By MARELENE DINES and PATRICK LEARY
National health-care reform is slowly taking shape. While movement toward insurance exchanges, covering new groups and other elements of the historic law may be slow, it's also sure. Unless the U.S. Supreme Court overturns the Affordable Care Act later this week, core provisions will continue to be systematically implemented by states, insurers, hospitals, technology companies and other industry players.
Implementation is slow because it is complicated. This is especially so because it is designed to shift our health system's focus from treating illnesses to preventing them. This will require basic changes in how health-care professionals are trained and compensated. It will even require a recognition of -- and public investment in -- new types of health-care professionals who focus on the prevention of illness and its personal and social costs.
This includes professionals who work to prevent employee absence and disability. Short- and long-term disability, especially that caused or influenced by "behavioral health" issues such as depression or stress, costs employers and governments hundreds of billions of dollars a year.
According to Mercer'sSurvey on the Total Financial Impact of Employee Absences, direct and indirect costs of all categories of absence amount to approximately 35 percent of payroll.Those who become disabled by behavioral health issues are the most extreme examples of a widespread reality of damaging individual behaviors and management systems that result in significant health-care costs.
The tens of thousands who have obtained professional designations in the field of absence and disability management from the Disability Management Employer Coalition and other associations help corporations and other organizations establish comprehensive programs to prevent employee absence and disability.
These programs, which increasingly focus on behavioral health issues such as stress, depression and obesity, necessarily overlap with traditional health-care treatments. Absence management and disability professionals often play as important a role as nurse practitioners do in general practitioners' offices. Both groups help lower costs and improve outcomes, largely by assisting employees and patients in preventing illnesses from reaching the point of hospitalization or even debilitation.
Legal changes in dozens of states have widened the role of nurse practitioners in the health-care system. They can do more and work more independently. Similar changes should be considered for absence and disability management professionals. Policymakers should even consider public support for those who obtain professional designations in this field. Their contributions to preventing disability help lower health-care costs for everyone.That is exactly what our health-care system needs and will increasingly reward -- regardless of what the Supreme Court decides about the Affordable Care Act.
Marlene Dines is Executive Consultant, National Integrated Disability Management at Kaiser Permanente. Patrick Leary is Program Manager, Workers Compensation, Disability and Leaves at Genentech Inc.
June 26, 2012
Copyright 2012© LRP Publications