Advisors, actuaries and healthcare insurance underwriters get nervous. When? When they are unsure of the level of risk and future risk. For six to seven months in 2020, preventative and non-emergency healthcare, came to a slow roll as hospitals and healthcare providers dealt with the pandemic and patients found the thought of engaging in preventative care impossible, difficult or unappetizing during the height of restrictions. Some of the outcomes are just being felt now and folks who analyze the impact of these things are beginning to get an understanding where we are and where we go from here.
The Emergency Room: An Illustration
Across the nation, many emergency rooms are swamped with seriously ill patients – many of whom don’t have COVID. As this recent NPR piece related, “patients are showing up to the ER sicker than they were before the pandemic, their diseases more advanced and in need of more complicated care.” At the same time, many hospitals are facing nursing shortages, nurse educator shortages and burnout while trying to serve this new wave of patients.
We went through a major worldwide health event in 2020. Emergency rooms are swamped. Then how can it be that some self-funded healthcare plans saved money in 2020? Thankfully, most plans didn’t have widespread COVID cases. But what they also didn’t have was extensive preventative care claims or hospital visits, as many people, by choice or necessity, delayed or deferred preventative and non-life threatening care during the height of the pandemic.
The outcome, as Americans went through the stress of a pandemic and put off medical treatment in 2020, is that their underlying conditions often worsened or new emerging conditions are being discovered later than normal. And in many cases, their habits changed – a six month gap in preventative care may have stretched to twelve or even eighteen months. From the emergency room perspective, this situation has placed additional stress on top of an already stressful and multi-faceted problem.
What Can Employers Do?
There are some things we can and should be doing right now to stem this tide, get our people healthy and do our part in relieving some of the systemic stress. If you were doing well in benefits and healthcare communication before the pandemic, get back to that level or better. Pump up the content. Utilize webinars, lunch and learns, open enrollment materials or email campaigns. And offer participation incentives. A couple of examples: reward Talk to your Doc interactions or encourage employees to know their numbers. You can also offer outcome-based incentives. These could be measurements like employee health year-over-year or employee health versus age cohort. Make sure to work with your benefits advisor to maintain the compliance and quality of this type of employee engagement.
Telehealth is a Blessing
Encourage and incentivize Telehealth usage. It’s convenient, safe and efficient. And it can save money. Telehealth can keep employees out of the emergency room. An emergency room visit, even one that it turns out is not an emergency, can easily run north of $1,500. An urgent care visit might run about one third of that. A pharmacy minute clinic, a little less. And a telehealth visit is still less than that. A telehealth visit with the same outcome as that “non-emergency” emergency room visit might be under $100.
If you can educate and encourage employees to evaluate their medical needs before dashing off to the emergency room, that’s a great practical step to take. This is just a moment of mental check-in – “do I have all my fingers and toes, am I breathing, nothing is broken…”, not a self-diagnosis! If you still need to sell employees on the value of Telehealth, ask them how long it takes them to boot up a Zoom call. (Hopefully the answer is ‘under a minute.’)
Telehealth is convenient and easy and we did, in fact, see a significant uptick in its use during the past year. This silver lining of the pandemic reflects the new comfort level on the part of both consumers and providers. This was especially meaningful in mental health. Rural areas, which may not have had access to counselors and psychiatrists, can more easily access them now.
If you’re incentivizing the use of telehealth, double down on that. If you’re communicating health and well-being benefits to your employees, double down on that. If you’re not, now is a time to move. With action, employers can push back against the rise in acute care cases and re-establish good preventative habits that existed pre-pandemic.
Last word: Don’t Forget Mental Health
Mental health problems and chronic conditions can have a ‘which came first, the chicken or the egg’ relationship. The presence of one can greatly exacerbate the presence of another. Pre-pandemic, most employers were behind in addressing the importance of mental health and well-being among their employee populations. Another silver lining of the pandemic is that it snapped leaders into attention. The reality of the connection between productivity, presenteeism and other performance indicators and mental health was never as stark as it was last year. It has to be a priority moving forward.
I wish you well in helping your employees get back to better healthcare habits and establishing better health and business outcomes. I wake up each day excited to help employers like you create benefits and total rewards strategies that help your organization and people thrive. I’d love to help you! Feel free to reach out to me directly or on LinkedIn if you have any questions or would like to talk through the report in more detail. You can also drop us a line here or tweet at us!