Patrick D. Haughey, is associative vice president, Workers’ Compensation, for UPMC WorkPartners, which is part of the UPMC Insurance Services Division. The UPMC Insurance Services Division offers a full range of insurance programs and products and also includes: UPMC Health Plan, UPMC for Life, UPMC for You, UPMC for Kids, Community Care Behavioral Health, LifeSolutions, EBenefit Solutions, and Askesis Development Group.
The impact the Affordable Care Act (ACA) has had on employers continues to evolve, sometimes surprisingly. For example, it may prove that the ACA may well have its greatest impact in the area of workers’ compensation.
In fact, the ACA may prove to be the greatest incentive to integrate all forms of disability management that has ever existed. The ACA mandates that employer groups have to provide disability for employees and organizations that can manage total disability from beginning to end, and those will be ones that can deliver for employer groups in this era.
Long-Term Benefits
According to a 2013 survey on Absence and Disability Management by Mercer, the direct cost of incidental absence and disability benefits is the equivalent of 4.9 percent of payroll. Mercer estimates that indirect costs (such as replacement labor and lost productivity) are roughly the same, making the total impact of absences at about 8 percent of payroll.
Looking at problems in nontraditional ways is essential to integrated absence management. For instance, if someone injures a knee at work and requires extended leave, in many cases that is looked at as an issue for a company’s workers’ compensation program. That means increased focus on the rehabilitation of the knee and on getting the employee back to work.
What does not happen is much time considering what may have caused or exacerbated the injury. Is it a weight problem? Is there a chance the injury could recur if the weight problem is not addressed? Is the employee possibly at risk for other health-related issues? What about the indirect impact of the injury such as stress or depression?
This is a “whole person” approach that looks at all the care provided to an employee and then coordinates that care for the individual by integrating benefits and programs. Health risk factors have consequences and should be addressed proactively. An integrated, total health management approach provides employers with the best strategy to proactively manage its population.
One benefit for employer groups in using integrated absence management is that it can keep premiums from escalating. An integrated approach, which can include wellness programs (which are rewarded by the ACA) and things like bringing in loss-prevention specialists, can result in premium reductions.
An Integrated Approach
Here is a good example of how an integrated approach can work. An employee filed a FMLA (Family and Medical Leave Act) claim in order to have time to care for her mother. The leave specialist was able to refer her to an employee assistance program (EAP) to help her get daily care for her mother. In talking with the EAP counselor, the woman revealed that she was overwhelmed by the burdens of a job and additional family responsibility. The woman was then enrolled in a coaching program to help her learn how to better manage her time and stress. The net result was an employee who was able to return to work with limited distractions.
It’s important to align and integrate workers’ compensation, disability and leave. You also must be able to provide access to medical expertise throughout the life of a claim. Understanding the connections between programs and how each program can impact an employee at a time when assistance is needed most, is critical to a successful integrated absence management strategy.
For information about UPMC WorkPartners’ full suite of integrated absence management services, visit http://workpartners.com/products-services/absence-management/.
