Group risk insurers have been talking generically about early intervention for years – but now they are increasingly doing so in terms of the return on investment such approaches can bring.
Premier Choice Employee Benefits head of group risk Steve Ellis says: “The great thing I’m seeing is that all insurers are starting to understand the importance of having a solid proposition. It was more talk than action before but now they are actually delivering the goods.
“The more complex cases still need the likes of Unum and Canada Life as they have greater depth of resources but we can now refer a case with confidence to any provider and get a result.”
But while the availability of robust services is one thing, persuading employers to take advantage of them and to integrate them into a broader health and wellbeing strategy is quite another.
Research sponsored by Generali last year found that 89 per cent of senior management teams are expressing a commitment to wellbeing mechanisms such as early intervention but, while managers are prepared to talk the talk, this isn’t necessarily translated into solid investment and a joined-up focus. That research found the two biggest barriers to building a wellbeing strategy are demonstrating a return on investment (ROI), a barrier in 57 per cent of cases and senior management commitment, responsible for 31 per cent of instances of initiatives stalling.
What then can consultants and advisers do to paint a compelling picture to employers of the fiscal value of a powerful early intervention and rehabilitation strategy?
Group Risk Development (Grid) statistics show that 2,989 employees were returned to work before benefit was paid in 2017. This represented 33.1 per cent of all claims submitted – a rise of 6 per cent over 2016.
While Grid does not yet actually offer an industrywide ROI figure it is debatable whether this is in fact a Holy Grail because finance and HR directors are primarily interested in data relevant to their own organisation.
Grid spokesperson Katharine Moxham says: “One size doesn’t fit all, and it’s about people interaction. If the employer engages with the provider then the provider can do some extraordinary things, and the
role of the adviser is to encourage this engagement.”
Sophisticated systems aren’t necessary for producing ROI data. All intermediaries need is knowledge of the sick pay policy, absence data and salary roll and they can then calculate things manually.
In other words, there is nothing to stop advisers performing such calculations themselves for clients if their insurer doesn’t offer the facility, and there can be few excuses for them not doing so. The reality is that, unless you can demonstrate ROI, finance directors and procurement will always find group income protection an easy target to cut back on.
Liaising with employers
Intermediaries should also be looking to make sure employers have the necessary triggers and processes in place to fulfil insurer requirements for early notification.
Zurich head of market management for corporate risk Nick Homer says: “We put in our terms and conditions that we should be notified when employees are off work for four weeks but the issue is that the line manager will never have seen the terms and conditions. However, the intermediary will have seen them and must point out the relevant bits.
“There has been a definite improvement in this respect in the last couple of years but some intermediaries are still better than others. We have a guide explaining our claims process that employers can share with employees but the impression we get is that the majority of intermediaries are still not passing it on or, if they are, not putting sufficient emphasis on it.”
The more switched-on intermediaries are meeting with client HR contacts to explain how the early intervention process works and sending out monthly reminders asking if anyone is off work or causing concern. Some even engage with payroll to find out who is receiving sick pay – thereby safeguarding against HR not passing on their messages – and focus on getting messages across to employees as well as line managers.
Aon head of health management Charles Alberts says: “Often accessing care early on is down to the employee themselves. Training on spotting signs and symptoms of common health issues will get
us on the road, but we also need to make sure employees know about the options for early intervention offered by their employer, how it benefits them, and how to access these.”
It is clearly easier to justify the time spent on such activities with larger clients than smaller ones but even advisers dealing with the tiniest schemes should at least be getting across the message that group income protection should be regarded as an investment in a range of valuable services that need to be capitalised upon rather than as just as an expense.
Early intervention for physio delivers spectacular ROI
With GP referral to NHS physiotherapy taking up to 14 weeks, East and North Hertfordshire NHS Trust teamed up with Physio Med in December 2016 to provide its employees with fast-track treatment access.
The trust’s occupational health service refers any of the 5,500 strong workforce incurring a musculoskeletal disorder to Physio Med, which contacts them for a telephone triage within two to four hours.
Appropriate referrals receive an initial assessment within three days, with acute conditions going through
an advice line and chronic injuries referred directly to face-to-face appointments.
Of the 237 cases progressed by Physio Med in the 12 months to December 2017, only 17 per cent remained off work and there was a reported average pain reduction of 64 per cent.
There was also a reported improvement in productivity and function in real terms of 52 per cent which, when multiplied by the days saved in not waiting to access NHS treatment, delivered
a total estimated saving of £809,536 – equating to an ROI of 18.5:1.
East and North Hertfordshire NHS Trust acting head of health at work Jennifer West says: “The physiotherapy provision is absolutely key and has played an important role in helping us improve both productivity levels and the overall health and wellbeing of staff, as well as helping us meet NHS targets, save money and reduce levels of sickness absence.”