What role do employers play in the post-pandemic era?

Over a year into the pandemic and COVID-19 continues to present challenges to businesses and employers. Even more than a benefits issue, it is a business continuity issue that employers are trying to manage.

Illness, absences and reduced employee morale are concrete threats to operations and critical business functions, regardless of whether your employees are able to work remotely, work in person, or work at all.

Related: Rethinking health benefit packages following a global pandemic

Meeting these challenges and ensuring employee safety is a charge that goes beyond HR departments to executives and senior leadership. It is a call to action on behalf of employees and communities that will also benefit your company financially and help ensure operations and core functions.

Within the difficulties of the pandemic, employers have a tremendous opportunity to further positive changes in telehealth availability, mental health care, and health care disparities.

There are three core actions senior leadership at every business level should enact: Design and execute a back-to-work strategy, advocate for mental health and primary care, and address health inequities within your employee population.

It is time for businesses to arm themselves for the next normal. Here’s how.

Build a back-to-work strategy

Whether your business is re-opening, remaining open, or transitioning back to in-person employment, you need a comprehensive back-to-work plan.

At this time, it is unclear whether COVID-19 will go away completely or become endemic, meaning that it will come and go throughout the year like the flu. This is not to say that COVID-19 is like the flu, but because we can learn from other endemic models, we know that mass vaccination will drastically reduce its harm, downgrading deaths to illnesses and reducing health care costs.

The average annual cost of seasonal influenza in the United States is $11.2 billion, according to a study published in the journal Vaccine. That includes illnesses, provider visits, hospitalizations, deaths, and 20.1 million days of lost productivity.

The Centers for Disease Control estimates that 38 million Americans had the flu in the 2019-2020 influenza season. Four hundred thousand people were hospitalized and 22,000 people died.

But because of flu vaccinations, 7.52 million people didn’t get the flu, according to CDC estimates. More than 100,000 people didn’t go to the hospital. And 6,300 people didn’t die.

While vaccinations are likely to reduce hospitalizations and deaths from COVID-19, an endemic virus would remain a threat to operations because of absences, operational interruptions, and productivity losses.

Accolade, which provides personalized, technology-enabled solutions for better health care outcomes, has developed a comprehensive guide to creating return-to-work plans, published recently in the New England Journal of Medicine. In coordination with a global manufacturing company, Accolade created actionable plans that work — ensuring employees safety and well-being and cost-savings for the employer.

A critical factor is employing outside clinical assistance. Keeping your employees safe and updated on protocols, providing triage on potential COVID-19 exposure and condition management, as well as contact tracing and health verifications are all necessary for an effective plan.

But that is a large burden to place on existing employees or HR departments, especially in a time when personnel may already be strained. A single external partner to manage the process is ideal, though an internal team that manages multiple external partners is also viable.

Trust from employees is crucial. The involvement of external clinical experts is essential to building that trust. Communication with your employees and support from your executives are other key factors.

Staying well at work: Expand access to mental health and primary care

The World Health Organization estimated that anxiety and depression cost the global economy $1 trillion annually. That was before COVID-19.

Americans’ mental health has since plummeted because of the pandemic. More than 95% of people reported that COVID-19 negatively impacted their stress levels, according to a report on workplace attitudes toward mental health released by Ginger, the leader in on-demand mental health care.

Perhaps more telling, 59% of people cried at work, including half of men surveyed and 70% of women, according to the same survey.

Fortunately, mental health care is more accessible than ever, in large part due to virtual care.

During COVID-19, virtual health care advanced dramatically. Almost half (46%) of US consumers used telehealth in the first quarter of 2020, up from only 11% in 2019, according to a McKinsey COVID-19 consumer survey. Additionally, 74% of people reported high satisfaction with virtual care and 76% indicated interesting in future virtual care, according to later McKinsey surveys.

Although many people expect some virtual care to revert to in-person care after the pandemic, most experts agree that telehealth is here to stay.

Virtual care could be equally important in primary care. Today, one in four American adults don’t have primary care providers. Challenges abound, including the logistical barriers of getting an appointment and then getting to the appointment. Many without primary providers must wait months for a checkup and not everyone is able to take time off work for the appointment. Virtual care can remove barriers with prompt appointments and an hour off instead of a whole afternoon or day.

While virtual care does not work for everyone or every condition, it can help close the loop for a significant portion of your employee population.

Employers can take advantage of this shift by offering comprehensive virtual primary care and mental health services. Savings are both immediate and long-term. An employee with high overall mental and physical health is more productive, less likely to miss work, and, with early diagnoses and interventions, can avoid more serious and more expensive conditions in the future.

Execution of a comprehensive telehealth benefits plan is not one size fits all. Companies may need different vendors for difference types of care, such as urgent, primary, and mental health services.

At Accolade, we partnered with Ginger to create a new Mental Health Integrated Care solution that destigmatizes mental health needs while making it easier for members to get access to best-in-class telehealth services directed specifically at mental health issues.

Addressing disparities in health care

In COVID-19’s wake, public awareness of the inequalities in health care has increased. Communities of color have been disproportionately effected by the pandemic, further exposing existing gaps in available services. Disparities exist across racial and ethnic lines, financial situations, geography (rural areas versus urban areas), disabilities, and age.

While employers can’t fix every systemic problem, such as institutional racism, many changes are within reach.

From a business perspective, it is essential as well as practical to make sure that all of your employees have equal access to excellent benefits. To do this, companies need to accept that there is problem, and then embrace the solution of personalized health care.

Employers can address disparities by first understanding their employee populations with data. If there is an outlier group, ask why. One instance could be unexpected absences. You may learn that there is a root cause, such as childcare expenses, for which there are available solutions. Services such as emergency daycare add tremendous value from a continuity standpoint, as well as in employee satisfaction.

Equally important is understanding the individual contexts of your employees and their families. Research has shown that understanding the contextual factors of a person’s life and incorporating that information into care plans leads to better clinical outcomes and significant savings.

In a study on contextual care out of the University of Illinois at Chicago, Dr. Saul Weiner and colleagues demonstrated a $25.2 million savings in avoided hospitalizations with an intervention that cost less than $340,000.

At Accolade, we have developed the LEARN2 model to operationalize contextual care for our clients and members in order to better uncover contextual factors and potential barriers to care, such as existing health issues, financial challenges, professional responsibilities, and family situations. Our Health Assistants and clinicians are deeply trained on use of this behavioral influence model to engage with and listen to our members, and contextual care is purpose built into our technology to enhance the identification of contextual barriers to care. .

Armed with personalized profiles, we are able to advise on the most appropriate treatments and the highest quality care for individuals and their families.

COVID-19 has shown us how impactful small changes can be. The benefit of an afternoon off to get a vaccine has an impact in measurable terms — for example, reduced sick leave — and in immeasurable ways: the shuddering sigh of relief when a member knows that they will be safe.

While we can hope that the COVID-19 pandemic will come to a close, companies need to prepare for all future possibilities. No matter what comes, there will be a new normal — a next normal — and employers are in a unique position to help make that a better normal.

Embracing these three solutions will make your company more resilient to challenges of all kinds, able to continue functioning in an endemic situation, and reduce health care costs. With a back-to-work plan, companies can keep their employees safe. With increased utilization of primary and mental health care, companies can help their employees be healthier.

And by embracing the battle against systemic inequalities, we can all effect positive change.

Shantanu Nundy, MD, MBA, is a primary care physician, technologist, and executive who serves as Chief Medical Officer for Accolade, which delivers personalized navigation and population health services to companies that cover over 2 million working Americans. In addition, he currently advises the World Bank Group on COVID-19 care and vaccine delivery and practices primary care in the greater Washington, DC, area. He is also the author of “Care After Covid: What the Pandemic Revealed is Broken in Healthcare and How to Reinvent It.”