Keenan & Associates
Effectively Merging Health and Absence Management
Historically, absence management outsourcing has been associated with disability management, since the majority of leaves are usually the result of an employee’s own serious health condition that may qualify for disability. From an employee perspective, it makes sense that there is a single point of contact for both income replacement benefits and job protection. However, it would be even better if all the health management services such as the health plan, EAP, wellness and disease management were also coordinated for the employee to reduce the overall incidence and duration of absence.
Achieving this goal requires better integration between absence management and health management vendors. Absence management can identify that an issue exists early on, usually after three days. But a disease management (DM) study revealed that, on average, DM vendors are not notified for 105 days. Having absence management assume coordination of leave, disability and health creates a comprehensive program that not only assures consistent leave compliance, but also streamlines the coordination of all benefits for the employee, reduces unnecessary health plan costs caused by inappropriate self-referrals, and engages the employee in all available health management services on day four. Sharing health and absence data also supports the development of interventions to reduce absenteeism and presenteeism.
Several obstacles exist that prevent many vendors from fully engaging shared responsibilities. Those obstacles include the discrepancy between the eligibility for leave and the eligibility for short-term disability, privacy laws and consumer skepticism that prevents the sharing of information, and the ability to prove a return on investment.
Most disabilities are leaves, but not all leaves are qualified disability claims. On average, disability waiting periods are seven days whereas Family and Medical Leave Act (FMLA) reporting is typically for absences greater than three days. In this situation again, the absence management vendor is best positioned to intervene early and coordinate all benefits for the employee.
According to the Center for Democracy & Technology:
“Consumers can only provide meaningful consent when they are fully informed about what information is being collected, under what circumstances it will be shared, and how it will be protected, as established in the other necessary information policies...”
Beyond Consumer Consent: Why We Need a Comprehensive Approach to Privacy in a Networked World; Connecting for Health Policy Brief; February, 2008
How do we convince employees that providing more information will be advantageous for them? The absence management vendor is the entry point to an employee advocacy-driven process. Acting as an employee advocate by guiding the employee through all aspects of a leave, the absence management vendor helps the employee understand what information needs to be collected, shared and protected.
Employees expect a process that is easy to access and recognizes their needs. By taking a holistic approach and supporting the 2006 Work Disability Prevention Guideline from the American College of Occupational and Environmental Medicine, vendors can significantly raise their service levels and improve outcomes. In the Introduction to ACOEM’s guideline, Dr. Jennifer Christian wrote:
“Employers, unions, and insurance carriers should devote more attention and resources to preventing disability by focusing on the “front end” of disability episodes while the window of opportunity to make the most difference is still open. In practice, this means ensuring that the right things happen during the first few days and weeks of work absence. Injured/ill workers should routinely receive the support and services they need to get their daily lives back to normal as soon as possible. “
Meanwhile, employers are looking for defensible outcomes in three broad areas:
Cost Savings – Does the activity being paid for actually save more money than the previous activity (or no activity)?
Customer Service – Will the employee experience be seen as fair and empathetic to their individual needs?
Best Practices – Are organizations doing what they can to improve future outcomes for both the individual and the employer?
The critical measure of cost savings is directly impacted by the adoption of the health management tool. Working together, vendors can dramatically increase the number of employees with knowledge and access to these programs. This increase can be measured as well as the recidivism within a given period and by leave reason.
Rather than relying on employers to coerce vendors into working together, ask your health and absence vendors should be asked to recognize their shared interests in reducing absenteeism and presenteeism. Working together, they can satisfy all three employer needs, while improving the overall experience for the employee.
Historically, absence management outsourcing has been associated with disability management, since the majority of leaves are usually the result of an employee’s own serious health condition that may qualify for disability. From an employee perspective, it makes sense that there is a single point of contact for both income replacement benefits and job protection. However, it would be even better if all the health management services such as the health plan, EAP, wellness and disease management were also coordinated for the employee to reduce the overall incidence and duration of absence.
Achieving this goal requires better integration between absence management and health management vendors. Absence management can identify that an issue exists early on, usually after three days. But a disease management (DM) study revealed that, on average, DM vendors are not notified for 105 days. Having absence management assume coordination of leave, disability and health creates a comprehensive program that not only assures consistent leave compliance, but also streamlines the coordination of all benefits for the employee, reduces unnecessary health plan costs caused by inappropriate self-referrals, and engages the employee in all available health management services on day four. Sharing health and absence data also supports the development of interventions to reduce absenteeism and presenteeism.
Several obstacles exist that prevent many vendors from fully engaging shared responsibilities. Those obstacles include the discrepancy between the eligibility for leave and the eligibility for short-term disability, privacy laws and consumer skepticism that prevents the sharing of information, and the ability to prove a return on investment.
Most disabilities are leaves, but not all leaves are qualified disability claims. On average, disability waiting periods are seven days whereas Family and Medical Leave Act (FMLA) reporting is typically for absences greater than three days. In this situation again, the absence management vendor is best positioned to intervene early and coordinate all benefits for the employee.
According to the Center for Democracy & Technology:
“Consumers can only provide meaningful consent when they are fully informed about what information is being collected, under what circumstances it will be shared, and how it will be protected, as established in the other necessary information policies...”
Beyond Consumer Consent: Why We Need a Comprehensive Approach to Privacy in a Networked World; Connecting for Health Policy Brief; February, 2008
How do we convince employees that providing more information will be advantageous for them? The absence management vendor is the entry point to an employee advocacy-driven process. Acting as an employee advocate by guiding the employee through all aspects of a leave, the absence management vendor helps the employee understand what information needs to be collected, shared and protected.
Employees expect a process that is easy to access and recognizes their needs. By taking a holistic approach and supporting the 2006 Work Disability Prevention Guideline from the American College of Occupational and Environmental Medicine, vendors can significantly raise their service levels and improve outcomes. In the Introduction to ACOEM’s guideline, Dr. Jennifer Christian wrote:
“Employers, unions, and insurance carriers should devote more attention and resources to preventing disability by focusing on the “front end” of disability episodes while the window of opportunity to make the most difference is still open. In practice, this means ensuring that the right things happen during the first few days and weeks of work absence. Injured/ill workers should routinely receive the support and services they need to get their daily lives back to normal as soon as possible. “
Meanwhile, employers are looking for defensible outcomes in three broad areas:
Cost Savings – Does the activity being paid for actually save more money than the previous activity (or no activity)?
Customer Service – Will the employee experience be seen as fair and empathetic to their individual needs?
Best Practices – Are organizations doing what they can to improve future outcomes for both the individual and the employer?
The critical measure of cost savings is directly impacted by the adoption of the health management tool. Working together, vendors can dramatically increase the number of employees with knowledge and access to these programs. This increase can be measured as well as the recidivism within a given period and by leave reason.
Rather than relying on employers to coerce vendors into working together, ask your health and absence vendors should be asked to recognize their shared interests in reducing absenteeism and presenteeism. Working together, they can satisfy all three employer needs, while improving the overall experience for the employee.
