NEWS & TRENDS

DISABILITY ON THE RISE

Across the board, employers are reporting increases in workers’ use of short- and long-term disability benefits, as well as family medical leave, according to a new report from Mercer Human Resource Consulting and Marsh Inc. One in three employers reports an increase in short-term disability incidence over the past two years, and one in five is seeing an increase in long-term disability utilization. Fewer than one in 10 report a decrease in each plan type. Additionally, nearly half of all employers report an increase in use of family medical leave, with only one percent reporting a decrease.

Why the big increases over the past two years? A rise in stress and health risk factors such as obesity are partially to blame. Asked which conditions increased in frequency or cost, 63 percent of employers pointed to stress/depression, 52 percent said cancer, and 49 percent cardiovascular conditions.

Other trends: Use of a third-party administrator or insurance carrier to integrate STD and LTD coverage has increased from 39 percent of employers in 2000 to 51 percent in 2003. Using a centralized reporting process for occupational and nonoccupational claims has risen 10 points to 42 percent. Consistent return-to-work programs are nearly twice as common at 62 percent vs. 32 percent in 2000 to 62 percent in 2003.

In related news, a Metlife report identifies the five chronic conditions responsible for the highest incidence of workplace disability claims. When combined, low back disorders, depression, heart disease, arthritis and pulmonary diseases account for almost 30 percent of all LTD claims for Metlife and cost employers over $500 billion in employee absences, reduced productivity and increased health care costs.

More employers are leaning towards mandatory mail-order fulfillment requirements to help lower drug spending, reports Managed Care Week. AdvancePCS’ mail-order pharmacy claims for the second quarter were up 10 percent from a year earlier. Caremark Rx, Inc’s mail-order pharmacy saw a 23 percent increase, and Express Scripts’ reported a 16 percent increase.

Common pain hits over half of U.S. workers and costs employers $61 billion in lost productive time, according to a recent AdvancePCS study. Three quarters of the lost productive time occurs at work, with one in eight employees losing five hours of productive time each week from such common conditions as headaches, back pain, arthritis and other muscle and joint issues.

DEPRESSION LEADING BARRIER TO WOMEN AT WORK

More so than pregnancy, sexual harassment or even childcare issues, the No. 1 obstacle to professional women in the workplace is depression. More than eight in 10 women with depression labeled the condition the main barrier to their success at work, according to a recent survey by the National Mental Health Association and the American Medical Women’s Association. Affecting nearly 5 million employed women each year, depression can result in women leaving work early, not returning from lunch, avoiding contact with coworkers and being unable to face work.

While depression is costly in terms of time missed from work, it can be even more expensive for employers when women who suffer symptoms do make it to their desks. One-third of women with continuing symptoms of depression say that the condition strongly interferes with their work and professional life. Specifics include being quiet and reserved, unmotivated to get things done, more prone to making mistakes due to lack of sleep, crying, not returning phone calls, difficulty making it into the office, and problems with coworkers. Besides job loss (three in 10 quit or lost their jobs due to symptoms), absenteeism for depressed women is twice as high as for women workers in general (10.6 days annually vs. 5).

Treatment, however, can produce true benefits. After seeking help for depression, 94 percent of the women noticed improvements at work, and 68 percent reestablished relationships with coworkers. Unfortunately, many women don’t know help is available. Among depressed women working for companies that offer Employee Assistance Programs — a likely source of treatment — more than one-third know little or nothing about the EAPs.

Patients 65 and older receive appropriate care for age-related diseases only 31 percent of the time, according to a recent RAND study. In terms of general medical conditions such as cardiovascular disease, seniors received the recommended care 52 percent of the time. But for common geriatric conditions such as malnutrition, dementia and urinary incontinence, seniors failed to receive recommended care roughly two-thirds of the time.

The Supreme Court will rule in two cases centering around patients having the right to sue their HMOs. Davila v. Aetna US Healthcare and Calad v. Cigna Healthcare of Texas both involve Texas patients who claim their HMOs ignored doctor-recommended treatment, causing further injury.

TO EVERY UNINSURED: CHURN, CHURN, CHURN

Almost 40 percent of working Americans under 65 were without health insurance at some point during 1996-1999, according to a new study by the Commonwealth Fund that tracks health coverage over time. Eighty-five million people under 65 were uninsured during the four-year period, more than double the number of uninsured at any one point in time and nearly double the 43.6 million estimated to be without coverage in 2002.

This longer-view study over a four-year period brings to light how unstable insurance puts millions more at risk then previously believed from annual studies. These higher numbers are due to millions of people cycling on and off coverage, otherwise known as "churning."

More than half (54 percent) of the uninsured in that period lacked health coverage for 13 months or more. That’s 45 million people without insurance for over a year. And nearly 35 percent (or 30 million) were uninsured for more than two years in total. Churning was a major contributor to the problem, as one in three uninsured had multiple spells without insurance as they gained and lost coverage over time.

The Joint Commission on Accreditation of Healthcare Organizations has developed a nationwide certification program to evaluate stroke care provided by hospitals. Stroke is the third leading cause of death in the U.S.; some 700,000 people experience new or recurring strokes each year. JCAHO’s program will assess compliance with consensus-based national standards, effective use of primary stroke center recommendations and clinical practice guidelines, and performance measurement and improvement activities.

The Washington Business Group on Health has officially changed its name to the National Business Group on Health. The new name for the organization with nearly 200 of the nation's largest private and public sector employers, underscores the organization's strong commitment to serve the business needs of companies nationally and globally.

News & Trends.

Business and Health

Dec. 10, 2003;21.