use time at work to talk on the phone with eldercare service providers and loved ones. Eldercare costs employers. They face various challenges including
Small measures can make a huge difference. To reduce and avoid the negative effects of eldercare issues in the workplace and to support employees who are tasked with providing eldercare, employers benefits from considering:
Eldercare and other issues affect worker well-being, productivity and potential benefit plan costs. There are importance preventative considerations for employers that we're well positioned to support. We invite you to contact us to learn more. We're here to help so that you can focus on what you do best. Addressing Mental Health in the Workplace and the importance of training front-line managers.8/1/2016  There was a time when top health issues in Canada were more physical in nature and relatively easy to identify. They ranged from musculoskeletal disorders to high blood pressure. In the last few years, more discrete and difficult to easily identify illnesses such as depression, anxiety and stress disorders top our country’s health issue charts.
When Morneau Shepell conducted their second annual national mental health survey in the fall of 2015, they received responses from over 1000 employees, 100 employers and 100 physicians. The report revealed that mental health issues and extreme stress — both workplace and personal — negatively impact an employee’s work. The facts pertaining to mental health in the workplace continue to demonstrate staggering financial implications. In 2013, the Mental Health Commission of Canada reported that of the total economic burden caused by mental illness in Canada, $20 billion of the $51 billion per year relates directly to workplace losses due to disability claims, absenteeism and lost productivity. This data also highlights that 500,000 Canadians are unable to work in any given week due to mental health issues with 20% wrestling with mental health issues in any given year. The Morneau Shepell report highlights that mental health absenteeism is significantly underreported. This means that 500,000 Canadians unable to work in any given week due to mental health issues might actually be significantly higher. Knowing the facts is important. It generates the need for further conversations about what is actually happening in the workplace and the importance of understanding organizational culture. Culture isn’t something you can see on the surface, it is felt and experienced by the employees who work in an organization. Similarly, workplace stress might not appear like a broken arm or someone recovering from surgery. It can be more difficult to identify. The Morneau Shepell report highlights that 60% of respondents said emotional/interpersonal issues were a source of workplace stress; these issues correspond directly to workplace culture. In the past, leaders were trained to bring greater attention to ensuring workers have a safe environment to work and the right equipment to do their jobs effectively. While these needs remain important, they ranked only at 14% as a cause of workplace stress in the Morneau Shepell report. Emotional/interpersonal workplace stresses may also be triggered by the behaviour of the person’s direct supervisor, their colleagues as well as feelings of isolation. Perhaps surprisingly, these stressors proved to be far more prominent than any stress generated by deadlines or a dislike for one’s job. As workplace stress and mental health issues continue to rise, action can be taken to stem the tide. The 2015 Morneau Shepell report demonstrates that employees would benefit from managers knowing what to do when an employee shows signs of distress. Leader training on mental health can address the fear employees have about bringing their issues forward. Many report fearing the existing stigma associated with mental health. Removing the unhealthy barriers preventing services from being accessed and much needed help provided can be achieved through this type of specific management training. Equipping front-line supervisors can be achieved through the implementation of an in-house program or through working with external vendors who provide the framework and/or the training itself. The key components to a leader’s mental health training program include:
Training and educating leaders is an action organizations can take when looking to reduce absenteeism, turnover, disability duration and frequency. Doing so helps to create healthy conduits for employees while enabling them to connect with much needed stress management and mental health resources. If you are looking to positively impact your disability management outcomes as well as increase productivity through employee engagement, please contact us — we have the resources and expertise to support your goals. We’re here to help so you can focus on what you do best.  Just as certain as snow is to arrive in Canada in winter and tulips are to bloom in spring, we, in the benefits industry, await the results of the annual Sanofi Canada Healthcare survey every June. While the focus of the questions may vary, the analysis of the results consistently proves to be of value whether from a plan sponsor, plan member or service provider perspective.
The 2016 findings continue to compare and contrast the views and wishes of surveyed plan members and plan sponsors. Where plan sponsors may wonder how plan members view the use of their benefits, the survey helps to bring clarity. Of the 1,500 plan members surveyed across Canada, 43% view health benefits plans as something to use only to treat or prevent illness or injury whereas 35% see it as extra compensation and something to use as much as possible to get their money's worth. Another 23% see health benefits as both a resource for health and extra compensation. Surveyed plan members also gave high marks for their plan's coverage of prescription drugs, basic dental and paramedical services. They were least likely to rate their health care spending account and vision coverage as excellent or very good. How did plan sponsors respond to the same questions? There were noted differences between the degree of satisfaction compared to those of their plan members. While both parties rated prescription drug, basic dental and paramedical coverage highly, there was a 20 point differential in more favourable responses by plan sponsors in each of these three categories. Where plan members felt vision coverage was less than excellent or good, plan sponsors responded this way regarding vaccine coverage instead. Demographic differences continue to surface and are reflected in the survey responses. Specifically, this was noted in plan member responses in massage therapy claiming patterns. Of all survey respondents, 43% of plan members indicated they submitted at least one claim for massage therapy in the past year, Millennials (born between 1980-2000) were more likely to get massages to relax or relieve tension (47%) where Baby Boomers (born between 1947-1964) were more likely to seek out massages to treat injuries or conditions. Another insightful survey finding pertained to chronic disease in that 59% of plan members reported having at least one chronic disease or condition. Of those age 55 to 64, 79% of them reported having been told they have a chronic condition such as arthritis, asthma, cancer, depression, diabetes, heart disease, high cholesterol or other. This percentage dropped to 40% for plan members age 18 to 34. Understanding the demographic makeup of one's organization is an important data source for predicting claiming patterns specifically where high cost prescription medications may be needed to treat chronic diseases. Those diagnosed with chronic conditions would like to know more about their disease and how to treat it. They also would be agreeable to meeting with a healthcare coach if available through their health benefit plan. When asked if it is hard to change their lifestyle habits that they need to change in order to improve their health condition, 67% of plan member respondents said they somewhat or strongly agreed this was the case. The result? More emphasis to support chronic disease management is warranted in the workplace. Finding ways to motivate plan members to make the necessary lifestyle changes will continue to be a lofty and difficult challenge. Only 28% of plan member respondents said they are doing fine when it comes to getting enough exercise with 40% indicating they were doing fine with eating healthy and 41% reporting they were getting enough sleep. The 2016 survey creates a call to action from its advisory board that health benefit plans must change if they are to survive and "fulfill their potential as agents for productivity in the workplace." Good news here is that 81% of plan sponsors would like to know where costs are coming from based on the health profile of their organization. There is a real interest in using data to eliminate conjecture and subjective hunches. Survey findings such as the Sanofi report create an opportunity to dialogue and surface additional questions that are organizationally specific. Looking to the Sanofi survey findings allows plan sponsors to compare and contrast what's happening with the views and experiences of their own plan members and potentially allow them to drive healthy organizational outcomes. Is it time to look at your group benefits plan in light of this year's Sanofi survey findings? Let's connect to discuss benefits trends, claim patterns and proactive solutions. Please contact us, We're here to help so you can focus on what you do best.  On June 6, 2016, the legal ban on physician-assisted dying expired allowing Canadians to legally access assisted dying under the guidelines outlined in the Supreme Court of Canada's ruling in the Carter case. Carter v. Canada was a landmark case that successfully challenged the prohibition of assisted suicide as being contrary to the Canadian Charter of Rights and Freedoms. The outcome: Canadian adults who are mentally competent, suffering intolerably and enduringly have the right to a doctor's help to end their life.
What does this mean for Canadians and what are the implications for drug costs? There are still a number of grey areas in this emotionally charged and controversial topic as well as questions regarding what drugs might be used to facilitate medically-assisted dying. Since June 6, our country's doctors, nurses and pharmacists may be called upon to help people end their lives. Many of these healthcare practitioners may be reluctant or unwilling to provide this type of medical assistance and they aren't required to do so if they so choose. It is apparent there remains a lot of uncertainty and a lack of clarity regarding who is eligible for medically assisted dying. In some provinces, two people must witness the signature of the patient and in other provinces, no such witnessing is necessary. Other examples allow people with mental illness as their only cause of suffering to be eligible whereas this is not a sufficient reason for medically assisted dying in other provinces. There is also much debate at the Senate level of our government as some say that Bill C-14 does not comply with the Supreme Court ruling in that it contravenes the Canadian Charter of Rights and Freedoms. Opponents say that the bill restricts access to people who are already near death. At present, Bill C-14 prohibits people with a severe chronic illness such as Alzheimer's, Huntington's disease and Multiple Sclerosis their right to die because their death is not considered imminent. What are the drugs? Physicians, provincial health ministries, pharmacists and private insurers are trying to sort out the answers related to what specific drugs will be needed to painlessly and humanely end a patient's life and honour their request to die with dignity. At present, oral drugs that could be taken by eligible people are not available in Canada. A barbiturate, pentobarbital, is a drug approved in Canada for this purpose, but the cost of a single dose, if it can be obtained by the company who sells it, is $23,000. Its is not known if pharmacies dispense drugs prescribed for medically assisted dying and therefore it isn't possible for private insurers to confirm payment of these drugs. Who administers the drug? Currently, doctors who agree to help with medically-assisted dying must administer the lethal medications. Who pays? It is believed that the provinces will cover the cost for the lethal prescriptions but this has yet to be confirmed by all provinces. In Quebec, the price tag for euthanasia drug kits is covered by the province. Ontario has said it will support covering the cost as well. Bill C-14 and the topic of medically-assisted dying is fraught with controversy for our nation, our elected officials, and the medical community. We continue to monitor this topic to ensure we're able to offer our clients the most informed support and guidance. Please contact us for additional information and resources. We're here to help so you can focus on what you do best.  Aside from celebrating Valentine’s Day, February is a time when people either embrace winter sports or look to venture to warmer climates to escape snow and cold temperatures.
It is also Heart Health Month and one that finds the Heart and Stroke Foundation busy promoting its mission to prevent disease, save lives and promote recovery. Did you know that heart disease and strokes cost the Canadian economy more than $20.9 billion each year in physician fees, hospital costs, lost wages and decreased productivity? Employers who focus on heart health — whether through their wellness program or otherwise — can make a huge contribution toward awareness that creates a heart smart work environment. Up to 80 percent of premature heart disease and stroke is preventable by adopting healthy behaviours. Sometimes I believe we think we’re making healthy choices without realizing our own negative contributing factors. Weekend health warriors who enjoy an oatmeal breakfast or a fruit smoothie may be tricked into believing they are heart healthy. What happens consistently during the work week can make the biggest difference. Employees who sit most of the day and find themselves hunched over a computer and who are dealing with high levels of daily stress are not doing themselves a favour when it comes to heart disease and stroke prevention. Helping employees pay attention to the benefits of a healthy weight and an awareness regarding managing their blood pressure can delay the onset of heart disease or stroke by as much as 14 years. Top heart smart tips include being active on a regular basis, maintaining a healthy diet and reducing levels of ongoing stress. While some think it is difficult to be active at work without changing into fitness clothes, there are plenty of opportunities that don’t require a change of clothes such as taking stairs instead of the elevator whenever possible, parking a car at a distance that maximizes exercise on the way to and from the office or walking around the workplace during a short 15 minute break. Starting a casual walking group or a more formal and larger scale one can make a positive impact on both workplace health and employee engagement. Tackling a healthy diet involves planning ahead and avoiding quick, convenient, processed sources of food. Encourage employees to introduce five servings of fruits and vegetables a day and if a workplace cafeteria exists, ensure that the menu supports a heart healthy meal plan. Stress reduction can be encouraged by promoting time management best practices, regular daily breaks and the introduction of mindfulness exercises and ways to effectively communicate work expectations, project roadblocks and deliverables. While there isn’t a one size fits all approach to creating a heart-healthy workplace, focusing on a few that you know your organization will value is key. There are number of free resources available including a cardiovascular risk assessment through the Heart and Stroke Foundation. We are focused on helping companies find ways to encourage employees to put their health first. We invite you to contact us to find out what other heart-healthy resources are available. We’re here to help so that you can focus on what you do best.  Every year I post a blog with high level findings about the Sanofi Canada Healthcare Survey results. This report is one of Canada's premier surveys on health benefit plans and reflects the opinions of 1500 primary holders of group health benefit plans. The data was statistically weighted to ensure age, gender and regional composition reflect those of the adult population according to recent Census data. (If you are looking for more detail about the survey itself, I've included a link to the full report on my Resources page.)
This year's survey reveals that respondents are diving deeper into what they are looking for in terms of data and return on investment (ROI) statistics for health and wellness programs (72 percent). They also want a greater understanding of the ways their benefit plan affects health outcomes and productivity (76 percent). They are also looking for more information about paramedical services and how plan design triggers utilization. I'm encouraged to see these results because it shows that plan sponsors are looking for more information in the areas where trusted advisors are well positioned to help them. We want to assist plan sponsors make the links between health benefits, wellness and chronic disease management along with the correlation to benefit plan design. In the past, I've written a fair bit about the affects of benefit plan design, communication best practices, and employee engagement. My team knows that these three areas contribute to prevention awareness and help employees make more informed choices about their state of health and well-being. We also recognize that when workers are healthy and content, they are going to show up at work in ways that lead to greater focus, energy, and productivity on the job. This year's survey also highlighted an important concern relating to the link between benefit plans and the prevalence of chronic disease. When asked the question, plan sponsors estimated that only 26 percent of their workforce had a chronic disease whereas 56 percent of plan members reported living with a condition that fell into the chronic disease category. Perhaps it remains that plan sponsors don't feel that they are able to move the needle enough to positively affecting health outcomes for their workforce. Working with a trusted advisor can help these plan sponsors move out of this mindset and enable greater health and productivity through the implementation of a more strategic approach that isn't seen in the traditional light. Having a group benefits plan is more than the cost of doing business in order to remain competitive. It is an important way of offering preventative resources and support for employees to manage their state of health. Understanding claims utilization patterns such as paramedical services can prove beneficial. The survey reported that 47 percent of plan members submitted a total of 7.3 paramedical claims on average. This statistic falls close behind prescription medications at 9.5 claims on average. When it comes to paramedical services covered under the plan, the survey also suggests that there might be value in considering the need for eligibility based on clinical criteria versus self-perceived needs of the plan member. The more we are able to collaborate with insurance providers to appropriately mine the plan data, the greater our ability to help the plan sponsor develop a benefits strategy that will meet their needs 3 to 5 years out, thereby increasing their confidence about the plan's value. We believe that this collaboration is essential to our success and we have an impressive track record of working with the various insurance providers. We know that there is more work to be done to develop greater support for employee health and wellness and we're ready to roll up our sleeves and begin this strategic journey. Please contact us to begin a conversation. We're here to help so that you can focus on what you do best.  It is estimated that 500,000 Canadians use marijuana for medical purposes and with the passing of the new Medical Marihuana Access Regulations, those who require it for medical purposes need only secure a doctor's prescription. They no longer need a licence from Health Canada.
An employee doesn't have the right to use medical marijuana wherever and whenever he or she wishes in the workplace. Both the employee and employer have specific obligations. Medical marijuana has the same principles of accommodation as other attending physician prescribed drugs. If any employee uses medical marijuana to address symptoms relating to a chronic disease or other medical condition, the employer has a duty to accommodate. Section 5.1 of the Ontario Human Rights Code mandates that an individual has the right to equal treatment with respect to their employment without discrimination on the grounds of "disability". This duty to accommodate applies to the point of undue hardship for the employer. The test for undue hardship considers three factors: 1) the cost of accommodation; 2) whether or not there is any outside funding to help subsidize the costs of accommodation and; 3) are there any health and safety concerns the accommodation may pose. Ontario's Occupational Health and Safety Act (OHSA) is another governing body that has placed requirements for employers relating to medical marijuana in the workplace. The employer needs to "take every precaution reasonable in the circumstances for the protection of a worker." Therefore, employees don't have the right to be 'impaired' in the workplace and where their 'impairment' might endanger their safety or the safety of other workers. The main issue for employers involves the consideration that even though an employee has a prescription for marijuana, they don't immediately have the right to use it where cigarettes are allowed. This points back to the potential risk to the safety of other workers. While medical grade marijuana is seen to be a pain reliever and doesn't get individuals high, there are some reports indicating that people react in different ways. If an employee comes forward with a script from a doctor indicating that he or she has been prescribed medical marijuana, the employer should ask the employee for documentation that addresses his or her ability to safely carry out assigned duties. Employees in safety-sensitive positions need to let their employer know if they are going to be using medical marijuana (e.g. drivers). Employers should create workplace policies to address the use of prescription medication in the workplace including the use of medical marijuana - particularly if there is a known side effect from taking the prescription. This documentation should clearly communicate the employee's entitlement and obligations when using it so that the employee understands when they fall under the scope of the policy, when the need to report the use of medical marijuana, and what the consequences are if they breach the protocol on reporting or using it. Along with seeking legal advice, employers will benefit from consulting with their workplace health and safety committee when developing their policy. The policy should include the obligations for both employee and employer regarding accommodation as well as circumstances when drug testing may be appropriate. Safety sensitivity is important in the workplace regardless of the type of prescription drug taken. For more information on this topic and considerations for the employer, please contact us. We're here to help so that you can focus on what you do best.  The World Health Organization reported that chronic disease is expected to account for 89% of all deaths in Canada. The Centers for Disease Control and Prevention indicate that there are more than 133 million Americans living with at least one chronic disease.
Whether you live north or south of the border, the statistics are staggering. Chronic conditions are becoming increasingly commonplace. The Almanac of Chronic Disease reported that at least 80% of the U.S. workforce lives with a chronic illness. The challenge for employers is to establish and maintain ways to keep employees healthy and engaged. Living and working with a chronic disease means additional challenges for the employee and for the employer. Once it is determined that the individual can continue to be a productive employee, one of the next considerations for an employer involves accommodation. Some chronic conditions are unpredictable with frequent flare ups and invisible symptoms. Working with Human Resources, the employee's leader and attending physician, workplace accommodation can help ensure the individual is able to stay on the job and continue to be a valuable, contributing employee. Information about the employee's condition and duty to accommodate must remain strictly confidential. On a need to know basis and where there could be health and safety issues, the chronically ill employee should ensure that his leader and colleagues know enough to respond quickly and accurately if an emergency occurs (e.g. seizure). Increasingly, there is greater workplace flexibility and work from home arrangements for many employees. This environment creates a more flexibility for those living and working with chronic disease. Key steps for an employee who has been diagnosed with a chronic disease to consider include -
Employers can help employees living and working with a chronic disease by being open, having clear policies to facilitate accommodation and foremost, but offering wellness programs that centre on illness and disease prevention. Many employers don't have a fulsome picture of productivity loss due to absenteeism and disability costs. Measuring downtime on human capital hasn't been easy to figure out or track. To find out more about ways to develop wellness and prevention programs as well as track direct and indirect costs due to productivity loss, contact us. We're here to help so that you can focus on what you do best. |
Dave Dickinson, B.Comm, CFP, CLU, CHFC
Experienced Benefits Specialist ready to optimize your group benefits and pension plans.
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