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Valuing health benefits

Monday June 08, 2015 Written by  Sanofi
Three-quarters of organizations offering heath benefits want more information to better understand how their plan affects employee health outcomes, productivity and absenteeism.

According to this year’s edition of the Sanofi Canada Healthcare Survey, another 72 per cent of employers want better reporting/evaluation of the return on investment (ROI) of their health and wellness programs, while 68 per cent want a better understanding of connections between claims and utilization of programs, and 62 per cent want to better understand their claims data.

“It’s encouraging that plan sponsors are looking for more information in these areas. It tells us there could be an appetite to do more, which we really haven’t seen before,” said Marilee Mark, vice-president of market development at Sun Life Financial and a member of the advisory board for the 2015 Sanofi Canada Healthcare Survey.

"Through the Sanofi Canada Healthcare Survey, we are happy to help the industry make important connections between health benefits, wellness and chronic disease management," said Jon Fairest, president and CEO of Sanofi Canada. "It is necessary to make these links so they can offer effective and sustainable programs. The benefits of good health go beyond reducing costs. We know that healthy, happy individuals are more satisfied in their personal lives and more productive in the workplace. It just makes good business sense."

Establishing the link with chronic disease

The survey reveals that plan sponsors and plan members are not making the link regarding their plans and the prevalence of chronic disease in the workplace. While plan sponsors estimate that about one-quarter of their workforce (26 per cent, on average) has a chronic condition, more than half of all plan members (56 per cent) indicate they have such a condition. The gap between perception and reality raises questions about the ability of traditional plan designs to support best health outcomes—as well as a meaningful return on investment for employers.

"Employers underestimate the prevalence of chronic disease in their workplaces and they underestimate the positive impact they can have on employee health," said David Willows, advisory board member and vice-president for strategic market solutions at Green Shield Canada.

"Right now there is clearly a disconnect between traditional plans and what will be required in the workplace due to chronic disease. Plan designs require more strategy along the lines of health and productivity," added board member Nathalie Laporte, vice-president of product development and marketing with group and business insurance at Desjardins.

Encouraging wellness in the workplace

On the wellness front, 45 per cent of employers report offering programs or support for health and fitness, such as weight-loss programs, fitness challenges. This finding that has not changed much since it was first explored in 2012.

Among employees who say they have access to such programs, 34 per cent say they definitely (11 per cent) or somewhat regularly (23 per cent) participate. Unfortunately, participation is even lower among employees who describe themselves as being in poor or very poor health (30 per cent), and 39 per cent do not participate at all.

Clearly wellness offerings, as with health benefits, need to be considered in a new light in order to encourage use by those who need it most.

Making the connection

Most plan sponsors regard benefit plans as a form of compensation or reward (39 per cent), or as a cost of doing business to be competitive (26 per cent). Almost one-third (31 per cent) indicate they make the connection between healthy employees and healthy businesses—which is the right approach, according to members of this year’s advisory board.

"Managing health becomes as important as managing turnover, competitive compensation, etc.," said Serafina Morgia, senior consultant at Towers Watson. "We can reshape how to use benefits dollars more effectively, for example, so that dollars can be put toward health risk screenings."

Such non-traditional benefits as screenings or one-on-one wellness coaching are also good for business because "they reduce the risk of much higher benefit costs down the road through the early detection of chronic diseases and risk factors," said Dr. Alain Sotto, occupational medical consultant at Toronto Transit Commission (TTC) and director of Medcan Wellness Clinic.

Assessing paramedical services

The survey shows that almost half of plan members (47 per cent) submitted at least one claim for paramedical services in the past year, and those that did submitted a total of 7.3 claims on average — a frequency second only to prescription medications (9.5).

While paramedical services can help make the connection between health and productivity for those suffering from injury or chronic pain, their level of use may suggest the need for eligibility based on clinical criteria rather than self-perceived needs.

"When you consider the disability issues in some workplaces and the issues around specialty pharmaceuticals, which can be life-changing for plan members, the cost and use of some paramedicals just don't seem to make sense," said Paula Allen, vice-president of research and integrative solutions at Morneau Shepell.

Collaboration and information sharing between insurance carriers, benefits advisors and other stakeholders are vital to such an evolution in health benefits and wellness offerings.

"We can see a desired shift toward supporting employees more on health and wellness, but until the components are better defined it's hard to move beyond the focus of traditional plan design. We need to identify the obstacles before we can overcome them, and what feeds into this is deeper data analytics," said Ben Harrison, director of group strategic relationships at Great-West Life.

Other key findings from this year’s survey include:

  • Three-quarters of plan members (77 per cent) say they would not move to a job that did not include health benefits.
  • Drug (94 per cent), dental (basic 92 per cent; major 83 per cent) and vision care (89 per cent) remain the most valued components of health benefit plans according to plan members.
  • When offered a list of seven possible new health benefits, plan members were most likely to select onsite health risk screenings (45 per cent), followed by onsite immunizations for infectious diseases (40 per cent).
  • Eighty-five per cent of plan members say they have one or more health or fitness goals, and one in five (21 per cent) reports that their workplace is a barrier to reaching those goals.
  • Less than half of all plan members (47 per cent) indicate they will definitely or most likely purchase private health benefits when they retire.

The online survey was conducted between Jan. 5 and 8. In total, a national sample of 1,504 primary holders of group health benefit plans completed the study. The data has been statistically weighted to ensure the age, gender and regional composition of the sample reflect those of the adult population according to the 2011 Census data. This survey was coupled with another online survey of 504 health benefit plan sponsors from across the country to bring employers perspective on the issues at hand.

The study was sponsored by Sanofi Canada, and received additional support from Desjardins Insurance, Manulife Financial, Medavie Blue Cross, Great-West Life Assurance, Green Shield Canada, and Sun Life Financial.

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