Computer coding Even inexceptional circumstances, past behavior is always a dependableindicator of future behavior. (Image: Shutterstock)

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After months of grappling with COVID-19, most businessesrecognize that the pandemic is not a one-and-done phenomenon.They're focused on employees' health and safety while wondering:What will tomorrow's economic and business landscapes looklike?

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Significant change is all but guaranteed; "0,0" on theproverbial cartesian frame is shifting as the world adapts. Withfew precedents for this unusual situation, employers have toredefine what "normal" means for their workforces movingforward.

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Related: Return to work: Mitigating the risk of COVID-19 inthe workplace

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Despite the uncertainty, data and analytics remain a familiarand reliable ally. Even in exceptional circumstances, past behavioris always a dependable indicator of future behavior. The same datathat offered benefits insights before COVID-19 can do so now—itjust needs to be viewed through a different lens.

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Since emerging data is so crucial to decision-making, benefitsbrokers and employers may find that a phased analytics approachprovides the most advantages:

  • Immediate phase—quantify population vulnerabilities forstrategic planning and resource management.
  • Short-term phase—reevaluate the current benefit year, trackwellness and begin cost modeling for 2021.
  • New normal phase—accelerate health and wellness and invest inprevention and contingency planning.

Immediate phase analysis: Evaluate "back to work" risk

It's a complicated time right now. Many U.S. businesses feelthey've already weathered the immediate COVID-19 crisis. Yet thereare significant risks transitioning back to work and balancingemployee health and safety against difficult economic pressures.Re-opening operations too soon could create greater long-termfinancial consequences if spikes in illness force secondaryshutdowns.

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That is why it's still crucial for businesses to analyze theiremployees' geographic distribution and correlating COVID-19infection rates. Data from current epicenters remains valuable.However, data that reveals emerging hot spots and trends alsoshould drive policy decisions—including rates of asymptomaticinfection, and the capacity to provide testing, personal protectiveequipment (PPE) and other resources to ensure people's safety.

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Locations where significant infection rates are eithernon-existent or declining would be candidates for the earliestre-openings. Businesses also can assess employee health risk asdefined by the Centers for Disease Control and Prevention (CDC)versus job type, business function or critical/non-criticalclassifications. Employees at least risk—e.g. people under 60 withno chronic conditions who sheltered-in-place or quarantined—couldbe prioritized for return. Some companies, in fact, may allowleast-risk employees to volunteer for early return to onsitejobs.

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Businesses should account for the resources and time needed forrequired screening procedures before employees' start dates. Askinga few other questions may also help manage back-to-workstrategies:

  • Is your business likely to experience pent-up demand forproducts and services and/or a peak season that drives the need forunusually high activity? If so, how do these areas of increase mapagainst your areas of medical, financial and personnel risk?
  • Have any segments of the business experienced steady orincreased productivity while working remotely? Consider bringingthose employees back onsite later.

Short-term phase analysis: Model costs

It's a gross understatement to say that predicting direct andindirect health care costs related to COVID-19 has challengedbusinesses. How much will coronavirus testing and treatmentultimately cost? How will the pandemic alter the bottom line?

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It's possible to model cost and/or productivity changesassociated with COVID-19 using robust, well-documented impact planning models that are flexible enoughto evolve with the ever-changing data.

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For example, look at historical data for conditions withbiological similarities to COVID-19 (i.e. other upper respiratoryviruses that spread in similar ways, such as influenza.) Models arewidely available that use community attack, hospitalization andfatality rates for the flu, and apply correction factors forCOVID-19 based on CDC, World Health Organization (WHO) and otherguidelines. Such predictive models can help quantify the:

  • Number of employees who could be infected with COVID-19
  • Projected number of employee hospitalizations
  • Potential requirements for intensive care services

Using historical costs incurred due to flu and otherrespiratory-related hospitalizations, we can project potentialhospitalization costs due to COVID-19. Adjusting for over- orunder-reporting and taking disease mitigation policies into accountcould provide a projected cost range. Likewise, this data can belayered with other inputs to reveal repercussions on benefitutilization such as absenteeism, short-term disability and lifeinsurance payments.

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The direct cost of infection (i.e. testing and treatment) isonly one aspect of the overall cost burden. Closer scrutiny ofbroader health care policies could provide a more complete view ofchange moving forward. One example: telehealth—or virtual doctors'visits.

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As we know, most physicians have switched to video visits toensure care continuity for their patients, often with nocost-sharing. Virtual visits will likely remain popular long afterCOVID-19, even with the expected reinstatement of cost-sharing. So,businesses may want to explore the potential health andproductivity benefits of telehealth screenings.

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Reducing infection rates is one idea behind such screenings.Employees worried they might have the flu or a stomach bug, forinstance, could use telehealth screenings to help decide whether togo to the office or work from home. Parents with young childrencould conveniently consult virtually with their pediatrician forsimple common ailments, to reduce exposure to other sickchildren.

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Despite little telehealth history, businesses can use data fromthe pandemic shutdown months to gauge telehealth adoption levels.Diagnosis and procedure code data helps identify the reasons peopleare using telehealth now. Modeling a 25-30% increase in telehealthadoption for the identified diagnoses and procedures when physicianoffices operate at full capacity, this helps inform futuredirection, evaluation of technology related investments, as well assavings if/when cost-sharing is reinstated.

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Businesses will need to balance projected costs against employeeproductivity and retention needs. To accommodate continuingdisruptions, it may be worth extending concessions made during thepandemic—e.g. continuing to offer additional childcare benefitswhile summer camps, daycares and schools remain closed or onaltered schedules.

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Studying workflows established during the COVID-19 shutdowns—andtheir impact on employee productivity and satisfaction—can guidefinancial policies. Flexible schedules and work-from-home optionsare an example. Although they might require some technologyinfrastructure investments, companies may choose to permanentlytransition parts of their workforce to remote work to cut down onfacility and overhead costs, as well as enhance employeeproductivity, satisfaction and retention.

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As the nation starts "going back to work," health careutilization rates that declined during the shutdowns will graduallyrise, impacting long-term costs. Data models can easily helpproject trends—such as preventive care, emergency care and electiveprocedures—to inform 2021 benefits strategies.

"New normal" phase analysis: Promote wellness

Moving forward, the best business investments will be directinvestments in human capital aka employees. Since health is aproduct of physical, mental and emotional wellness, a targetedfocus on mental and behavioral health benefits should be consideredin addition to preventive and wellness programs. Integratingmedical and supplemental mental/behavioral health benefits, e.g.employee assistance programs (EAPs), can ensure continuity of care,leading to better health and lower costs over the long haul.

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One indicator of COVID-19's effect on people has been askyrocketing number of antidepressant and anti-anxiety prescriptions.Some experts have even dubbed this "thesecond pandemic of 2020." When the COVID-19 crisis abates,mental health conditions won't just ebb away. It's imperative forbusinesses to address employee mental health and productivity ifthey want to lower long-term costs.

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Before the COVID-19 crisis, one national retail business usedmedical claims data to analyze the prevalence and impact of mentalhealth conditions on the company and its employees. It found thatmore than 12% of its workforce had a mental health or substanceabuse-related diagnosis. These diagnoses were becoming more common,and over three years led to a 7.7% per member per month (PMPM)cost increase. The company also identifiedcorrelations between mental health-related claims and employee sickdays, performance metrics and staff turnover. Despite richpsychotherapy benefits, awareness and utilization were low.Consequently, the employer improved communication around its mentalhealth benefits to enhance plan engagement and promote a stigmafree culture.

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This example illustrates that mental health benefit utilizationis commonly low because employees may lack awareness of theirexistence. Hence, frequent communication is key. Businesses withEAPs could work with their vendors to engage all employeesproactively, acknowledge the strain of COVID-19 on the individualand families, and extend mental health support if needed.

To balance the bottom line, focus on employee health

COVID-19 is not a one-time event. The infectious nature of thedisease will require ongoing data analysis to ensure agile staffingand benefits models. Businesses should be prepared for repeatedadaptation.

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Just because COVID-19 appeared quickly does not mean change hasto occur overnight. Data and analytics can support gradual policyand benefits adaptations. By taking a people-centric anddata-driven approach, businesses can ensure employee productivityand engagement remain high—which, over time, can bring betterresults to the bottom line.

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Rani Aravamudhan is senior clinicalconsultant at HDMS. She is a physician (specialty- GeneralMedicine) with extensive experience in the EMR/EHR and populationhealth industries with a focus on clinical transformation, workflowdesign and development, value-based care, risk management andclinical quality and performance reporting. Her strong backgroundin clinical medicine and experience in the HIT industry make hersuccessful in navigating payer, provider and technology vendorlandscapes.


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