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The Inside Story: P is for Pandemic Again

P IS FOR PANDEMIC AGAIN...

And predictions, possibilities, promises, and partnerships for workplace health

If that headline looks familiar, you’re not imagining things. As we all became increasingly pandemic weary, we used this clickbait-style headline to try to spark your curiosity regarding more COVID-19 talk and theorizing. But here’s the thing—that was back in August 2020! Turns out we didn’t really know the meaning of weary. However, now over a year later, we definitely do. So we thought, what better time to reflect on where we’ve been and see if we’re still headed in the same direction.

With this in mind, we dusted off the August 2020 feature where, as you may recall (or not), we reached out to some insightful minds in the health benefits industry to get the pulse on how the evolving pandemic may impact workplace health. Interestingly, in a pandemic full of acronyms, most of the “P”s that the article covered are now in full swing while others are still in the works. To guide you through we’ve added or taken away some commentary here and there.

Predicting a renewed and ongoing focus on employee wellness

Our industry thought leaders must have had a crystal ball as employee wellness has certainly prevailed as an enduring issue. Mike McClenahan, managing partner, Benefits By Design, predicted, “We will see a renewed focus on employee wellness, including mental, physical, social, and financial health. Although at first this trend will be reactionary in response to the initial COVID issues like financial stress and loneliness, it will shift to preventive approaches with measurables and will ideally result in improved health outcomes.”

As the pandemic evolves, keeping laser focused on common themes in public opinion polls and industry surveys—namely, that employees are struggling on any number of fronts—will hopefully ensure wellness is front and centre.1 In addition, research published during the pandemic reinforces that wellness isn’t simple; it’s not just a matter of physical or mental health. Rather, it’s made up of numerous interrelated domains, and the pandemic is taking its toll across them: “The need to balance challenging work and family demands not only may cause individuals to underperform in both the work and family domains but can also result in increased emotional exhaustion, stress, and burnout.”2

The pandemic may also spur on a renewed focus on employee wellness by shedding light on long-standing issues with the industry’s current approach to employee wellness. As Chris Bonnett, principal consultant, H3 Consulting, explained: “The massive human and financial cost of the pandemic is the proverbial burning platform that is highlighting deficiencies in our current approach.” Many of the issues Chris identified are a work in progress, like the need for carriers to provide more real-time reports with comprehensive, consistent, and timely data. Data are still inadequate, inconsistent, and late, which deters insight and proactive intervention. Indeed, as the pandemic continues, carriers can make a real impact by helping employers translate the data and provide direction for achieving better health outcomes.

Individual experiences need diverse options

Shannon MacDonald, senior managing director, Accenture, provided insight into how the pandemic has highlighted just how inflexible many of our traditional plan designs are in meeting plan member needs. “It seems that while shedding light on how individualized plan members’ needs are, the pandemic is also highlighting a universal need for flexibility and choices. And ideally, flexibility with ease—like digital access to make plan changes even within a calendar year.”

As the pandemic continues, it’s even clearer how varied the pandemic experience is from person to person. Shannon’s initial insights ring true louder than ever: “Choices definitely add value, which can translate into enhanced wellness, productivity, and engagement. What about coverage for emergency childcare? Or for eldercare support and long-term care expenses not covered by the province?”

Similarly, although research shows that a common pain point is the pandemic’s financial hit, its specific impact on people’s finances is quite individualized.3 For instance, for some it’s job loss and for others, it’s decreased income level, while for almost everyone it’s increasing inflation.

Michael Bradie (who now has a new role at GSC as vice president, Growth & Client Service, Group) also weighed in, “The pandemic’s impact on the economy and personal finances will dictate a continued emphasis on financial wellness as a benefit. Fortunately, the flourishing of fin-tech is making it easier to take control of finances through technology like apps. We’re sure to see more products on the market and in turn, more options consistently included as a benefit offering.”

In addition, GSC’s Ned Pojskic, (who by the way is also in a new role as vice president, Pharmacy Benefits Management) advised that “Economic turmoil may persist for years, putting benefit plans and especially drug coverage under greater scrutiny. The good news is that there is relief available as this situation provides fertile ground for implementing some of the cost management strategies that employers have traditionally shied away from.”

And of course, as one of the pandemic’s hottest topics, virtual services continue to be in the spotlight.

Promises come true as employee health goes virtual

Steve Mast, president and chief innovation officer, Delvinia, emphasized how “the digitization of everything has been slowly transforming society and culture. COVID-19 poured rocket fuel on this.”

And it looks like as predicted, for virtual health care this rocket fuel was in fact the boost that the promise of more accessible and more affordable health care needed to really get off the ground. Although virtual health services were on the horizon for some time—with some options having already dawned pre-pandemic—now telehealth services have really taken off.

It’s interesting to reflect on a study GSC conducted in May 2020 measuring attitudes about virtual health care. David Willows, GSC’s executive vice president of Digital, Innovation and Brand Experience, commented that “Clearly, this crisis and the required physical distancing has changed the entire health care environment.” Seventy-four per cent said they’re willing to use a virtual service to consult with a doctor, 67% said they’d fill a prescription from an online pharmacy, and 43% said they’d be open to online mental-health support. By this point in the pandemic, this all seems the norm.

It’s full steam ahead just as this industry veteran and GSC alumni predicted. You may remember Peter Gove in his previous life as GSC’s innovation leader, Health Management (now happily in retirement land). Peter explained the slow adoption history and finally the uptake that, now over a year since his input, has been tremendous. “To date, the provinces have been loath to allow physicians to deliver health care remotely or digitally. In Ontario for example, physicians could do remote health care, but only by utilizing the Ontario Telehealth network. Employees typically had to leave the workplace and lose work time to attend medical appointments. The natural experiment that has been driven by this pandemic demonstrates that all kinds of heath care services are presently being delivered digitally, and users appear to be very satisfied. User acceptance of digital delivery has undergone a significant shift. Digital health care is a winner for the patient, and a winner for the employer, and a winner for the system. This world has permanently changed.”

For employee health, this means give the people what they want. With many virtual health care offerings already part of health benefit plans, the launch of many more options is likely to accelerate. And leading the charge? Virtual mental health care. 

The real second wave of the pandemic: mental health issues

This is yet another prediction that is spot on, if not even stronger than predicted. Deteriorating mental health is being referred to as the second wave of the pandemic and as “a health and economic emergency in one, with all the components of a mental-health tsunami.”4 Steve Mast shares an experience that illustrates how the necessary strain of physical distancing—and all the things that go along with it, like face masks, plexiglass barriers, and distancing markings—may be contributing to a growing sense of isolation and loneliness. “I was picking up a few things from Home Depot and although the staff were very helpful, I sensed sadness. So I asked the cashier how she was doing. She stopped scanning, teared up, and thanked me for asking. She said that between the face masks and the barriers that it’s hard to hear customers and difficult to connect with them. It made me think that the long-term effects of loneliness represent a serious consequence of the pandemic and something we need to provide support for.”

Stephen Frank, president and CEO of the Canadian Life and Health Insurance Association, agreed, “As the pandemic continues to evolve, mental health and access to therapy will be a very big part of the recovery. If employers have not yet re-looked at their benefit plans from this perspective, they probably should. Working from home, physical distancing, having to rely on devices to connect people, not being able to hold or attend social events, and of course the virus itself; there are so many reasons why employees may be struggling to cope.

“Although we’re learning how to deliver various sorts of health care services at a distance, including even physical services and products like physiotherapy and orthotics, for this to really stick, regulators will need to help. They will need to clearly indicate what services can be delivered virtually within each health provider’s scope of practice. Many regulators hadn’t considered virtual before mid-March 2020, so they had to pivot pretty quickly to ensure that everyone has clarity.”

Partnerships make predictions, possibilities, and promises a reality

Partnerships have certainly continued to be a key success factor. Partnerships between governments and mental health service providers have made it possible for many people in need to easily access free counselling services.

Hopefully, taking a “we’re all in this together” attitude may drive more collaboration and in turn, enable more initiatives to become a reality. Collaboration may also mean teaming up in different ways. Although the debate about who does what in health care is a recurring theme, as predicted, the pandemic may be bringing various scope of practice issues to the forefront. Like the age-old debate regarding how to leverage the skills of nurses and nurse practitioners so they can play a bigger role, increasing access to timely care. And most visible as the pandemic continues, the role pharmacists have played—and continue to play in giving vaccines and distributing test kits.

The fifth ‘P’

Surprisingly, the pandemic’s 4Ps of predictions, possibilities, promises, and partnerships, point to a fifth P—positive. Of course positive and pandemic rarely go together but there just may be some positive changes in store for how plan sponsors and insurers approach workplace health.

Sources

1 How has COVID-19 impacted Canadians’ mental health? The Conference Board of Canada, May 2020. Retrieved August 2020: https://www.conferenceboard.ca/focus-areas/health/how-has-covid-19-impacted-canadians-mental-health? and Webinar: Overall health key to employee well-being during, after pandemic, Cassandra Williamson-Hopp, Benefits Canada, July 20, 2020. Retrieved August 2020: https://www.benefitscanada.com/news/webinar-overall-health-key-to-employee-well-being-during-after-pandemic-148138

2 Taking control amidst the chaos: Emotion regulation during the COVID-19 pandemic, Simon Lloyd D. Restubog, Anna Carmella G. Ocampo, Lu Wang, Journal of Vocational Behaviour, June 2020. Retrieved August 2020: https://www.sciencedirect.com/science/article/pii/S0001879120300658

3 COVID-19 Implications for Canada and the economic impact, The Conference Board of Canada, Updated August 7, 2020. Retrieved August 2020: https://www.conferenceboard.ca/insights/covid-19 and ‘Two years of income up in the air’: How the pandemic has impacted Canadians’ finances, Nicole Bogart, CTV News, May 26, 2020. Retrieved August 2020: https://www.ctvnews.ca/health/coronavirus/two-years-of-income-up-in-the-air-how-the-pandemic-has-impacted-canadians-finances-1.4955334

4 The impact of COVID-19 on the Canadian Life & Health Insurance industry – A perspective from Deloitte, Deliotte Development LLC, April 2020. Retrieved August 2020: https://www2.deloitte.com/ca/en/pages/finance/articles/the-impact-of-covid-19-on-the-canadian-life-and-health-insurance-industry.html

WHAT'S UP

What’s new with the flu shot?

Moderna, Sanofi, and Pfizer-BioNTech have applied the mRNA technology—used to develop the COVID-19 vaccine—to develop flu vaccines that are in early clinical trials. More companies are expected to follow suit by also starting to develop and test new flu vaccines using mRNA technology.

It’s very early days, but mRNA flu vaccines might prove more effective due to features that could result in greater immune protection. However, there are hurdles like the new vaccines’ tolerability. Interestingly, even before the pandemic, many of the new mRNA flu vaccines were under development. When the pandemic hit, researchers pivoted by swapping out the flu coding for the COVID-19 coding (SARS-CoV-2 sequences). Time will tell what the future holds as the clinical trials continue to unfold. In fact, researchers are also hopeful that one day vaccine innovation will advance to the point where it’s possible to combine protection from COVID-19 and the flu into a single shot.

For more information about the flu shot, visit https://www.canada.ca/en/public-health/ services/diseases/flu-influenza/get-your-flu-shot. For more information about the flu shot and mRNA technology, visit https://www.cbc.ca/radio/whitecoat/flu-covid-vaccines-combined-1.6228595.

COVID-19 biggest health care cost driver in 2021 and beyond

It’s likely safe to say that with the COVID-19 pandemic, none of us is overly keen to look back at 2021. However, hopefully, reflecting on the following international health care and cost trends will help prepare us for 2022 and beyond.

The Ipsos Global Health Services Monitor annually explores public perceptions regarding health challenges and how well-equipped health care systems are to tackle them. For 2021, the online survey included 21,513 adults across 30 countries. Not surprisingly, it found that for 2021, survey participants identify coronavirus as the main health threat facing their country. However, the survey also found that despite the challenges due to the pandemic, 53% rate their country’s health care services positively, and 51% trust they will receive the best treatment.

Similarly, other studies also identify the pandemic as a main threat; specifically that it is a main cost driver. For instance, the Willis Towers Watson 2022 Global Medical Trends Survey, which included 209 insurers across 61 countries, reports that employer-sponsored health benefit cost trends are expected to increase 8.1% on average globally in 2022. In addition, over three-quarters of participating health insurers anticipate a higher or significantly higher medical trend over the next three years.

In terms of specific costs, the survey participants ranked musculoskeletal disorders as the top condition by incidence of claims. This may be due to poor ergonomics in work-from-home environments. In terms of predictions for the next 18 months, mental and behavioural disorders were identified as the fastest-growing condition by incidence, and that cancer is the fastest growing by cost.

The cost impact of the pandemic is also identified in the National Health Expenditure Trends report by the Canadian Institute for Health Information (CIHI). Due to the pandemic response, health spending in Canada is expected to have increased by more than 12% between 2019 and 2020. This is the highest rate of increase in more than 30 years and is triple the growth rate from 2015 to 2019, which was approximately 4% per year. In terms of specific costs for 2021, hospitals, drugs, and doctors are expected to account for the largest shares of health spending.

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