Driving Toward a Better View of Your Risks

Friday, November 15, 2019

The Federal Motor Carrier Safety Administration and Federal Railroad Administration backed off plans that would have required truckers and train operators with safety sensitive duties to be tested for obstructive sleep apnea. The move came as a surprise because reducing fatigue-related accidents is on the National Transportation Safety Board’s 10 Most Wanted List.

Image Source: NTSB’s 10 Most Wanted:
https://www.ntsb.gov/safety/mwl/Pages/default.aspx

The agencies defended their decision, saying railroad and trucking companies should decide whether to test their employees. With nearly 8.9 million people working in the trucking industry—3.5 million are driving trucks (American Trucking Association)—testing would have a big impact on employer healthcare spend. Costs range from $100-500 for home testing, or up to $1500 for a study at a hospital or sleep center. (American Sleep Association). But not testing for sleep apnea can be far more costly for all employers, not just those in the transportation industry.

Who is at Risk for Sleep Apnea?

Reduce fatigue-related accidents

Sleep apnea is more common in men, especially African-American and Hispanic males. Other risk factors include being over age 40 and being overweight, but sleep apnea can strike anyone at any age.

Risks of Sleep Apnea

More than 18 million Americans suffer from sleep apnea (National Sleep Foundation). A person with sleep apnea stops breathing multiple times while sleeping, but often isn’t aware of it. Of the three types of sleep apnea, obstructive sleep apnea is the most common.

Without treatment, sleep apnea can have serious and life-shortening consequences, such as:

  • High blood pressure and other cardiovascular disease
  • Heart disease
  • Stroke
  • Memory problems
  • Job impairment
  • Motor vehicle accidents caused by falling asleep at the wheel
  • Diabetes
  • Weight gain
  • Depression
  • Headaches
  • Impotence

Why Should Employers Care?

With the serious impact sleep apnea has on overall health, all employers may be able to reduce healthcare costs and improve employee health and productivity by seeing that employees with sleep apnea are treated. When medically necessary, most insurance companies cover testing.

You should educate employees about sleep apnea, and take a closer look at those who have it to make sure they’re adhering to their treatment plans. The dangers of not looking at employees’ health holistically can increase your overall risk.

The Need for Integrated Risk Management

A $50 million settlement by a trucking company and its insurer over an accident involving 6 fatalities, including the driver, is causing underwriters to take a new view on risk management. The trucking company switched to a high deductible health plan. This put a strain on the driver’s ability to feed and house his family and pay for needed medications to treat sleep apnea, diabetes, and obesity, all while still working and driving.

The judge ruled that the:

  • Company’s move to a high deductible plan with its financial burden put its drivers and the American public in harm’s way
  • Company was negligent by not fully understanding how its employees’ health impacted their ability to safely perform their jobs.

The Benefits of Integrated Risk Management

As an employer or benefits administrator, you’re putting yourself at considerable risk by making healthcare decisions in a vacuum. If you’re looking only at controlling your costs, you could wind up paying a large settlement.

You need to get an integrated view across all your programs. As I wrote in a previous post, if you aren’t looking at pharmacy costs paid through medical as well as your Rx benefit, you don’t have a full view of the amount you and your employees are spending on prescription drugs. Without data, you don’t know if employees are taking their medications as prescribed or the impact of depression on your population.

You also can’t identify:

  • Program correlations, such as the impact that switching to a high deductible health plan has on your workers’ compensation or disability costs.
  • The impact of health and absenteeism on productivity

You don’t make decisions with incomplete data in other areas of your company. You shouldn’t make benefit program decisions without all the data either. It could put you and your employees at serious risk.

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