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Sound Minds Make For Sound Business

Employers must become advocates for routine depression screening of their workers.

Like most of you, I’ve worked with all kinds of people in all kinds of employment settings. And like most of you, I fancy myself an amateur psychologist, secretly diagnosing the mental health problems that I think explain some of the counterproductive behavior of my managers, co-workers and subordinates over the years.

I’m a journalist, not a psychologist, psychiatrist, behavioral therapist or social worker. What I think about why people act the way they do has no basis in fact, education, training or experience. That’s why I keep my diagnoses to myself.

But what I do know is some people need help. And given the important role that work environment plays in their lives, employers are in a great position to advocate for routine employee screening for depression. If companies don’t want to do it for humanitarian reasons, they should do it for business reasons.

Let’s look at some numbers, shall we?

  • According to the latest data from the National Center for Health Statistics, 3.5 percent of adults age 18 and older reported in 2015 that they had experienced serious psychological distress during the past 30 days (1.usa.gov/1ULQgHV). That’s the second-highest reported percentage in the past 10 years (see chart).
  • A 2013 Gallup survey of more than 35,000 adults working full time found that 11 percent said they had been diagnosed with depression at some point, and 5.6 percent said they currently were being treated for depression (bit.ly/1qxSmyJ).
  • A study published in 2014 by researchers at the University of South Florida calculated that depression cost employers between $316 to $649 per employee per year in lost productivity, depending on how productivity was measured and the industry of the employer (1.usa.gov/25OfhFS).

I could go on citing other research, but you get the point. Lots of people suffer from depression and some are in your workplace. They’re costing you money in terms of lost productivity through absenteeism and poor work performance.

So what’s a business to do? You could rely on the government. The U.S. Preventive Services Task Force, which establishes the guidelines on what health screenings should be done for which medical conditions on who and when, recommended in January that all adults age 18 or older be screened for depression regardless of risk factors (bit.ly/1PPHX6j).

But the recommendation isn’t mandatory and doesn’t say who should do the screenings, when they should be done or who should pay for them.

You could rely on doctors. But a recent study in the health services journal Health Affairs found that primary care doctors, like family practitioners and internists, screen for depression far less than they do for other chronic medical illnesses such as asthma, congestive heart failure or diabetes (bit.ly/1TaxJ7F). I guess it’s easier to ask a patient whether they’re having difficulty breathing than to ask them whether they’re having trouble focusing at work or having suicidal thoughts.

Ultimately, I think it’s up to the people who pay the bills, and that’s you, the employer. Employers have a few options to promote screening for depression. One way is to provide incentives to doctors through your health plan to regularly screen your employees who come to their offices for care.

Another way is to give incentives to employees directly through your health plan. For example, a separate study in Health Affairs reported that Connecticut successfully used value-based insurance design, or VBID, to encourage state employees to increase their use of preventive health services. The state eliminated co-pays for trips to the doctor to treat chronic medical conditions and for medications used to control chronic medical conditions (bit.ly/1RHyJOB).

Yet another way, as advocated by Harvard Medical School psychiatrist Douglas Jacobs in a piece in the Harvard Business Review, is just offering depression screenings free to employees; the productivity savings from mentally healthy employees will more than cover the cost (bit.ly/1NWagPd).

That’s my diagnosis and treatment plan.

Short Take

The settlement by a Minnesota hospital system is another reminder that businesses that get involved with the health of their employees through workplace wellness programs should stop short of handling the protected health information of their workers. North Memorial Health Care in Robbinsdale agreed to pay about $1.6 million to settle allegations that it violated HIPAA privacy rules by giving access to patients’ medical records to Accretive Health, a billing and collection firm, without having a business associate agreement in place to protect the privacy of the information (1.usa.gov/1VdxurK).

A laptop with the medical records of nearly 10,000 North Memorial patients was stolen from an Accretive Health employee in 2011, according to the settlement. Under the terms of the deal, North Memorial admitted no violation of law but agreed to a corrective action plan. Think about the proprietary business information that is on your employees’ laptops and where those laptops go every day. Now what if any of those laptops had your personal medical information on it? Scary stuff.

Update

Did your company raise prices by 10 percent this year just because you could, after adding to your share of the market for what you do? If you did, then your company behaved just like a hospital that merges with another hospital in a neighboring town or city in the same state. That’s the finding from a newly released scholarly paper from researchers at Northwestern University’s Kellogg School of Management in Evanston, Ill., which studied the impact of “cross-market” hospital mergers on prices for hospital services (bit.ly/1Mhvbm1).

They defined cross-market hospital mergers as those between hospitals in the same state but in different geographic markets. After studying hundreds of hospital mergers that were consummated between 2002 and 2010, they found that hospitals involved in cross-market deals raised their prices 6 percent to 10 percent for the same services. The biggest price increases occurred when the hospitals were located within a 30- to 90-minute drive in the same state, they found. That’s a noteworthy finding because hospitals increasingly are looking to other in-state markets to expand their operations as opportunities to merge with the hospital across the street dry up.

David Burda (twitter.com/@davidrburda, dburda@msp-c.com) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.

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