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Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Partnering to reduce absenteeism

30 October 2009 Dr James Arens, Clinical Operations Executive, Pro Sano Medical Scheme
Dr James Arens, Clinical Operations Executive, Pro Sano Medical Scheme

Dr James Arens, Clinical Operations Executive, Pro Sano Medical Scheme

There is a pressing need for meaningful partnerships between corporate and medical schemes to boost wellness and reduce absenteeism.

There are well-documented cases, both in South Africa and internationally, that demonstrate the positive impact of corporate health and wellness programmes in reducing the risk factors and consequences of lifestyle diseases.

Corporate wellness and disease management are terms frequently used by corporate and medical schemes, respectively. Corporate wellness purports to seek to improve the financial, mental, social and physical wellbeing of the employee, whilst medical schemes seek to intervene proactively to address and contain risk factors of lifestyle diseases such as cholesterol, hypertension and diabetes.

Challenges

The following may be some of the reasons hampering a successful partnership between corporates and medical schemes:

1. Mal-aligned objectives

The Occupational Health and Safety Act compels employers to create an environment safe from physical, chemical and other external harm, but places no obligation on the employer to intervene in the prevention of lifestyle diseases. Medical schemes are governed by the Medical Schemes Act, which outlines that a medical scheme must make provision for the obtaining of any relevant health service and, where applicable, of rendering the relevant health service, in addition to being a health insurance. Organisations, therefore, may hope to benefit from schemes’ disease-management programmes to contain levels of absenteeism, while medical schemes hope to latch onto the organisations’ infrastructures to execute their disease-management programmes.


2. Unequal partnerships

Organisations may dictate how they envisage medical schemes’ involvement in corporate wellness programmes, which may even be linked to whether a scheme will be retained as the medical scheme of choice. This may lead to schemes feeling coerced into programmes they do not co-own.

3. Who pays for the programmes?

Corporate health and wellness programmes, when implemented properly, can be costly. A typical example is Wellness Days that companies host with their associated health-promotion programmes. Organisations may demand that schemes pay the cost of such activities, whether or not these are part of the scheme’s benefit structure and schemes often feel obliged to participate.

4. Lack of information sharing

Employee confidentially needs to be maintained at all times. The opportunity to identify and act on individual cases is often lost under circumstances of confidentiality, as relevant information cannot be transferred to the scheme disease management unit without the employee returning for the results and consenting to the transfer of information. This prohibits the scheme from proactively contacting employees and registering them on the programmes.

So what’s the solution?

The state sector will benefit enormously from successful corporate health and wellness outcomes as not all employees belong to medical schemes. Government needs to overtly encourage corporate wellness efforts and partnerships to an extent that good performance and healthy lifestyle choices are incentivised. Unions are also well placed to be the custodians of corporate health and wellness programmes.

The Medical Research Council report on the Burden of Disease in South Africa suggests that out of the 17 risk factors, unsafe sex, interpersonal violence, alcohol, tobacco smoking, excess body weight, high blood pressure, diabetes and high cholesterol are among the top ten risk factors adding to the disease burden in this country. It is therefore imperative that corporate wellness activities are structured and coordinated so that national priorities can be adequately addressed.

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