Don't overlook indirect costs of presenteeism

Assess mental health

What would you say are the two strongest drivers of lost productivity due to a health-related problem at your workplace? According to Lisa Jing, program manager of integrated health at San Jose, CA-based Cisco Systems, these are depression and anxiety.

"Indirect health costs due to presenteeism are greater than direct costs due to medical and pharmacy claims," says Jing, who says that this conclusion is based on both industry data and Cisco-specific data for the past four years.

"We know that 25% of our San Jose-based workforce is co-morbid, with five or more medical conditions," says Jing. "Mental health is usually one or more of the co-morbid conditions."

Regardless, however, most companies focus on direct medical costs such as claims, pharmacy, and disability due to chronic diseases like cancer, heart disease, and musculoskeletal problems, says Jing. Indirect costs, such as presenteeism among the larger population, are overlooked.

"Mental health issues, depression and anxiety in particular, often occur in combination with medical conditions," says Jing.

Jing says that the mental health issue must be treated along with the medical condition to obtain a sustained positive outcome. This is true regardless of whether the mental health issue is the presenting issue or co-morbid with a medical condition.

As an occupational health professional, you can play a critical role in this. "Conduct thorough assessments to detect mental health factors," says Jing. "Coordinate an integrated approach to treatment which considers the whole person."

Jing says that Cisco has "excellent utilization" of its Employee Assistance Program (EAP). This provides a wide range of confidential psychological and emotional support resources to employees and members of their immediate households, at no charge to the employee.

At the LifeConnections Health Center, Cisco's onsite medical facility in San Jose, physicians and various allied health professionals representing a wide range of clinical services provide holistic and integrated treatment for employees and their dependents. These include health coaches, condition management nurses, EAP counselors, chiropractors, acupuncturists, physical therapists, and pharmacists. "Cisco also offers generous mental health and substance abuse coverage through the behavioral health component of the medical plan," says Jing.

Jing says that the company's onsite health center, web-based health enhancement programs, health coaching, condition management, resilience and stress management programming, and EAP all contribute to health improvement, better quality of life, increased productivity, and lower costs for employees and the company.

"Many companies are unaware of the indirect costs because they don't know how to measure these," says Jing. "So, there is a great opportunity to demonstrate significantly more cost savings and ROI."