Serious health issues can affect anyone in our society, and health care workers are no exception. Research finds that more than half are overweight or obese, many suffer from lower back pain, and mental health challenges such as depression, stress, burnout, and substance use disorders are not uncommon. In addition, health care workers are among employees in the U.S. workforce who have the lowest levels of vitality.

“The health and vitality of doctors, nurses, and other healthcare workers directly impact their ability to care for their patients,” said Kim Funderburk, president of the government, education, and health systems business at Cigna Healthcare. “These professionals are the lifeblood of health care, so supporting their overall well-being is essential to advancing the health and vitality of everyone.”

The health status of health care workers was no surprise to Allison Hofmann, vice president of the health systems division at Cigna Healthcare. She has been supporting health care employees for nearly 30 years and has witnessed firsthand the recent changes to the health care service industry.

Since the COVID-19 pandemic, there has been widespread financial instability in health systems across the country, Hofmann said, which impacts the work environment. Compounding the issue are severe staffing shortages, which means increased workloads and greater occupational strain. About 100,000 registered nurses left the workforce during the pandemic, and the U.S. health care system is expected to be short nearly 200,000 nurses by 2031. The number of primary care physicians per person has decreased steadily for more than a decade, and fewer students are entering the medical fields. “These are challenges that we are going to face for years to come,” Hofmann said.

These challenges are driving an increase in health issues among health care workers, especially behavioral health issues. “Today, many health care workers are serving more patients, and there doesn’t seem to be any relief in sight,” Hofmann said.

She also noted that many hospitals used wartime protocols for triaging and treating patients during the pandemic. “Imagine the post-traumatic stress that came from that,” she said. “I don’t even think we’ve seen the full picture of mental health and substance abuse issues health care workers are facing, but the numbers we do see are worrisome.”

Unique solutions for unique employers

The employees of hospitals and health systems are in a unique situation, Hofmann said. “In addition to having high rates of certain physical and mental health conditions, health care workers are the only employees who can be both a member and a care provider in the health plan, which means they have a very different relationship with their health care benefits than workers in other industries.”

Because health systems are so unique, Cigna Healthcare established its health systems division to offer specialized solutions around client-specific networks, the call center experience, informatics, medical management programs, and other capabilities – all tailored to the specific needs of health systems and their workforces.

Cigna Healthcare offers customized benefit solutions for health care workers by working closely with each hospital and health system client, analyzing workforce health data to identify key areas of concern, and considering the services and benefits employees want.

Hofmann noted that the most common benefits health care employees want include fertility benefits and coverage of GLP-1 agonists for weight loss, both of which Cigna Healthcare can provide. Clients, meanwhile, want to ensure their employees can connect with their health plan in a way that is most convenient to them. “Health workers are available 24/7/365, so are we,” Hofmann said. “These employees work shifts that cover any hour of the day or night, so we make sure that they can call us anytime and connect to a live person for consultation on any health issue.” Hofmann added that Cigna Healthcare is one of the few health plans that offer this service.

In addition, Cigna Healthcare offers high-touch customer service through a dedicated team of specially trained advocates who help health care workers understand their health benefits and connect them to care. For larger, multi-site facilities, Cigna Healthcare assigns a full-time service coordinator who works on-site to provide health care workers with a face-to-face concierge experience, from answering any questions about their benefits and coverage to personally educating staff teams about various aspects of their health plan. Hofmann notes that these service coordinators also play a critical role for certain staff whose schedule makes it difficult to attend a benefits fair or open enrollment event, such as those who work in the emergency room and recovery areas. “Our advocates and on-site coordinators are specially trained to understand the needs of clinicians and other health care workers, and to help them understand the best benefit and service options that can meet their individual needs,” Hofmann said.
 

RELATED: Becker's Healthcare Podcast features a conversation with Allison Hofmann, who talks about the unique ways Cigna Healthcare partners with health systems to support health care workers.

Joining forces to manage care

One of the more innovative custom solutions developed by Cigna Healthcare in partnership with larger hospital and medical center clients is a shared medical management model, in which the clients leverage their own expertise and specialized programs to help their employees and covered family members. “We work together as a team to manage care, with the client’s own nurses and specialists handling some aspect of the employee’s treatment journey,” Hofmann said.

For example, a hospital client developed an effective diabetes program in-house, and the shared model enables the hospital to use that program to care for employees diagnosed with diabetes. The hospital provides progress data to Cigna Healthcare, which in turn shares information and insights about other aspects of the employee’s health and coordinates any additional medical or behavioral treatment needed to ensure the employee receives holistic care. “It’s a great partnership, and we tend to see very high domestic utilization of services in these shared programs, because these workers recognize that they can receive the best care when they go to the institutions that they work for,” Hofmann said. She added that every interaction with a health system employee is an opportunity for Cigna Healthcare to inform and educate them about available services and programs that can give them the most benefit for their particular situation.

Forming a larger health system community

In addition to enabling clients to collaborate in their employees’ medical management, Cigna Healthcare offers opportunities for these clients to share their insights and expertise on ways to better address workforce issues and enhance care programs and services.

“Essentially, when a hospital or health system becomes a Cigna Healthcare client, they become part of a bigger community,” Hofmann said.

Cigna Healthcare hosts virtual “health system huddles” throughout the year, in which health industry experts share their perspective on workforce topics that are top of mind for hospital and health system clients, she said. In addition, Cigna Healthcare convenes regular “community webinars” in which these clients share their experiences implementing and running successful employee wellness programs, including best practices and tips for boosting engagement and overcoming challenges. “These venues offer a safe environment for our clients to connect with each other and share best practices,” Hofmann said. “It’s amazing to see our clients treat each other not as competitors, but as colleagues that can learn from each other.”

Addressing behavioral health challenges

For hospitals and health systems, employee data illuminates the importance of supporting mental health to enhance physical health. For example, one of Cigna Healthcare’s hospital clients learned that 92% of its employees diagnosed with a behavioral health condition also had been diagnosed with a serious physical health condition. Another health system reported that its employees with a mental health diagnosis had the highest overall medical claims costs. “When we effectively enable health care workers to improve and maintain their mental health, we can make a positive impact on their overall health, as well as on the financial health of the organization,” Hofmann said.

She added that Evernorth, the health services division of The Cigna Group, which powers Cigna Healthcare’s behavioral solutions, had nearly doubled the number of contracted providers in its nationwide network over the past four years to ensure greater accessibility to specialized care. The network also identifies behavioral health practitioners who have experience and expertise in treating clinical workers, who can find these practitioners easily through an online search. In addition, health care employees in need of behavioral services can call Cigna Healthcare to connect to a live behavioral health clinician 24/7/365 for immediate guidance on their situation and the next steps to care.

Hofmann said that hospital and health system employers strongly support behavioral health, and they have regular discussions regarding the services and resources Cigna Healthcare can offer. “It’s wonderful to see how focused they are in providing robust behavioral health programs for their employees,” she said.

While there can be a stigma around doctors and nurses utilizing mental health services, the behavioral health network provides ample opportunity for clinicians who would rather see a specialist outside of their organization. “We have actually seen a big uptick in behavioral health care usage among health care workers recently, which is a good sign that stigma is reducing,” Hofmann said.

In addition to care services, Hofmann shared other innovative ways hospitals and health systems are helping their employees maintain their emotional well-being. “Many hospitals have set up quiet rooms on floors where there is a lot of patient activity,” she said. These designated rooms are mini-suites that offer employees the opportunity to relax in a calming, spa-like setting with low lighting and soft music.

Some hospitals have also established “employee ambassadors” throughout their organization. “They have trained one employee in each department, and it’s not necessarily a manager, to essentially check on everyone else in the department by asking very simple things like: ‘How are you doing today? How are you feeling? Did you make sure to take your break? Did you have lunch? Can I get you a water?’” she said. “Just that simple act of making people feel acknowledged, recognized, and cared for has paid huge dividends for these organizations, especially in terms of employee morale.” Hofmann added that the ambassadors can also direct department employees to on-site resources and benefit services as needed.

Hofmann noted that the innovation in support services and programs show no signs of stopping.

“There are so many different aspects of hospitals and health systems, and even of health care itself, and they all continue to evolve,” she said. “We continually work with our clients to evolve our solutions and programs to meet the everchanging needs of health care workers, so they will always be in the best condition they can be when they are caring for others. It’s all a part of how we can collectively provide the best experience for our clients, providers and customers.”