Employers have a duty to ensure employees’ health and safety, and this duty extends to employees working from home. In this COVID-19 era, benefit professionals need to be agile and adapt to the constantly changing business and workforce needs. They should ask themselves if the 2020 benefits are still relevant for 2021 and is the balance still right for the new working environment?

The short answer is No – because a lot has changed.

CHANGES TO WORKING ENVIRONMENT

The COVID-19 pandemic has caused significant changes to our working environment. Beyond employee’s health and safety, some businesses save about $11,000/year for every person who works remotely half of the time, without much impact on productivity. That’s why some technology businesses are now considering making a move to working from home on a more permanent basis. Most other businesses are thinking a hybrid model where employees will work from home one to three days a week, and come into the office the rest of the time. This means that significant number of employees will be spending a considerable time working from home in future.

PAIN AT HOME

After going through it for over 4 months, many employees are now realizing that working from home day after day for months is very different from doing it for a couple hours a week. The ‘always on’ mentality is leading to burnout with over two-thirds, or 69%, of employees are experiencing burnout symptoms. Many of them are finding themselves hunching, slouched or slumping, or sitting with their legs twisted – leading to several musculoskeletal issues including back, neck, wrist, hip and knee pain.

Very few of them are seeking care due to fear of infection. Left untreated, the acute pain will likely progress to chronic pain, increasing the risk of downstream disability and depressive status.

COST CONTAINMENT PRESSURE

A number of businesses are experiencing significant challenges due to plunging demand from aerospace, automotive, hospitality, retail and energy sectors. In most areas business is down. Low demand, supply chain breakdowns and sharply reduced production and revenue have made liquidity a major challenge.

Employee benefits account for approximately 30-40 percent of an employer’s compensation costs, the cost pressures from the top will bring a sharp focus onto healthcare spending (about 10-15% of employee’s compensation).

UPTICK IN MSK SURGICAL PROCEDURES

While many musculoskeletal procedures are often considered “elective,” that does not mean that they are “optional.” There is generally a finite period of time for which procedures can be delayed without clinical consequences, but they eventually do occur.

While some businesses will experience lower costs this year due to restrictions on elective surgery, an increase in demand for delayed procedures and continuing care related to COVID-19 is likely to drive health care costs higher next year.

WHAT NEXT?


Given that MSK spend is likely to significantly grow in the next year due to the issues stated above, benefit professionals should work on adding a digital MSK solution that takes into account that can a) proactively address the evolving and lingering MSK issues and b) reduces costs and c) meets the dynamic needs of employees working at home.

There are a number of existing point solutions (such as tele-PT, second opinion, digital program for chronic pain etc.) that claim to address one of the the above goals. However since these ‘point’ solutions are not integrated, you’ll end up doing a lot of work to piece them together. A complete digital MSK solution should provide a single place of access for all musculoskeletal conditions across the entire continuum including preventive, acute, chronic, rehab and surgical treatment services. Here are some services that should be included in the solution.

Physioline

Think of it as digitally-delivered urgent care for MSK issues. As your people are doing work for extended periods, providing them quick access to MSK specialists is essential for those who have knee, hip, back and shoulder condition. They can get assessed and receive sensible suggestions to relieve their symptoms.

Fast access to physical therapy by messaging, telephone or video leads to early assessment, self-management and, when appropriate, treatment and thus begins a shift to greater empowerment.

MSK assessment, triage and referral

40% of people with MSK conditions are misdiagnosed and go through unnecessary surgeries – which often don’t work for them and 50% of patients are back in the system within 12 months of treatment with the same issue.

MSK Triage Service can assess and diagnose complex musculoskeletal conditions and signpost your people to the most appropriate treatment (Physical Therapy, Orthopedics, Rheumatology, Pain clinic etc.) or a digital therapeutic program, as quickly as possible. This assessment typically includes an examination and members may be referred for investigations like x-rays, MRIs, blood tests and ultrasound scans to help the clinician decide whether or not an onward referral is needed.

Virtual Physical Therapy

Virtual physical therapy should be seen as a viable alternative to in-person sessions beyond the Covid-19 pandemic, with research finding that patients who were treated virtually experienced a significant reduction in pain.

This model enables a more holistic patient-centered focus, encourages more conversation and provides the clinician with a better opportunity to ask questions and provide bespoke advice, education and reassurance, while also tackling some of the psychosocial aspects of pain. For members, this approach encourages accountability and can be very motivating as they become more engaged in the information and advice they are given.

Chronic MSK Care

Evidence-based, clinically validated digital programs for chronic MSK pain are showing a lot of promise in effectively managing chronic pain. These programs should include the right interventions (physical, psychological, and educational) for maximum impact. Unlike traditional clinic-based therapy models, where adherence to home exercise in rehabilitation is a significant problem (with estimates of non-adherence as high as 70%, having a detrimental effect on clinical outcomes), the digital PT-led program tracks member adherence to exercise plans and report it back to the therapist for course-correction, when needed.

Bundled Surgery

Benefits professions should explore this supplemental benefit for non-emergency surgeries that provides high-quality care, concierge-level customer service, and lower cost. In this model, healthcare services are “bundled” together for the whole surgical episode. For example, rather than paying separately for the surgeon, facility, anesthesiologist, and radiologist, the bundled surgery provider negotiates one “bundled” rate, which is typically 30-40% cheaper than typical ‘PPO’ paid charges.

SUMMARY


As more companies expand and embrace remote working, a major downside has emerged: New or worsening back, neck, leg, and shoulder pain among telecommuters. Left untreated, this chronic pain is often exacerbated, leading to opioids, injections, surgeries and high cost impact for employers. Benefit professionals can proactively manage this impending situation by incorporating a digital MSK solution in their 2021 benefit offering.

Sprite Health’s digital MSK HUB uniquely covers the full continuum of MSK care, to provide employers and health plans the most complete solution, and to their people a consistent experience to simplify their MSK care journeys.