Presenteeism is the fifth type of health-related cost that employers commonly experience. In this recent series of posts we have looked at health plan costs, sick leave absenteeism costs, workers’ compensation costs, disability insurance costs and now presenteeism cost. This is a newer concern for employers. Research has demonstrated that when employees decide to come to work when they have an underlying health problem (Like a cold, allergies, migraines, indigestion, muscle pain, etc.) they are not as productive on the whole. The amount of productivity loss can be measured by using specific questions on survey instruments such as HRAs or annual evaluation surveys. This loss of productivity can be reduced by wellness programs. It’s high-time more wellness program managers like you take credit!
Presenteeism: the problem
First off, here are the most typical health problems that create presenteeism losses for employers identified in the scientific literature:
Anxiety, Arthritis, Bladder problems, Chills, Chronic back pain, Chronic fatigue, Chronic neck pain, Chronic obstructive pulmonary disease, Congestive heart failure, Constipation, Coronary heart disease, Cough, Depression, Diabetes, Diarrhea, Fever, Fibromyalgia, Hay fever, Heartburn, High blood pressure, High cholesterol, Hopelessness, Hypertension, Indigestion, Irritable bowel syndrome, Low energy, Migraine headaches, Muscle soreness, Nausea, Nervousness, Obesity, Osteoporosis, Other cancer, Other chronic pain, Panic attack, Psoriasis, Refux disease, Restless, Rheumatism, Runny nose, Seasonal allergies, Skin cancer, Sleep disorders, Sore throat, Stomach ulcer, Substance abuse, Tension headaches, Urinary problems, Vertigo, and Watery eyes
According to the National Health Survey the average working adult American experiences an average of two medical symptoms a month or twenty-four a year. The majority of the time we choose to go to work rather than stay at home. Presenteeism losses are therefore very common for all employees and employers. Studies have found that presenteeism effects more than 8% of the total productivity of a work force! That means that in most organizations 8% of the total compensation cost pays workers for non-productive time. Total compensation or salary, wage and benefit costs are usually the largest costs for most organizations across industries. Another way to think about it: presenteeism takes away economic value that amounts to 2 to 4 times what employers spent on employee health benefit plans! If wellness programs can reduce the frequency and severity of many of the common self-limiting health problems employees commonly take to work, it can have a significant impact on the productivity a work force. We saved a heavy-hitter for last!
Ways wellness reduces presenteeism losses
Wellness programs can reduce presenteeism loss in several different ways depending on the design of the wellness program:
- Reducing health risks: The first way is by reducing health risks in individuals and collectively in the population at large which then reduces the occurrence of those common medical symptoms so that less productivity losses take place.
- Medical self-care training: The second major way is to provide medical self-care training to employees to help them make better decisions about preventing and treating those all-to-common medical problems. This training can be carried out in person or through Learning Management Systems (LMS). It can also mean helping people access medical self-care resources online such as WebMD’s public portal at www.webmd.com.
- Self-care resources: The third major way is to provide online resources at work and possibly onsite resources to help employees minimize the adverse symptoms associate with the various common health problems. For example, some companies provide a “Not Feeling Good?” tab on their Intranet home page site. This also may include providing access to specific Over-the-Counter (OTC) and prescription pharmaceuticals that are designed to minimize the symptoms associated with those specific health problems through an occupational health unit or onsite primary care center.
But if you want to address presenteeism as a possible area of economic return for your wellness program you have to have a credible method for measuring presenteeism losses and the ability to track it over time. There are a couple of ways to do this.
First you can use one of the more valid standardized instruments for measuring presenteeism such as the Work Limitations Questionnaire (WLQ) or Stanford Presenteeism Scale (SPS). These survey instruments are multi-question and can be used in a random sampling method with program participants and non-participants as well as prior to the introduction of the wellness program and at regular intervals afterward. They provide a quantitative estimate of the productivity loss that can be converted into monetary values. This approach takes some effort but does provide a valid measurement of productivity loss.
Second, a global presenteeism question can be added to your HRA or annual wellness program evaluation survey. This question would read something like this:
“In the last month that you have been at work about how much of your work productivity has been adversely affected by any of the following health problems? Please estimate the approximate percentage of your work productivity reduced by any of the identified health problems. _____.__ % (You can use the above box with the various health conditions)
Third, if you have a website that provides advice for dealing with the various common health problems you can have a follow-up survey mechanism that asks users to estimate the effect of the help they received on the users work productivity which can them be used to monetize the value of the wellness program’s intervention.
As with the other measurement methods we have discussed there are lots of ways to strengthen or weaken the validity and utility of the findings from your evaluation. Also this approach doesn’t necessarily address the pain, discomfort, disability, work and family disruption, quality of life effects of fewer injured or ill employees due to healthier lifestyles brought about by the wellness program, but you can certainly mention it.
Presenteeism isn’t something most executives spend a lot of time thinking about. If you are going to communicate the presenteeism benefits of your program to executives, you probably will have to spend significant airtime explaining the concept to them.
Remember: always make your methods for estimating savings transparent so if critics have concerns they can be challenged to come up with a better approach.
Check out our wellness economics series courses on measuring the impact of wellness on presenteeism costs to go deeper on this topic.