Sneezing and headaches are starting to mean something to many employers.
Sensing that they're hitting a ceiling in terms of passing along health costs to employees, some companies -- often working with drug makers -- have started tackling ailments that don't necessarily lead to big medical bills or many missed days of work but often keep employees from getting much done when they are on the job.
Companies are analyzing the bottom-line effect of conditions such as seasonal allergies, migraines and stomach troubles, particularly when employees show up for work but operate at far less than 100%. That lack of productivity has been dubbed by health professionals as "presenteeism."
Corporate efforts to improve employee health aren't new. Some of the more established programs target severe health problems, such as heart disease and diabetes, on an individual basis via the insurer. Other efforts concern general wellness, stress and weight control. It is a newer tack, however, to address the lower tier of pesky chronic conditions.
Comerica, Dow Chemical, Bank One, a unit of J.P. Morgan Chase & Co., and International Truck & Engine are among companies that have put programs in place to help employees avoid or treat some of these seemingly smaller health conditions -- or at least keep productive in spite of them.
"We have cut as much as we can cut in terms of cost-sharing and getting people to pay higher co-payments," says David Groves, vice president of corporate health management at Comerica Bank. "The one opportunity that's left is cost-avoidance."
Results will be hard to measure. It's easier to put dollar amounts on medical claims and sick days than it is to figure out the cost if a worker on the job isn't accomplishing much. It's also tough to decipher whether programs to help, say, headaches have really improved employees' productivity. To evaluate presenteeism, companies are using employee questionnaires developed by researchers at universities including Harvard, Tufts and Stanford. The researchers have formulas to quantify the reduced productivity that comes when an employee has, for example, irritable bowel syndrome or back pain.
"These are, admittedly, rough-and-ready kinds of things, but in a world of having no information at all, it's a heck of a lot better than having nothing," says Ron Kessler, a professor at Harvard Medical School who helped develop one of the questionnaires and is now working with business groups in Chicago and Atlanta to study productivity at local businesses.
In late 2002, Dow Chemical surveyed its employees through a third party about several chronic ailments, including allergies, arthritis, back and neck problems, depression, migraines, gastrointestinal issues, diabetes and heart problems. The surveys show many more employees with the problems than the company would have been aware of by looking at insurance claims alone, says Catherine Baase, the company's director of health services. This year, Dow is implementing a broad effort to try to tackle the problems and encourage employees to address them. Among several early steps, the company plans to reveal the aggregate survey results to doctors and hospitals in communities where many of its employees live, asking where there could be improvements in employees' care, Dr. Baase says.
The trend is also leading employers to develop closer relationships with drug makers. Novartis AG, maker of Zelnorm, a drug for irritable bowel syndrome, provided funding for a Comerica study to determine the prevalence of IBS among employees. Pfizer Inc., maker of painkillers Celebrex and Bextra, meanwhile, is supporting a study that the bank is doing on arthritis, according to Comerica. Merck & Co. provided funding for Dow Chemical's work, Dr. Baase says.
At Bank One, one of the earlier companies to work on this issue, a study of allergies at the company has led to educational programs that, among other things, encouraged employees to take antihistamines that are nonsedating, says Wayne Burton, a wellness and productivity executive at J.P. Morgan Chase.
Merck, Schering-Plough and Eli Lilly & helped pay for the research on allergy problems at Bank One, Dr. Burton says. Schering-Plough, which markets nonsedating antihistamines Claritin and Clarinex, helped fund Bank One's study to help businesses understand "the far-reaching impact of allergies in all environments and activities," spokeswoman Julie Lux says.
Creating awareness of the health problems and their costs benefits employers as well as the drug makers that sell potential treatments, says Sean Sullivan, chief executive of the Institute for Health and Productivity Management, a nonprofit that's trying to address presenteeism and other health issues for employers.
Comerica surveyed its employees and found that about 40% of respondents said they suffered from irritable bowel syndrome, which can involve abdominal discomfort, bloating or diarrhea. Extrapolating from that, it was estimated that the problem cost the company at least US$8 million a year in lost productivity, Groves says. The surveys were conducted through a third party to ensure employee privacy, Groves says.
Comerica now provides written materials for its employees about IBS and has sponsored physician seminars to educate workers about how to recognize and deal with it through their living habits, diet and possible medications. The company has asked insurers to explore ways to encourage employees to get medical care that could improve productivity. One option would be to lower co-payments on drugs for a condition a company is concerned about, Groves says.