Integrating Physical and Mental Health Care to Improve Employee Outcomes

BY Riley Kaminer | June 14, 2023

In a past job working on a company’s benefits team, Accolade’s Shannon Rickert consulted with an employee who had been prescribed medication for an autoimmune disorder.

“She was dealing with a lot of anxiety in general, but then also specific anxiety related to potential side effects of the medication she was prescribed,” Rickert shared in a recent webinar hosted by From Day One and moderated by her colleague, Katie Miller Blakemore.

When the employee went to her provider and said she hadn't been taking the medication because of her anxiety, the provider told her that they needed to address the anxiety first. “It was a judgment-free conversation, where they were able to discuss options for therapy, options for medication, and ways for her to better control her anxiety to enable her to better manage her autoimmune condition,” asserted Rickert.

This employee shared her story because she was pleasantly surprised by the fact that one provider could address both her physical and mental health – thereby successfully managing both of her conditions. For Rickert, this holistic perspective ultimately meant centering the human experience: “It’s really about considering what a treatment does for a person who is trying to get help for their needs.”

Shannon Rickert, Accolade's director of product marketing presented during the webinar (company photo)

And the need is greater than ever. A 2021 survey from the National Institutes of Mental Health revealed that around one in five adults, 58 million people, suffer from some type of mental health condition. Even more striking: 85% of those adults inflicted with a mental health condition go undiagnosed or untreated.

This is not just a crisis for those affected, but rather the economy as a whole. A 2021 report from the NIH estimates that the economic burden of major depressive disorder alone to be $210 billion annually. Approximately half of that burden was attributed to workplace costs.

What Can Employers Do to Make a Difference in Their Employees’ Well-being?

The good news is that employers are far from powerless in this situation. Rickert shared a handful of ways that employers can better support their team members’ health. For instance: embracing mental health care practices, discussing the importance of self care and mental wellbeing, and approaching physical and mental health care in an integrated way.

“This approach is critical to recruitment, retention, and productivity,” she said, emphasizing the importance of creating a culture of wellness. “Integrating physical and mental health opens up the chance for the early identification of mental health conditions so that the right intervention can take place.

Dr. Leo Vieira, a family physician and medical director at Accolade, has seen this firsthand. He added that integrating physical and mental health care through a platform like Accolade offers an opportunity for more personalized, comprehensive, and intimate health care–all thanks to features such as virtual appointments. 

“Our virtual care model sets us apart and increases access to both medical and mental health care,” Vieira asserted. “I think that we can really overcome many of the barriers that block so many of our patients from getting the medical and mental health care that they need.”

What Makes a Good Wellness Program?

For Rickert, a good wellness program should be comprehensive and have options for all employees across risk levels and abilities.

“It is vital to include mental health support options, along with physical health support options, and present them as equally important in your wellness messaging,” she said. Good wellness programs should also provide education on various topics around mental health such as stress management and work/life balance.

“Most importantly, a strong culture of wellbeing helps ensure the access of your wellness program because you'll have employees that feel seen, feel accepted, and feel supported,” Rickert continued. In her experience, when employees work in an environment like that, they tend to be happier, healthier, and more invested in the success of their company.”

An integrated approach to health care – one that supports both mental and physical health – ultimately can reduce absenteeism, create a healthier workplace culture, and lower health care costs.

How Can Employers Ensure That All Employees Receive Comprehensive Care?

It is far from a given that employees will receive comprehensive care. However, employers now have access to tools that can enable them to offer whole-person health care services to employees.

“Employers can use a collaborative care model: an evidence-based practice that treats physical and mental health conditions concurrently,” suggested Rickert. Accolade’s platform enables this kind of comprehensive care. 

“That’s important because mental health is very much connected to physical health and vice versa,” Vieira added.

Editor's note: From Day One thanks our partner, Accolade, for sponsoring this webinar.

Riley Kaminer is a Miami-based journalist, researcher, and content strategist. As a freelance tech writer and researcher, he has profiled more than 400 of the world’s top entrepreneurs and investors. His work has been featured in publications including Forbes, the Times (UK), the Economist, and LatAm Investor.


RELATED STORIES

How to Provide Best-in-Class Menopause Support in the Workplace

Despite it impacting half the population, menopause is rarely discussed. For many women, life-altering symptoms strike just as they’re reaching the peak of their careers, disrupting them at a time when peak performance is critical. Companies must step up and provide support, or they could potentially lose 20% of these women who move to less demanding jobs.MaryAnne Hraba, RVP of employer growth at the Maven Clinic and Dr. Toni Morrissey, OB-GYN at the Maven Clinic spoke about providing best-in-class menopause support during From Day One’s October virtual conference. Jenny Sucov, health and well-being journalist moderated the thought leadership spotlight. Maven is a team of health care advocates across the world who offer personalized care via telehealth. They partner with over 2,000 employers and health plans to bridge the gaps between limited access to care for everything from fertility treatment to pediatric care, including filling the gap in traditional menopause care.Opening the DialogueSeveral years ago, Hraba started experiencing what she now knows is symptoms of perimenopause, including worsening depression and anxiety, low libido, and it became increasingly difficult to sleep. The most cumbersome symptom, especially with regards to showing up for work every day, was brain fog.“I seriously thought that I had something wrong with my brain,” she said. “It just wasn't working anymore, like having a hard time even reacting in conversations.” She had no idea what was going on with her body. “It was just so hard to get through every single day.”She went to see her OB-GYN and explained what was happening, but during the short visit was simply told that is what happens when you get older. No help or relief. Later, Hraba went down a Google rabbit hole, which made things worse. Unfortunately, only about 20% of OBs receive any sort of formal training on menopause, says Sucov.Hraba then turned to Maven for care. She scheduled a virtual appointment with one of their OB-GYNs who was trained in menopause. “I got more out of that 15-minute appointment than anything prior,” Hraba said.Dr. Toni Morrissey and MaryAnne Hraba of Maven Clinic spoke on "How to Provide Best-in-Class Menopause Support in the Workplace" (photo by From Day One)Questions about hormone replacement therapy, supplements, and a clear direction of where to go next were answered. “Finally, I was being seen and being heard, which was the first step.” She also got access to clinically vetted content she could trust, as well as community forums of other women experiencing similar issues. Additionally, she asked Maven for a local doctor who was trained to better help her and was connected with one covered by her insurance.“Fast forward. Now I’m talking to this provider in person. I’m a lot more empowered, a lot more educated, and I’m able to have that two-way conversation,” Hraba said.She still uses the Maven app for resources she doesn’t have access to locally, but when it comes to women’s health, it is going to take more than just one provider to fulfill her needs. “It's still a process. There’s no single magic bullet.” But thankfully, now that she feels better, her life—including her work life—have improved exponentially, she says.  Workforce ImpactThe implications of menopause in the workplace are more far-reaching than employers may realize. “Menopause isn't just a personal health journey,” Dr. Morrissey said. “It impacts everybody around them in the workforce.”Untreated symptoms can render even the most resilient individuals less able to manage stress, leading to higher absenteeism and decreased productivity, says Dr. Morrissey. Moreover, menopause often coincides with a pivotal career phase when many women are in or approaching leadership roles. Without adequate support, companies risk losing experienced professionals and stalling diversity progress in senior positions.“Employers who invest in comprehensive menopause support aren’t just doing the right thing for their people, but they're making a smart business decision, and they’re creating a culture that normalizes conversations about menopause and provides meaningful, holistic care,” said Dr. Morrissey. How do women who go through this type of care feel? “They typically will say, now I feel back to myself.”Effective Menopause BenefitsProviding tailored menopause benefits, such as telehealth consultations and educational resources, empowers employees and cultivates a culture that normalizes and supports women's health at all stages. By integrating menopause care into their wellness programs, employers can demonstrate a commitment to their workforce’s well-being, fostering loyalty and positioning themselves as leaders in employee care.Here’s what Dr. Morrissey recommends for employers to make sure is included in menopause coverage:Access to Specialty Care: Employers should provide on-demand, virtual access to a variety of specialists (e.g., GYNs, mental health providers, sex coaches, nutritionists, career and physical support coaches) to address the wide range of menopause symptoms. Global and same-day support empowers employees to manage their health comprehensively.Education and Community Resources: Expert-reviewed resources such as articles, webinars, and community support should be available to educate employees and help them understand and manage symptoms.Personalized Care Plans: Employees need individualized care plans that consider their medical history, lifestyle, and personal circumstances. Concierge support should help them navigate care and connect to specialists and local providers as needed.Addressing menopause in the workplace is no longer optional—it’s a vital aspect of supporting employees’ well-being and fostering an inclusive work environment. As more women reach pivotal stages in their careers while navigating the challenges of menopause, companies that proactively offer comprehensive support can stand out as leaders in employee care. Editor’s note: From Day One thanks our partner, Maven Clinic, for sponsoring this thought leadership spotlight.Carrie Snider is a Phoenix-based journalist and marketing copywriter.

Carrie Snider | November 18, 2024

The Role of GLP-1s in Employee Benefits

Companies that offer inclusive care benefits are not only seeing higher retention rates but are also attracting job seekers who prioritize well-being over just a high salary. With obesity on the rise in the U.S., leading to increased rates of cardiovascular disease and Type 2 diabetes, employees are looking for workplaces that support their health holistically, recognizing that inclusive benefits can be life-changing.The prevalence of chronic disease presents a challenge for employers over increasing healthcare costs. 60% of employers expect healthcare costs to surge over the next three years. Yet, it is critical to offer comprehensive care and wellness for higher retention.The American Institute of Certified Public Accountants (AICPA) found that workers would choose a job with benefits over a similar job providing 30% more salary but with no benefits. Consequently, employers also face more competition with other companies that provide more inclusive healthcare benefits.The growing off-label use of GLP-1 drugs, originally approved for treating Type 2 diabetes, has fueled discussions around treatments for cardiometabolic diseases. However, cultural misuse has also associated these drugs with rapid weight loss management.What are the potential risks and benefits associated with including FDA-approved weight loss drugs in care benefits? Is there an ROI of covering weight loss medication?The Reality of CardiodiabesityDeanna Critchley the AVP of Cigna led the sessionDeanna Critchley, area vice president at Cigna, provided insight into the reality of cardiodiabesity management at From Day One’s NYC half-day benefits conference in a thought leadership spotlight.There are several factors to consider when adding FDA-approved weight loss medications such as Wogovy into care benefits. While GLP-1s are automatically covered to treat Type 2 diabetes, weight loss drugs such as Wogovy are considered add-ons or buy-ups, which affects claims costs.Currently, there is no evidence suggesting a decrease in cancer, stroke, heart attack, or other emergency room visits by taking these prescriptions alone.Secondly, drugs such as Ozempic and Wogovy generally have to be taken for an extended period of time, or even a lifetime. People gain back ⅔ of their weight within two years of stopping.Cigna conducted an internal study and found that 66% of people on weight loss medications stopped taking them within 6 months due to rapid weight loss, social pressure, and significant side effects from taking the drugs.This further presents the risk of employers facing increased medical expenditures without guaranteed positive results. It can become unsustainable to find it as pharmacy claims rise. “That’s where we’re still looking at the longevity of this to see if it’s worth you as an employer covering these drugs if they’re not even going to continue taking it.”But if employees are more likely to choose a job that covers weight loss medications, companies face undeniable pressure. “You have to actually consider your benefit philosophy, how you cover it, and what type of population you have,” Critchley said.“Do you use it as talent acquisition? Are your competitors offering that? Do you offer lifestyle management programs and that’s part of your well-being philosophy?” she asked.The benefits of investing in weight loss supplemental coverage, then, lie in having long-term employee populations, the ability and foresight to invest in long-term cost avoidance, and incentivizing customers to enroll in holistic weight management programs.Utilization Management Is KeyCritchley recommended that employers not yet covering weight loss medications should first confirm with their carriers whether utilization management measures are in place. This safeguard helps ensure that GLP-1 drugs are prescribed only to individuals with diabetes.At Cigna, their utilization program confirms clients with Type 2 Diabetes and asks if they would consider taking Metformin, a more affordable and generic prescription drug similar to Ozempic.Cigna Healthcare has developed several solutions, including RxClaimsConnect, which automates claims processing for clients with documented Type 2 diabetes. For self-funded clients offering weight loss coverage, Cigna provides access to EncircleRX, a program equipped with safeguards to ensure the appropriate individuals qualify. Eligible clients must have a BMI of 30, or 32 with two additional co-morbidities. The program also includes a cost cap or a pricing guarantee.More importantly, it includes required enrollment and ongoing engagement with a lifestyle modification program. Nutritional counseling and exercise programs are required management systems in place. This demonstrates the effectiveness of integrated and holistic healthcare as effective and inclusive care benefits.Editor's note: From Day One thanks our partner, Cigna, for sponsoring this thought leadership spotlight. Stephanie Reed is a freelance news, marketing, and content writer. Much of her work features small business owners throughout diverse industries. She is passionate about promoting small, ethical, and eco-conscious businesses.

Stephanie Reed | November 12, 2024

Conversations: The Currency of the Future

Steve Artnz, CEO of Campfire, poses the question, “what is a conversation to you?” In the digital age, conversations can include verbal communication, texts, phone calls and even interactions with artificial intelligence.During a thought leadership spotlight at From Day One’s October virtual conference, Arntz spoke about the art of conversations to build stronger relationships, productive work environments and inclusive workplaces.Conversations are fundamental to fueling relationships with everyone in your life, but some conversations are harder than others. Arntz presents the audience with a mnemonic to help people focus on the key aspects to a conversation: FLAME for fluid, lively, authentic, meaningful, engaging.Fluidity “creates a mutual understanding and respect,” he said. Liveliness provides the enthusiasm and engagement between people. Authenticity helps build trust and opens up meaningful conversations that strengthen relationships. Engagement is crucial to maintain participation from both sides in the conversation.As conversation tools in the workplace, Arntz focuses on check-ins, asking deep questions and listening generatively.Steve Arntz, CEO of Campfire, led the virtual thought leadership spotlight In a general check-in, you might ask “How are you feeling?” but Arntz suggests posing deeper questions like “What are you feeling? What are your distractions? What are your intentions for our time and space together?” These can serve as more effective starting points for teams to check-in on each other.Starting off with these questions,“will reduce the number of meetings on your calendar” and “increase the path to efficiency in those meetings,” Arntz said.To dive even deeper, ask people why, how and what questions to learn more about their feelings. For example, “why is this situation frustrating you?” or “how does this feeling impact your work right now?” Asking these types of questions will allow the conversation to flow into greater discussions on feelings, thoughts and intentions.Following this tool, Arntz provides four ways to engage in conversations fully: download, which is confirming that people are heard; facts, listening with an open mind and asking questions to gather information; empathy, connecting with experiences and emotions; and creation, which is the act of creating something new together.“When you practice this generative listening with intent to learn from the unknown, to connect with the broader, bigger thing, then you can really build on each other’s insights and create new insights,” Arntz said.Although these questions and conversations can provide deeper connections between managers and employees, an existing feeling of distrust can also hold people back from being honest and vulnerable. Especially when companies are aiming for efficiency and profitability, actions can seem more transactional.“If my manager were to ask me, ‘what are you feeling?’ I might have a hard time really trusting that person actually cares and sometimes it’s because I don’t trust that the organization cares,” said Artnz. “So the manager and organization start to become conflated and they inherit each other’s weaknesses and strengths.”In these cases, it can be helpful to see vulnerability from the manager first. Prior to opening up the conversation on what employees may be feeling, start off by sharing your own thoughts and emotions, creating an environment that welcomes and encourages others to share.These skills can be utilized when holding conversations with people, but with the increased use of AI, it’s important to remember that communicating with robots is much different. “Artificial intelligence does not equal conversational intelligence,” said Arntz.Conversations with AI focus on logic, accuracy and efficiency, lacking the emotion and authenticity that takes place in human interactions. But this is not to say that technology is not useful in bettering conversations.“It’s not robots or humans. It’s robots and humans together. I see a world in which we can stop tripping on each other as much as we are today,” said Arntz. “As we get assistance from these robots…we can have much more impactful and meaningful and creative relationships and that’s a world that I'm really excited about helping to shape and create.”Arntz encourages people to use the conversational tools he discussed in addition to interactions with both robots and humans. Blending the two can help expand their insight on how to engage, create partnerships, and take action with others.Editor's note: From Day One thanks our partner, Campfire, for sponsoring this thought leadership spotlight. Jennifer Yoshikoshi is a local news and education reporter based in the San Francisco Bay Area.

Jennifer Yoshikoshi | November 08, 2024