US companies consistently report the rising cost of health insurance as a top concern. Indeed, it is the largest employee-related expense, and the cost of health insurance has consistently risen faster than inflation.
Surveys show that large, self-insured employers have adopted various strategies to reduce health care costs (for example, adopting high-deductible health plans) and, more productively, improve the value of health spending (for example, reducing employee cost sharing for high-value services and medications). The vast majority also offer wellness benefits to improve their employees’ health. Nevertheless, many of these efforts have been in vain: As health care costs continue to rise, the most rigorous studies of wellness programs show little effect on health outcomes, and evaluations of individual interventions to improve the value of health spending show no single solution consistently reduces health spending without compromising quality of care or employee health.
Largely absent from the conversation about rising employee health care costs is how company policies contribute to employees’ illnesses and to rising health care costs. Shift work and long work hours (for example, 12-hour shifts) increase employees’ risks of chronic illness, and our work has shown that this ultimately contributes to sizeable excess health care spending for companies. For one US manufacturer employing 2,600 shift workers, such costs were $1.3 million annually. Companies try to ensure workplace safety and prevent immediate injury, consistent with requirements from the US Department of Labor’s Occupational Safety and Health Administration. However, relatively little emphasis has been placed on mitigating the long-term chronic health effects of shift work. (author abstract)