Reprinted with permission from the May 14, 2021 issue of BenefitsPro. © 2021 ALM Media Properties, LLC. Further duplication without permission is prohibited. All rights reserved.
By: Christi Coleman, EVP of Employer Engagement, Proactive MD
Any remaining resistance in corporate America toward the blending of work and home life dissipated during the Covid-19 pandemic. While the reality of the mental load and practical demands associated with caregiving has been widely recognized for years, many otherwise-progressive employers continued to operate under rigid traditional work environments—holdovers from a bygone era of a male-dominated workforce—which were not conducive to the demands required to tend to young children, disabled partners, or aging parents.
But as business, education, and even healthcare delivery shifted abruptly into individuals’ homes over the past year, corporate employers were likewise compelled to shift to a more individualized approach to managing their employees. The need for flexibility was especially evident in the lives of caregivers: instead of giving 40 uninterrupted hours to their employers, working parents were facilitating virtual schooling in between meetings and catching up on tasks after bedtime; caretakers of disabled individuals were using office hours to manage care in the absence of home health; and family members were working around the clock to protect and provide for their elderly relatives. For caregivers especially, 2020 was the year that work, home, and healthcare became inextricably intertwined.
While this lack of delineation presented numerous challenges and a newfound appreciation for work-life boundaries, it also spotlighted the benefits of a more accommodating approach to doing business—an approach that was successfully applied without the productivity plunge employers once feared would follow. Today, as they look forward to a post-pandemic work culture, many employers hope to uphold this flexibility—and its associated job satisfaction—while finding new ways to empower caregivers in a corporate world that has so often left them behind. As this new era of caregiver-friendly business evolves, healthcare benefits will make or break it.
Embracing the Marriage of Work and Life
Many employers have begun their foray into caregiver support by formalizing and permanentizing the work at home policies they developed by necessity last year. And while not every person prefers a living room to a board room, the shift has been a major benefit to many caregivers, who can now complete their regular job duties while also finding more personal time to meet the needs of their families and loved ones. And by eliminating transportation costs, as well as by potentially reducing food and clothing spend, working from home affords savings that can be used to offset some of the financial burdens associated with caregiving.
Employers should also consider providing pathways to financial independence intentionally rather than simply as a positive byproduct of remote work policy. Ensuring equitable and competitive compensation for caregivers—a disproportionate percentage of which are women—can provide disposable income to fund personal support services like housekeeping or dependent care that ultimately help enhance focus and productivity at work. Employers will likely see a strong return on this investment in their talent as caregivers are incentivized to grow, innovate, and develop into leaders in ways they previously were not.
Employees at work have always been affected by their responsibilities at home, but it wasn’t until 2020 that big business began to accept this reality and develop policies to support rather than suppress it. Providing flexible work schedules and competitive compensation plans leans into the inevitable integration of work and home, offering caregivers more autonomy and opportunity in their lives and careers than ever before.
Incorporating Healthcare into the Mix
So employers are recognizing that the personal and the professional will become increasingly integrated, and that this is a good thing. But what about the physical? As much as Covid-19 demonstrated the long-term viability of work-life integration, it made equally clear that both families and corporations depend on good health. If the trend toward blending work and home continues—and it will—healthcare must be an equal part of the mix. Deciding to implement a holistic healthcare strategy over the next 5 years will be the difference between a fulfilled, productive workforce and a burned out, complacent one.
This is especially true when it comes to caregiving employees, who bear the weight of not only their personal health, but also of the health of those in their care. If employers can develop a healthcare strategy that meets the needs of this population, the health and wellbeing of their entire organization will likewise flourish. And while such a strategy will take time, intention, and investment to deliver, its three core tenets are simple: advocacy, access, and affordability.
Patient advocacy and care navigation services are growing in popularity among employers—and for good reason. With a robust advocacy program, employers can close some of the biggest gaps that exist in the healthcare system: mental health support, solutions for the social determinants of health, and health literacy. While this threefold approach is an asset to anyone who personally engages with the healthcare system, it is especially useful for caregivers, who often serve as their dependents’ own unofficial advocate and care navigator—a fulltime job in itself.
Providing a service dedicated to guiding and supporting employees and their families through the entire continuum of care removes this burden from caregivers and passes it to a professional who has the expertise to do it more efficiently and effectively. A concierge-level advocacy program can educate employees on understanding their health insurance and medical bills to maximize their benefits, help them find and acquire community or government resources to address social barriers to care, schedule appointments and counsel employees on care plans, and even offer mental health support when caregivers experience burnout, depression, or anxiety. In short, a patient advocate is a caregiver for caregivers, ensuring that employees have the resources and support they need to thrive both at home and at work.
While advocates and navigators are experts in guiding patients through the system and maximizing benefits, their ability to impact quality of life for caregivers is limited by employees’ access to care. Many employers assume that funneling patients into a local network of high-quality and cost-effective providers solves for the healthcare access problem, but unfortunately this approach underestimates the complexities of the current healthcare system as well as the demands associated with caregiving. Even if caregivers have access to care on paper, this access often does not translate practically because of one major barrier: time. Certainly the time required of caregivers to schedule an appointment, travel to their in-network provider, and take time off of work to be seen is limiting when caregivers already feel there are not enough hours in a day to fulfill their immediate responsibilities. But the issue of time plagues the system as much as it does individuals: in a fee-for-service model that incentivizes providing the maximum amount of services in the shortest amount of time, access to a provider’s time is actually extremely limited, regardless of if they are in network or not.
Considering that fee-for-service is still the primary payment model in most healthcare systems, truly solving for access can require a creative and progressive approach. The first step toward improving access is to incentivize employee adoption of primary care. While most family medicine practices still operate on a fee-for-service basis, a good primary care physician will approach patient care as personally as the system allows, with a focus on building trust and managing a patient’s total care. To enrich a primary care-first philosophy, consider moving toward a value-based plan design and providing direct care memberships, which both give patients meaningful access to care by incentivizing clinical outcomes and provider performance. This approach will be especially transformative for caregivers if direct access is granted to spouses and dependents and is conveniently located near home or work with an integrated virtual primary care solution to eliminate transportation barriers.
An advanced primary care solution is the key to affordably meeting everyday health concerns, but caregivers are often also responsible for procuring medical services for higher-risk and higher-cost populations: disabled individuals, elderly adults, and young children. A caregiver-centered healthcare strategy must also provide affordable solutions to address specialty, complex, and catastrophic concerns that are outside the scope of primary care.
A simple first step is to provide virtual specialist consultations facilitated via the primary care physician, which can offer limited expertise without an additional fee or trip to the doctor’s office. For care that requires an in-person referral, integration is key: an employer’s direct care partner or care navigation service should have access to population health data that captures the highest-quality, most cost-effective specialists in-network and can be used to direct referrals. Active follow-up and continued patient engagement in primary care are crucial during this process to ensure that caregivers understand and follow the resulting care plans long term. To fully address costs associated with specialty care, employers can look to partner with a second opinion or complex diagnosis management partner that directs the most costly of conditions and surgeries to centers of excellence at bundled case rates, dramatically reducing misdiagnoses and revisions and giving caregivers peace of mind that they and their loved ones are receiving the best possible care.
Caring for caregivers is the compassionate thing to do; but it is also the only thing to do if a business is going to thrive in a post-pandemic world. As organizations begin to grasp the impact that personal lives have on professional lives and learn new ways to empower employees in both areas, they must do the same for their employees’ physical health. A holistic healthcare strategy that empowers caregivers will by extension empower the entire organization.