“The employment setting remainsan undervalued investment opportunity for employee healthimprovement.,” says one expert. (Photo: Shutterstock)

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The role of employers in helping employees find the bestevidence-based medical treatments is thesubject of a new report released last week by the Center forWorkforce Health and Performance (CWHP). Evidence-based research isone of the pillars of medical practice in the United States, yetthere are many cases where consumers get incorrect or incomplete information.

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The new report, “The Employers Role in Using Research-Based HealthCare Evidence” finds that although employers are often left outof the discussion of how to make research more relevant to clinicalpractice, they can help improve the use of evidence-based care.

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“There's little doubt about the value of research-based evidencein making health and health care decisions. Yet passage fromresearch setting to provider's office, let alone to the employmentsetting, is typically neither timely nor guaranteed,” said CWHPpresident and CEO Kimberly Jinnett, MSPH, PhD, who co-authored thestudy. “The employment setting remains an undervalued investmentopportunity for employee health improvement. Given employers'relationships with health plans, providers, and employees, they canplay a significant role in making this process more effective.”

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Related: Health care data analytics: true meaning,actionability and value

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The authors identify a number of issues and barriers thataffect the ability of evidence-based research to inform health careof employees on company-sponsored plans:

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1. Claims and cost. the report suggeststhat many employer-based plans pay much more attention to cost andclaims data than to medical literature. For example, costs fordepression treatment are often not a top expense when looking onlyat claims data, but when lost work time and other issues are considered,its impact is much more pronounced. Likewise, a specific drug mightbe the most effective in treating a disease, but it may not beincluded in a plan's formulary. These situations, where short-termdata outweighs medical literature, may be harmful to the company inthe long run.

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The cost vs. data conflict can cause tensions between healthinsurance carriers and employers, the study notes. Although largeremployers with in-house clinics do better on integratingclinical data into their plans, there still can be resistance onthe part of insurance carriers to new treatments, even if the datashow them to be effective. The study suggests that employers usemore complete health analysis of their employees, including healthrisk assessments, which can point out gaps in care. Better data onthe population will lead to better use evidence-based medicine, thereport said.

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2. Employee and provider buy-in. Some ofthe problem may be at point-of care, the study notes. To addressthis, incentives can be written into contracts with providers toregarding use of research-based evidence in care. Employers andcarriers can work together to provide trusted resources ofinformation to employees. The study also singles out high-deductible health plans as problematic.“High-deductible health plans are often just risk/cost shifting toemployees with the likelihood that employees will become lesscompliant with evidence-based care,” said one of the researchers inthe study. “It also assumes that an employee can take a totallyrational and long-term approach to their own investments in health,which they don't or can't.”

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3. Support for employees. Several of thosequoted in the study emphasized the need to support employees inseeking the best evidence-based care. If drugs or treatment aredenied by a provider, some employers intervene directly. Educatingemployees about the best care for their conditions can help themspot problems or barriers in their own care plans. And providingonsite clinics and wellness programs can also improve the use ofevidence-based medicine, the study found.

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The report suggests employers take a more holistic view ofhealth care, along with finding resources and partners to helpcompanies work toward the goal of more-informed health care. “Inpartnership, employers, their solutions partners, evaluators, andthe larger research community can better fit solutions to problemsby taking a broader perspective,” the study recommends. “Thisshould result in better evidence and better use of thatevidence.”

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