employer pandemic 2.0: the four key actions u.s. business

Employer Pandemic 2.0: The four key actions U.S. business leaders should consider to protect their employees’ health

HEALTH SOLUTIONS THOUGHT LEADERSHIP

Although experts predicted SARS-CoV-2 virus would impact American lives for years, there was a collective sigh of relief when vaccines were rolled out in early 2021. Unfortunately, a combination of vaccine hesitancy and new virus variants means more work is needed to manage the ongoing COVID pandemic and keep people safe.

With distrust in both government and the scientific community running high, employers must take a more active role in protecting the health of employees and their communities, even as vaccine mandates begin to take hold in the public and private sectors.

Even if you cannot return employees to the office, you can return them to wellness. The pandemic has resulted in poorer health and health management for many; employees shouldn’t skip their annual exam two years in a row. Now is the time to evaluate current health benefit strategies and plan to re-engage employees to ensure well-being.

Many U.S. businesses have already invested heavily in new health benefits during the pandemic, increasing employee expectations of health system access and convenience. The continued pandemic is transforming “nice to have” benefits into benefits that “need to work well.”

Our research reveals four key actions employers can take to protect their workforce:

Improve workplace safety

Expand remote health care access

Safeguard mental health

Manage health care financesConsequently, employers need to act quickly to provide the right combination of health benefits to keep up with evolving employee needs.

Perhaps the most challenging decisions for employers have been around return to work, and those choices are not getting easier.

THE FOUR KEY ACTIONS U.S. BUSINESS LEADERS SHOULD CONSIDER TO PROTECT THEIR EMPLOYEES’ HEALTH

Tough decisions need to be made about return to work, including the toughest: vaccine mandates

As federal mandates take shape, employers need to focus on:

All companies should consider: Employers should prepare for ad hoc staffing shortages as a result of mandates and testing protocols.

Companies that opt for testing as a substitute to vaccination should:

Those choices were made more complicated with safety protocols around social distancing, testing, and tracking, but until recently, vaccine workplace mandates were rare.

Previously, employers had to decide between

REMOTE IN-PERSON HYBRID

OR OR

AND

That all changed with the full commercial approval of the COVID vaccines and the rise of infection levels. Now businesses and organizations, from health systems to airlines and technology companies, are beginning to mandate vaccinations as a condition of employment or, at least, a condition of entering the in-person worksite. Even before the federal government started taking action with vaccine mandates for federal employees and contractors and new mandate rules for large employers, businesses were already moving toward more mandates. And now, within three weeks of the federal mandate, vaccination mandates at large employers increased 9%.1

KEY TAKEAWAY

Vaccine mandates from U.S. businesses are growing

Source: Fidelity Health Solutions Thought Leadership analysis of U.S. Census Bureau, Small Business Pulse Survey (SBPS)

National average of “small” businesses requiring employees to have proof of COVID-19 vaccination before physically coming to work

FEB APR JUN AUG2.1% 2.3%

4.6%

9.5%

Recordkeeping proof of vaccination, including any allowable exemptions

Some of these may be short-lived but will require preparation to reduce disruption.

Keep a close eye on test availability

Timeliness of test results

Many health care organizations and consumer-facing companies announced mandated vaccinations prior to federal action because they wanted to uphold their reputations for safety and good health.

Brand and reputational risk

This investment is expected to continue into the coming years as virtual health moves from being a “nice to have” benefit to a “must-have.” The pandemic has once again resulted in hurdles for employees to access the health system: Hospitals are cancelling elective procedures and grappling with staffing shortages.

The good news is many studies show high consumer satisfaction with virtual visits. Consumers generally report they would use this type of care again after their first experience. But there is still work to be done to improve the employee experience with virtual health.

Even a small number of challenges for employees can be costly and reduce treatment access for those who need the health system the most. Employers need virtual access to work well for a variety of different employee health needs, from primary care to chronic disease management to specialty visits.


Virtual health benefits are now table stakes; making them work better for your employees is the next bet

76% of employersaccelerated telehealth and virtual health offerings during the pandemic2

Areas of opportunity for employees’virtual health experience

KEY TAKEAWAY

Provide education and communication to ensure they are using the right access point

Reduce health disparities by making sure employees have the technology to support virtual care

Optimize employee care integration by ensuring virtual care records are sent to primary care physicians

Provide real-time feedback options to monitor experiences

To support employees with virtual health benefits and ensure that your investment in digital health benefits is realized:

Virtual health options for employees are now a necessary part of health delivery and need to be optimized for the best consumer experience. While some employers may think providing the benefit equals good access and care, the data reveals this is not always the case.

Appropriate fit of services

Technical challenges to access

Privacy and security

18% of virtual health users disagreed

Approximately 26% of consumers

that they were able to show a provider a physical concern,3 which may point to a lack of education on the type of visits appropriate for virtual health.

Health benefits don’t always equal access, especially when technology is the connection point. Understanding employee access is an important part of a successful user experience.

Educating employees on the privacy and security measures health providers use for virtual visits may ease this distrust.

Source: Fidelity Health Solutions Thought Leadership meta-analysis of consumer virtual health studies

said they encountered a technical issue during their virtual health visit4

73% of consumers said it’s importantthat virtual health visits be private and secure5

16% of consumersprefer office visits because they don’t trust their health information will be secure5

It is no secret the pandemic has caused additional stress for employees. Increased substance abuse, questions of returning to school campuses and workplaces, politicized public health measures, and ongoing uncertainty in the economy all contribute to poor mental health. At the beginning of the pandemic, there was a 21% increase in prescriptions filled per week for antidepressant, anti-anxiety, and anti-insomnia drugs.6

The impact of the pandemic on employees’ lifestyle also makes it more difficult to manage mental health. Nearly a quarter of employees in our survey said their exercise habits and eating choices were worse, and nearly a third said their sleep habits were worse.7 Unfortunately, these trends continue as the pandemic grinds on.

In response to these challenges, many employers have expanded their mental health benefits, but this does not always result in access to care. One reason mental health remains a challenge: There is a shortage of mental health professionals to provide care.


Digital benefits may be the best way to safeguard employees’ mental health

Symptoms of anxiety and depressive disorders are continuing,but they don’t affect all people equally

Source: Fidelity Health Solutions Thought Leadership analysis of CDC National Center for Health Statistics household pulse survey10

Bolstering virtual mental health benefits may help. Consider virtual mental health offerings, including offering free behavioral health telehealth visits or expanding the number of visits available. But be aware that mental health provider shortages can also challenge virtual platforms; therefore, you may also want to consider other digital solutions that expand access, such as apps and digital therapeutics. Recent announcements from insurers indicate more investment and potential access options through virtual platforms for alcohol and substance abuse. These platforms also have the benefit of treating employees virtually, which can be more convenient and less costly than inpatient rehab.9

130 million Americans live in an area with a mental health professional shortage

Almost 6,600 practitioners are neededto fill the gap8

32% of the U.S. population reported symptoms of anxiety and depressive disorders

From August 18 to August 30, 2021, But some groups are disproportionately impacted

TWICE AS LIKELY AS Older

Young

TWICE AS LIKELY AS Cisgender

Transgender

9% MORE LIKELY THAN Whites

Multiracial

MORE THAN TWICE AS LIKELY ASThose without disabilities

Those with disabilities

10% MORE LIKELY THAN Males

Females

21% MORE LIKELY THAN Straight

Gay or lesbian

9% MORE LIKELY THANCollege-educated

Those with less than a college diploma

Our research shows those savvy in both health care and financial decisions make the most of their HSA dollars, report the highest levels of total well-being, and are more likely to be in good mental health.


KEY TAKEAWAY

Lead with empathy. This crisis provides business leaders more opportunity to reduce stigmas around caring for mental health.

Employers should: Employees should:Explore and potentially use a combination of mental health resources, spanning in-person, virtual, app-based, and FDA-approved digital therapeutics to improve cognitive brain function and address mental health needs.

Communicate with employees about available mental health resources, being transparent that the demand for mental health professionals may exceed supply. They should also promote a sense of community to reduce feelings of loneliness and solitude, even if these interactions are virtual.

The pandemic revealed the fragility of the health system, the economy, and our communities and the interconnectedness of these systems. These dependencies are similar for employees. Fidelity research conducted early in the pandemic showed the top three most pressing issues for employees were personal well-being, health status, and short-term finances. When people worry about finances and health simultaneously, the negative results are compounded. Employees reported lower mental health when they were concerned about finances (31%) and health (45%), but when concerned about both, 69% of employees reported mental health issues such as anxiety.11

Connecting the importance of financial and health benefits for employees is one strategy to address

Savvy decision-makers (i.e., those who are knowledgeable and confident) are engaging in the most important health care and savings behaviors and prefer to follow health and financial expert advice.

The strong connection between finances and health means employees need support for both

overall health and well-being during the pandemic.

Now, more than ever, it is imperative to educate employees so that they can confidently make good, productive decisions.

Employees most effectively engaged in both health and finance are doing better across multiple areas of wellness

100

80

60

40

20

0

Percent likely to report high well-being based on level of health care and/or financial engagement

Mental health Physical healthFinancial wellness Workplace wellness

Unengaged

Financially savvyHealth savvyBoth financially and health savvy

Source: Fidelity Health Solutions Thought Leadership analysis of Fidelity Investments survey.12

1 Bloomberg, “Vaccine Mandates Reach 25% of Companies After Biden Order,” September 30, 2021.2 Business Group on Health, 2022 Large Employers’ Health Care Strategy and Plan Design Survey, August 2021, https://www.businessgrouphealth.org/resources/2021-large-employers-health-care-strategy-and-plan-design-survey3 COVID-19 Telehealth Impact Study Work Group, Telehealth Impact: Patient Survey Analysis, https://c19hcc.org/telehealth/patient-survey-Analysis/.4 PwC Health Research Institute, Top Health Industry Issues of 2021, December 2020, https://www.pwc.com/us/en/industries/health-industries/assets/pwc-us-health-top-health-issues-2021.pdf.5 Accelerate Health 2020 Consumer Telehealth survey. HIMSS Accelerate Health 2020 Consumer Telehealth survey 2020. https://www.himss.org/resources/consumer-perspectives-telehealth-and-virtual-healthcare-survey-highlights.6 Express Scripts “America’s State of Mind Report”, April 16, 2020, https://www.express-scripts.com/corporate/americas-state-of-mind-report.7 Fidelity Investments Market Sentiment Study, a nationwide online survey of 3,012 adults, at least 18 years old from which 1,591

respondents qualified as having at least one investment account. The study was fielded April 1-8, 2020, by ENGINE INSIGHTS, an independent research firm not affiliated with Fidelity Investments.

8 Health Resources and Services Administration, Health Professional Shortage Areas (HPSA) dashboard, Shortage Areas (hrsa.gov), https://data.hrsa.gov/topics/health-workforce/shortage-areas.9 Nona Tepper, “Payer investment in virtual substance abuse treatment grows”, Modern Healthcare, September 14, 2021.10 Centers for Disease Control, National Center for Health Statistics, Household Pulse Survey, National Estimates 2020-2021. https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm.11 Fidelity Investments 2020 Health and Financial Preparation During a Crisis, a nationwide online survey of ~1,000 people using a nationally representative sample. This survey was fielded by Ipsos, once April 2. 2020 (with 1,004 respondents) and again on May 11, 2020 (1,002 respondents). Ipsos and Fidelity Investments are not legally affiliated.12 Fidelity Investments Health and Financial Decision-Making Research online survey of 13,060 active Fidelity 401(k) and 403(b) participants from across the United States. The survey was conducted by Health Solutions Thought Leadership January - February 2021.


KEY TAKEAWAY

Revisit your communication strategy around health and financial tools, such as HSAs and emergency savings, to determine what worked and what didn’t.

Ensure communications promote both knowledge and confidence in decision-making.

For plan sponsor use only.

Fidelity Workplace Services LLC, 245 Summer St., Boston, MA 02210

© 2021 FMR LLC. All rights reserved.

997093.1.0

Share other employees’ representative experiences regarding their challenges and successes, as a powerful teaching tool.

Reinforce the value of good financial decisions on overall employee well-being and how these preparations can create the resilience needed to overcome pandemic fatigue.

employer pandemic 2.0: the four key actions u.s. business

Documents