Completing the circle of organizational health, worker well-being and risk management with data integration

Using benefits data to drive better outcomes.

Transcription:

Alyssa Place (00:09):

Today we have Mari Kemp, CEO and founder of MK Global Consulting Partners, a training and consulting business, and Dr. Monty Maston, chief Medical Officer at Professional Services firm, marsh McLennan. And today We are going to be talking about organizational health, mental health, how that's all playing out in some claims data, what We are seeing and what employers and clients are doing about that. So why do not we just start with a little bit of an employer claims. What are some of the things that have really changed over the last couple years that seemed to be really kind of high touchpoint areas for employers at this moment?

Dr. Monty Maston (00:47):

Well, sure I can start and good afternoon everyone. We are certainly seeing the impact of behavioral health. I mean, when you think about it, this was really a challenge for employer groups going back several years, substance use disorder, anxiety, depression and then covid exacerbated that manyfold. And it is still going to be the challenge even as Covid exit stage left. So we have certainly seen the prevalence of behavioral health conditions go up. we have seen the costs go up as well.

Alyssa Place (01:14):

And what about you

Mari Kemp (01:15):

Definitely have to agree from an employer perspective when we do in our benefit renewals, this is the first time we have seen mental health just really take off even from the level of prescription drugs being used as well as claims. And so it really calls as a underlying state of emergency is, if you will, for employers to start being a lot more proactive in doing what they can to help people out and empower them to do more. So I can agree a hundred percent We are seeing the same thing as well. And I love the fact that We are here though, because it is like he is got the inside information and I am like, yeah, from an employer perspective. So I like the balance of this conversation very much.

Alyssa Place (01:53):

And when you are talking to employers, are they obviously the data and the claims will show certain things, but in terms of their head space about it, are they really aware of this uptick and how the crisis mode that you are talking about at this point,

Mari Kemp (02:09):

It is almost like the silent killer of an organization because when people go out on F M L A or for whatever reason, you truly cannot disclose the why. And so you are just starting seeing people fall out and all of a sudden can not show up to work or they are taken off the next few weeks. There is really not a conversation about it. So similar to the prior conversation that just occurred, are our employers aware? No. And similar to how the workforce has changed, no, there is a lack of huge lack of awareness, and that is where the beauty and the power of having a strong HR team to consistently manage the data and monitor the change so that you can be proactive about what you do for your organization.

Dr. Monty Maston (02:53):

We did a really cool analysis using data for a client out west. So they have about 20,000 employees. And we were told by the HR team that they were just getting killed with short-term disability claims around mental health. And so what we did is we looked at the data and we identified actually that the majority of the short-term disability claims for mental health were coming from call center employees, 20 to 30 year old females with less than one year tenure on the job. And so what we did with the HR team is say, look, when you hire people into this call center from day one, you need to let them know what is available around behavioral health, what does the medical carrier bring, what is out there in the community what is available through the EAP program? And so that is just an example of employer probably telling us there's a problem and then using data to back that up.

Alyssa Place (03:46):

And I mean, obviously money talks. So what are employers saying when they see these huge amount of claims? I mean, is there this sort of anxiety of we have to play catch up or?

Dr. Monty Maston (03:59):

Well, I think when you look at behavioral health, I mean typically it is a lower cost area for employers. it is usually around three to 5% of their overall spend because so much of it is been rendered on an outpatient, outpatient basis. But what you are seeing in the last few years is the per member per month costs are escalating because you are seeing a lot more utilization in rehab rehabilitative services for substance use disorder, for eating disorders and so forth. And that gets very expensive, very fast for employers because a lot of it is outta network outta state. No one goes into rehab for three days, they are there for three weeks. And there's a lot of ancillary cost to that too. So I think they are starting to see the cost go up. And the last point I'll make on this is that mental health cuts into so many other areas.

(04:48)

We talk about high cost claimants and people with cancer and diabetes and rightfully, but think about the impact of behavioral health on those individuals. If you are a diabetic and you are depressed and you do not take your insulin for three or four days, you can end up in the emergency with a life-threatening condition. And if you have got chronic back issues and you are on narcotics, if you can actually take some steps as an employer to put in place a program and have people feel better about their outlook, then maybe they come down off some of those narcotics, you can present a accidental overdose.

Alyssa Place (05:20):

And are those some of the connections that you are making taking this mental health and connecting it to some of these other benefits that would come down the line in terms of the cost?

Mari Kemp (05:29):

There are definitely untapped areas in the past, and I think the benefit of this happening during a time when remote working is now the new way of working for most organizations, the mentality is the shift of, okay, since We are not spending so much on travel, We are not spending so much on real estate. How about let's put more money towards things that really matter. And so when it comes to benefits renewals, it is important that you are asking your broker to give you the breakdown of just where did things go so that you can properly plan in real time with the shifts of your organization.

Dr. Monty Maston (06:06):

It is interesting that you bring up the point about remote workforce, and we have had so many clients that either temporarily or permanently have moved to a remote hybrid workforce, and you are seen in the claims, the substance use disorder claims go up, the prevalence of people with narcotic issues, with alcohol dependence and so forth. And the thought is what is really going on there. And I think part of it is tied into the social isolation. I mean, think about it, if you are onsite and you are going out for happy hour but your boss is there, you may not have more than one drink, but if you are working at home and you have an alcohol dependence problem, you may drink a six pack and then end up in problems. So I think We are seeing some of the impact of the social isolation due to covid in behavioral health, certainly.

Mari Kemp (06:53):

Absolutely. Absolutely. And you have to think about the workforce is just now becoming more humanistic in that people have feelings, they have emotions, they have wants, they have needs. And just as was stated before about the Maslow hierarchy of needs, we have psychologically and emotionally gone through so much in the last two to three years. There is situations where I know mothers were sitting at the table and they have their five or six kids in homeschool at the same time where they are taking a conference call, where is that moment to take a break? And you are still at home all day long. So there has to be a human effort. The purpose of the workforce is to make better people as well. And so you have to answer that and deal with the fact that there is going to be a period of time where you have to really focus on balance, emotional and mental health.

Dr. Monty Maston (07:45):

I would say that you can't just have the focus on the employees. I mean, one of the troubling things that We are seeing in the claims actually is that third for a given employer, usually 30 to 40% of their behavioral health claims are coming from the dependence 26. And we all know what is going on with the kids, the suicide rates for teenagers through the roof and so forth. So we try to get the message on, Hey, your employee may be fine, but you have no idea what she may be going home to at night. Maybe there's a troubled kid attempted suicide, keeping her up at night so when she comes to work the next day, she is less productive depending on the job. If it is a nurse or someone in logistics or something, it could be safety issues as well. So mm-hmm. Focus on the complete family unit, not just the employees when it is related to behavioral health.

Alyssa Place (08:34):

I mean, I am interested because we cover this a lot at employee benefit news. The sheer amount of solutions that seem to be available right now mean how are employers dealing with that? You talked about the balance, you are talking about the claims and the costs. How can they find that right fit of, we wanna help with all of these different things, but it is just becoming cost prohibitive?

Dr. Monty Maston (08:58):

Well, I can start. I think actually the good thing about behavioral health resources, a lot of those solutions are fairly inexpensive. So what we do with Marsh McLean is first of all, we have got a lot of internal resources, toolkits, employee communications that we can help our clients with, but then also look at what is in the community, what are the community resources around behavioral health what is available through the eap? What does your medical carrier bring? And we found a lot of interest with something called mental health first aid at work. It is a very low cost program. It is available across the country. And the gist of it is to get managers and supervisors more cognizant, more comfortable in talking with someone that has a behavioral health challenge. they are not going to sit these people down and counsel them. That is not the role of this program, but it is really to be more comfortable talking with them and know where the entry points are into the behavioral health system in the community to get those people help.

Mari Kemp (09:55):

Yeah, I can agree. The cost point is something that we can handle. The key is just intention. And so when you build a strategy and a plan around the intention of mental health, it is a different conversation. But essentially you will find you are probably spending the same dollars, and in fact, you are probably saving on the claim side at the end of the day by putting intention towards it. So I think it all comes hand in hand. And I, before I remember when there were shootings or different things that happened, you were sending out the EAP information if you need anywhere to call, or if you do not feel a certain way or whatever, call this number. And it was like, oh yeah, I forgot all about it. There is not a lot of intention around mental health in the workplace because we were supposed to be robots where We are humans now. And I think that even as an employee does not have to necessarily come from HR or the executive team, start talking about that. Raise it within your organization because it is not just an isolated problem, it is not just one person. It is a human issue.

Dr. Monty Maston (10:55):

And think about the demographics for your population as well. One of the troubling statistics around behavioral health in this country is looking at various industry sectors. So for construction in this country, male weighted demographic and men in construction have a suicide rate. That is three times the national average. And we know there's a stigma around behavioral health in general, but it is amplified many times with men. So get, they are a difficult population to engage in any kind of health and wellness, but particularly with behavioral health. And we found some interesting resources for men. There is actually something really cool called man therapy.org. It uses humor to try to engage males in the conversation around behavioral health. And if you have not seen it go out there it is funny, but it is actually serving a purpose.

Alyssa Place (11:47):

And I would really like to talk about that intentionality that you are talking about. There is so many great opportunities out there. How are you building these benefit plans with intention, and what sort of tools and resources are you using when it comes to data employee pulse surveys, that sort of thing?

Mari Kemp (12:06):

That is a huge one. I, first of all, going back to data rules, everything and prior to the conversation with so many things popping in my head, but we have to get to a point where everything we do in the workplace, we have enough technology that almost everything you do can be data driven. So being able to, because that is the real and true way that you can validate your effectiveness. If you are just rolling out all these initiatives and you think they are great, that is fantastic. But if you are not listening to your people to find out if it actually works, then it is a waste of energy. So I think in terms of being intentional, there's things like you can do a health and wellness channel, you can offer meditation, you can do yoga real time and live yoga, you can offer health and wellness. What we do is we give them a little bit of a stipend for them to go to the gym and to step out.

(12:59)

And then at the same time, back to the social aspect that you were talking about, which was really interesting what I am seeing in the workplace is that people, they wanna see their coworkers, but no more than two to three times that week, anything more than that is overkill. I remember the first time I went on an executive retreat, and it was four days straight after day one, I had to go to my hotel room to stare at the wall. I was so overwhelmed with just the social capacity that it was taking from me. So I do think that the workforce would probably never be the same. And we have to do the change management with the executive team to let them know that We are moving into a different era and this is what it looks like. And part of that is recognizing humans where they are today.

(13:46)

And that comes from intentionality. That comes from offering different programs. Making that investment in your people will take them a long way. And if you think about it today, from an efficiency perspective, humans are far more efficient today. If you think about the typewriter when we were doing work versus the laptop and the cell phone and the slack, all that we have right now and how much information We are processing in a minute today versus a while ago, We are efficient. We just have to give ourselves credit. And we also have to know how to turn it off.

Dr. Monty Maston (14:19):

And we try to get really granular with the data. So most of you in the audience probably have, if you are coming from the HR side, you probably have a very diverse multi-generational workforce. So being able to look at the data and understand the population health drivers, the utilization drivers from the millennials versus the boomers, and then the benefit design around that. I mean, the boomers have different needs. They are looking at retirement and so forth. And then you have got the millennials and the younger generation that they are stressed about job career finding a home or buying a home and so forth. And then we also really get into the weeds with showing the clients where the trends are coming from. So for example, if it is a school district, they wanna look at the data by the teachers, environmental services, bus drivers and so forth. And they wanna look at the different school locations. So being able to show them if they have got a trend from behavioral health or diabetes at a certain location among a certain job class, that can really help you pinpoint your communication strategies and can help you also look at where you want to put in maybe a pilot program for diabetes or behavioral health from target, the target segment of the population that's actually driving the trend.

Alyssa Place (15:34):

And obviously employers have been, I do not wanna judge employers, but in a reactionary mode, I would say in the last couple years, everybody is trying to keep their heads above water. As We are sort of looking ahead, what are some of the trends that you are anticipating that employers should maybe think ahead of now so that in six months or a year or two years, they are not completely taken aback by the next health thing that's going on?

Dr. Monty Maston (16:01):

Well gene therapy is a great example. This from a medical perspective, these are drugs, specialty drugs that are medical miracles. They may cure some of the most expensive rare conditions out there. The most common form of hemophilia, hemophilia A, as an example, there is a drug you have probably heard about, it is been tied up in the FDA process that may come to market next year. But there is even a more current example. There is a condition called beta thalassemia. One in a hundred thousand Americans have it. People with that condition have to get frequent blood transfusion. So think about the inconvenience, think about the risk of hepatitis, hiv, etc. And the average cost about a hundred thousand dollars a year for that treatment, six and a half million over someone's lifetime. A drug is in the process, it is going through the fda. There is a meeting on August 19th, and it is likely a struggle come to market at the end of this year or next year at 2 to 3 million in cost there. If you go to covid and you look at the technology and the research from the Mr. mRNA vaccines, put Covid aside, the benefit of that research is going to be what We are going to see over the next five to 10 years in treatments for cancer and HIV and things like that. And those will come with the cost. So I think gene therapy is really an area where employers need to look over the next five years or so to what their risk is for that category.

Mari Kemp (17:24):

Yeah, and it is really interesting. We were talking about this earlier, just going over there. There is so many booths on sleep. I think sleep. And so two things actually, sleep and empowerment. So it is been an organization where most companies are like, what can we do for you? What can we do for you now? How do we give the employees the tool set or the best practices so that they can continue to function in their life in a very healthy way? I have had children 26 years ago, and I remember I would leave work and my big old computer was on my desk that I was clonking at, and I would go home and cook dinner with my children. And there was no distractions. There was not that cell phone, the slack, it was pure. And so technology is a gift, but it is also a curse if you do not know how to turn it off.

(18:10)

And I talk to my team currently all the time. When you wake up, you should not roll over and grab your phone, charge it in a different room. it is those simple best practices. Because when We are talking about mental health, sleep is a big issue of that. you are not sleeping enough, your brain isn't healing, you are not allowing yourself to reset. And so when you are doing that, you are burning yourselves at both ends. So empowering people on what they can do for themselves, because it is not going to be done by anyone else, especially in a remote setting when they are sitting at home. So empowering people on healthy and ways of behaviors that are far different than what it used to be. You get up in the morning, you get in the car, you go to work, you have your lunch. That whole school system that you have been built, your entire life has shifted to where you have to wake up, think about should I grab my phone or should I work out first and take care of myself, or should I take a walk at lunch? Should I have no zoom Fridays? There's all of those different things that we can embed within our people, which are healthier lifestyles.

Dr. Monty Maston (19:10):

It was really interesting. We saw a huge increase in obstructive sleep apnea claims in the last two years and sort of wondering why we were seeing that. But morbid obesity and ossa by themselves together are really the strongest risk factors for severe covid, for someone being admitted of the hospital in an intensive care unit on a ventilator. So the fact that millions of people were diagnosed with covid and being evaluated in emergency rooms, you are seeing more of that obstructive sleep apnea come out and the claims and people being diagnosed, which a good thing because being diagnosed with that earlier leads to earlier treatment. And OSSA can also be tied to heart disease and can be a killer. I mean, if you are driving a truck and you fall asleep obviously it can be a bad outcome. So really interesting to see that in the claims during Covid.

Alyssa Place (20:03):

Yeah, I mean, I think this is such an interesting conversation cuz We are talking about the practicality of the claims and the money. We are also talking about more abstract ideas about empowerment. I mean, if you could give this audience one takeaway for what they can do in five minutes or next week, what is the one thing that you would say is most important for them to do for their employers employees at this point?

Mari Kemp (20:29):

And I would say this is for large businesses, or if you are just a business that has five employees or a very small organization, just remember it is okay to be human and it to feel. And so being able to connect with your people, that is how you now tap into increasing a high performing organization is now connecting with your people and then having clear expectations. If you are a leader what are the expectations and how do you drive that down to data so that it is very black and white versus the ambiguity of, I knew you were working because you were sitting in your cube all day long. That does not work anymore. So level up in terms of management and understanding, how do I create a data-driven organization so that I am not losing sleep on all night, whether or not people are working simply because they are working from home. So just remember, We are all humans. We are a people business for the first time. The employees are ruling the world. We can see that through our recruiting strategies, et cetera. Evolve with it, do not fight it and make your business a human business.

Dr. Monty Maston (21:33):

Yeah. My team at Marsh, We are a team of physicians, registered nurses, data analysts, and health and wellbeing experts support hundreds of employers across the country. All industry sectors, all sizes a couple hundred employees to over 30, 40,000 or so. And it really does not matter the size or the industry. The consistent thing that we have learned over the years is that their HR teams are small their finance teams are small, so there is not a lot of people to put behind initiatives or strategies, and there is always competing or financial opportunities or commitments as well. So you really have to be data driven to use the data to find what are the one or two things that are really impacting the health of our employees, what is impacting the cost to the health plan, and then bring maybe one or two things that are more innovative and prescriptive to the table. There you go to the exhibit hall, there is a lot of cool new vendors out there. Some of the medical carriers are doing the same things in diabetes that they were doing 10, 15 years ago. And not taking advantage of new ways to engage people like text messaging and social media and so forth. So learn from the vendors but I think data is really, really critical to making strategic decisions.

Alyssa Place (22:49):

All right, great. We would love to hear from the audience if there is any questions or follow ups.

Audience Member 1 (22:55):

Monte, you mentioned a resource way in the beginning about maybe a hub for mental health. What

Dr. Monty Maston (23:02):

Was that? Well, there is two resources. Yeah. One is mental health first aid at work, and it is again, a national organization. They can do training and really it is to get managers and supervisors more comfortable with that conversation. The other is man therapy.org using humor to get men more engaged in mental health conversations.

Audience Member 2 (23:24):

Two things Diane from University of Michigan, absolutely second, mental Health First Aid. Dr. Melany, chief health officer and myself brought in the organization over two 50 champions certified mental health First Aid advisors in their units. And we have heard nothing but positive about that. So just giving another plug for that. Great absolutely believe in it, a great program to go to. They shortened it for us, but we were able to, again, like I said, two 50 and We are trying to figure out how we can bring it back to do more. And then second it is really interesting, just even through the conference, I have been noticing that we continue to use eap. And one of the things that we found on our campus is higher ed's just a different forum. But one of the things we found on our campus is that we had to change the words EAP to include the word counsel.

(24:25)

And what was happening was that people were doing, it was for services that were low level and high level mental health was not associated with pap. And so once we changed it to office of counseling services and resources, honestly, our call volume went up. I can tell you the last number that I remember is we had a 25% increase in utilization amongs, the counseling services for mental health, just by changing EAP to have counseling in it one for faculty and staff, and then one, so we have got two, one for our health system and one for our campus. So in that regard, we can change the name on both of those. it is still the same services as eap, but it was important for us to really get down to the tack and say, we know the council and people should know that this is the service and counseling them multitudes of things, and just the flood leads literally. So I offer that as just a quick fix if your service being wise, but for the most part, again, well too

Dr. Monty Maston (25:44):

Glad. Well glad that you mentioned that because first of all, go Blue used to work at University of Michigan Health System, so I did my time in Ann Arbor so go blue as strong. But the second point too is more important. We actually had a large client county government in the south that did exactly that. They changed the branding or the marketing around their E A P historically had abysmal utilization rates. They changed that to a more employee friendly type of brand, and did see the utilization go up too. So it is a great thing to certainly look at how you rebrand that.

Mari Kemp (26:28):

I definitely project a huge disruption happening with eap, just what we call it, how we looked at it in the past. I know there is a company by the name of hafi Twill now called Twill, but that's all they do is focus on making it a normal conversation. It doesn't have to be some top secret mission that you are looking and offering help to your employees, but you are making it more of a conversational piece. So I know that you can actually see disruption all next door. All of there's things specifically focused because it shows the intentionality around it. And so when you start to bring these things into your organization, like Dream and Sleep IO, and mental health and big health, all of those things really focus on exactly what it is. Versus eap, which is like a basket of things you just put your hand in and you are like, oh, a lawyer and a counselor and daycare prov. I mean, what is that? So again, the intentionality is definitely necessary and disruption's definitely happening.

Alyssa Place (27:28):

All right. Great. Well, thank you all so much. We will be around. So please feel free to come and chat and thank you all.

Mari Kemp (27:36):

Thank you.