Scott MacStravic, Ph.D.
Managing employee health is probably the major alternative to shifting healthcare costs to employees and dealing with workers as costs rather than assets. EHM includes promoting health, reducing disease/injury risks and managing existing chronic conditions among employees, and often dependents as well. It aims to improve worker productivity, quality, customer satisfaction, and thereby overall performance of both individual workers and the organization as a whole.
It combines cost savings related to sickness care expense/insurance, disability and workers compensation expense, absenteeism and presenteeism-related loss of productivity. It can include any measurable impacts on recruitment and retention, and other labor costs, as well as the impact that healthy and engaged workers have on customer retention, sales, market success and revenue. The combination of cost reductions and revenue increases represents the ROI achievable through EHM.
One of the major challenges in EHM is the fact that improving employee health, reducing risks and managing diseases depends primarily on the levels of collaboration achieved among workers. Providers, vendors, coaches and others may help, but they add to the costs of EHM. And ultimately, it is the employee and family members whose behaviors have to be changed and maintained for the full benefits of EHM to be achieved.
Unlike direct productivity, quality and similar performance enhancement efforts unrelated to employee health, EHM success depends first on what employees do away from work. It is their home life, their daily habits, particularly relative to physical activity, diet, weight and stress management, as well as unhealthy habits such as smoking and substance abuse that make the most difference. Some inroads may be achieved at work, via sponsored fitness activities, healthy cafeteria foods, etc. but most improvements depend on the rest of workers’ time and activities.
Fortunately, the major obstacles to many EHM efforts by employees are usually time and work/life balance issues. And the more effective management of time is directly related to worker productivity, in addition to its indirect impact through health improvement efforts. Thus investments in improving worker time management can have a double effect, with synergies impacting productivity both directly and indirectly.
An ideal system to meet this dual, synergistic challenge would teach and train employees to organize the tasks and challenges they face, provide the information and reminders that will help them accomplish both, and keep focus on personal as well as work-related purposes, visions, goals, areas of focus, projects and actions. The skills and confidence that employees gain in either work or personal application of these skills can then aid in application to the other.
The determinants of EHM success are simple – 1) achieve sufficient direct (e.g. sickness care, disability and WC) cost reductions and indirect (absenteeism and presenteeism, quality, customer satisfaction, sales and revenue) effects to generate the “top line” or numerator; and 2) keep the costs of achieving these gains low enough to ensure an acceptable, even admirable financial ROI. The synergies involved in empowering employees to manage their time and efforts more efficiently and effectively will aid in both requirements.
There is yet another synergy possible. Since improving worker productivity reduces labor costs, through both direct and indirect routes, it will enable HCOs to be able to afford to offer their employees incentives for achieving both worksite productivity and personal or group health effects. Such incentives will, in turn, add to the motivation that employees have to achieve the necessary self-efficacy in time and personal health management.
Hospitals and other healthcare organizations have plenty of reasons already to empower their employees to manage their own time and efforts better. Many have no doubt already found techniques for achieving efficacy among employees that work. By applying such techniques to both work and life challenges, particularly to EHM commitments they are willing and able to make, such efficacy-building techniques can combine direct and indirect cost savings and revenue enhancement efforts far in excess of applications at the worksite alone.
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