Patient outcomes and productivity: Employers fail to make the connection

Patient-reported outcomes on productivity measurements hold promise but are seldom used in benefit design, according to a recent study.

Because of the shortcomings in useful data, employers and benefits specialists have not made much use of PRO-P measurements. (Photo: Getty)

A new study from the Integrated Benefits Institute (IBI) asks whether a common tool of cancer research, patient-reported outcomes on productivity (PRO-P), could help businesses improve benefit plans. With such patient-reported outcomes, the study said, employers and insurers might learn more about the productivity value of specific interventions.

To explore how PRO-P results are currently being used, researchers did a literature review of 138 cancer studies that included PRO-P measurements, and then asked a panel of benefits specialists whether businesses utilized such measurements, and if not, how they could be incorporated into benefit design.

Related: The cost of poor health: $575B and 1.5B days of productivity annually

“Specialists noted that PRO-P is often used in tandem with medical records by doctors and absence experts to transition employees on leave back to their jobs smoothly. And certainly, PRO-P could be helpful in informing benefits decisions, especially in having individual data on whether employer-sponsored wellness programs improve employees’ productivity to produce a return on investment,” wrote Nicole Nicksic, PhD, MPH, lead researcher in the study. However, she added, although the PRO-P measurements might hold promise for benefits design, so far employers are generally not using such tools.

Looking at PRO-P from cancer patients

The study focused on PRO-P results from cancer studies because improvements in cancer treatment over the years have allowed many cancer survivors to return to work much sooner than in past decades. “The results of the literature review indicated that while many cancer studies have included PRO-P, most did not use instruments best suited to communicating costs to employers,” the study found.

In addition, work productivity in these studies was rarely reported in financial terms, instead tending to focus on quality of life. And the clinical research lacked consistency in terms and measurements of productivity, the study said.

“Very few studies collected PRO-P as part of randomized controlled trials—the typical gold standard of study designs,” the IBI study noted. “When assessed, instruments to assess work productivity used various measures to assess absenteeism and presenteeism, but they rarely monetized any findings and often used variables that were not self-reported.”

A lack of utility for benefits specialists

Because of the shortcomings in useful data, employers and benefits specialists have not made much use of PRO-P measurements, the report concluded. “Specialists revealed that they rarely use or even see information on employee productivity,” Nicksic wrote. “Not surprisingly, employers largely use disability claims and payroll data on sick leave to shape their benefits plans, and therefore did not currently see a strong need for using PRO-P.

“When asking discussants about the literature review findings, they found PRO-P to be important and are receptive to using it; there was, however, a lack of exposure to PRO-P among employers,” the study said. “PRO-P is not commonly used to structure benefits directly; rather, it is typically used by other parties—such as doctors, disability carriers, and pharmacy benefits managers—in combination with objective data to show clinical improvement and to work with ill employees individually to help them return to work.”

The IBI report concludes by suggesting ways to make PRO-P measurements more relevant to employers. The report suggested the following guidelines:

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