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Brokers Can Help Clients Tackle Presenteeism

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It’s when employees come to work but aren’t fully productive

Mary is at her desk working on a financial report, but she’s having trouble focusing on her project. That morning she experienced an asthma attack, which left her feeling exhausted, irritable and nauseated, a side effect from her inhaler medication. With her deadline looming, she notices an error in her calculations. Although she’s feeling poorly, she decides to tough it out but fails to make much progress the entire day.

This is an example of presenteeism, the buzzword commonly used to describe employees who come to work but aren’t fully productive. Presenteeism is not a new problem for employers and appears to be getting worse according to a 2004 study by the Cornell University Institute for Health and Productivity and the health information company Medstat. Productivity losses for businesses were estimated to be on average $225 per employee, per year, and account for as much as 60% of the total cost of worker illness, exceeding the costs of absenteeism and medical and disability benefits, the study found.

To help their clients reap the benefits of “total health and productivity” management, as it is now commonly known, brokers must be prepared to extend their expertise and knowledge into areas that may appear more nebulous in nature but are just as influential when it comes to reducing lost time and improving costs. By understanding the entire spectrum of factors that minimize productivity, including presenteeism to a large degree, brokers can differentiate themselves better and add value to their services.

Presenteeism is often the result of an illness, such as migraine headaches, asthma, allergies or back pain, or can be caused by side effects, such as drowsiness, nausea or dizziness, from medications used to treat those conditions. However, there are a myriad of other non-medical circumstances, such as financial or legal issues, family problems and stress, for example, that can also diminish an employee’s ability to work productively.

Brokers whose customers are looking for ways to increase productivity and reduce overall health and lost time costs should advise their clients to consider the effects of presenteeism as part of an overall health and productivity program. Many health and disability plans offer a number of products or services that directly or indirectly address presenteeism but are highly underused by most employers. Rather than purchase new costly programs, employers can maximize the benefits of these and other existing programs to help keep workers healthy and fully productive.

Among the options available to help minimize the impact of presenteeism are Employee Assistance Programs.

Depression has a profound impact on an employee’s ability to work and be productive. According to a report in the June 2003 Journal of the American Medical Association, depressed workers lose about 5.6 hours of productive time on the job each week compared with an average of 1.5 hours for non-depressed workers. EAPs have proven to be beneficial in helping employees deal with a variety of mental or nervous issues that diminish their ability to concentrate or be productive at work. EAPs also help employers save money. According to studies by the U.S. Department of Labor, $5 to $16 in health care costs can be saved for every $1 invested in an Employee Assistance Program.

Workplace accommodations also can be a factor in dwindling productivity.

On occasion, an employee’s ability to be fully productive may be enhanced by ergonomic or other workplace accommodations. Workers with back pain have benefited from ergonomic enhancements to their work stations or from the installation of anti-fatigue mats, for example, for employees who stand for long periods of time. Computer glare guards, replacing fluorescent lighting with full spectrum lighting and the use of environmental sound machines that help mask workplace noise, are common accommodations employers use to help people with frequent migraine headaches.

Active management of chronic health issues through disease management programs, such as those for heart disease, asthma and diabetes, has been proven successful in helping reduce hospital visits, medical costs and lost time. In fact, in a recent CIGNA Group Insurance study, when disability management was coordinated with disease management, employees participating in the cardiac program experienced a 3% reduction in disability incidence and nearly an 8% reduction in disability durations. For Mary, the asthmatic employee described above, an asthma disease management program could improve her overall health and well-being, thus increasing her ability to work more productively.

When disability and health care case management are coordinated, disabled workers have a 6% higher return-to-work rate than those without coordinated programs. Integration of these programs increases the opportunities for case managers to identify problems, such as side effects from medications or workplace accommodation issues that may inhibit an employee from making a smooth transition back to total productivity.

Health Risk Assessments are voluntary questionnaires that help employees identify whether they may be at risk for a variety of health issues, such as heart disease, obesity and other chronic diseases. The HRAs also provide employees with a variety of resources, such as disease management programs, fitness or smoking cessation programs, to help them better manage their health.

Sometimes even the most basic education can go a long way in preventing workplace illnesses. Flu and colds are among the top five causes of presenteeism, according to AdvancePCS. Employers should instruct employees about simple ways to minimize the spreading of viruses, such as washing hands regularly and avoiding close contact with sick employees.

Helping employees stay healthy–mentally and physically–goes a long way in keeping them productive at work. Brokers can play a key role in that effort by acknowledging the significant impact that presenteeism has on employers and their workplace and by recommending programs that focus on wellness, education and workplace accommodation.

Dr. Barton Margoshes is a board certified internist with CIGNA.

While presenteeism is often the result of an illness, there are also a myriad of other non-medical circumstances, such as financial or legal issues, family problems and stress that can diminish an employee’s ability to work productively.

Workplace accommodations also can be a factor in dwindling productivity


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