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The hidden cost of GI issues for employers — beyond medical claims

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Perhaps more than anyone, benefits professionals understand that when employees don't feel their best, they don't perform their best. The last decade has given us incredible progress in helping employees get support they need from benefits, in part thanks to things like the Affordable Care Act's requirement for mental health coverage.

Despite that progress, though, many employees still face wellness issues that hurt their ability to do their best work. One of the most common is GI issues.

In fact, 40% of Americans have GI problems that are painful and debilitating. And while we've gotten much better at addressing mental health matters in the workplace, gut issues are still somewhat taboo.

The good news is that there are solutions out there. To understand why your organization should consider them, let's take a closer look at how GI issues cost employers — even those who don't see GI-related problems in their medical claims.

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How early-stage GI issues hurt employee performance
When GI symptoms (bloating, gas, chronic nausea, chronic constipation, etc.) first show up, the disruption to daily life and work may be small. Maybe workers are Googling their symptoms during the day to understand them better and seek cures.

They may try self-medicating with OTC solutions or dietary changes. They're perhaps a little preoccupied by their discomfort, but it's not having a serious impact on their quality of life or their work performance — yet. 

Over time, that shifts. When symptoms persist or get worse, we start to see ripple effects. Maybe workers start to skip social events because they're not comfortable being away from a bathroom or because they just don't feel well enough to attend. Or else they're exhausted from having pain all the time. As this stage progresses, people tend to feel more isolated.

And while many people feel comfortable commiserating with friends about, say, a sore shoulder, the stigma around GI issues means a lot of them end up suffering in silence. That has a twofold impact: first, you think you're the only one suffering; and second, you don't get social support from your friends.

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From there, the impacts snowball. Isolation contributes to stress and anxiety, which can affect overall well-being and hurt workplace performance. The exact impact is nearly impossible to quantify. But it's safe to assume some portion of your workforce is less focused, less engaged, less productive — and even showing up less often — because of their GI issues. And this is all before anything shows up as medical claims.

Many GI medical claims are "invisible"
Eventually, many people with GI issues seek out medical care, most often starting with their primary care provider. Or maybe they wait until their annual physical to bring it up — which, again, means you're still not seeing any GI-related claims.

But with many GI issues, there's rarely an obvious cause. That means there's no one test to run as there might be with, say, diabetes or cancer. "Digestive health issues" is a huge umbrella that includes everything from ulcerative colitis to Crohn's Disease to irritable bowel syndrome to lactose intolerance — and more.

So the PCP may schedule several diagnostic tests, which your employee must take time off to complete. This is where the claims start to show up. Often, though, those tests are inconclusive, so the PCP refers your employee to a gastroenterologist — whom they have to wait six months to see.

By that visit, your employee feels worse than ever, their performance has suffered, their mental health has worsened, and there's still no path to wellness. Even when GI doctors order specialty tests, results often remain inconclusive: Something is wrong, but nobody knows what.

Aside from the impact on daily life for your employees, the financial cost of this process is significant: The average healthcare cost of individuals with digestive disease is $17,200 annually. Digestive issues are a leading cause of ER admissions; when patients do visit the ER for digestive issues, they're admitted to the hospital in about two-thirds of cases.

The good news: As mentioned above, there are effective ways to deal with GI issues that benefit your employees and your organization as a whole.

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The right interventions can improve quality of life and reduce medical costs
Often, the problem for people suffering GI issues is not necessarily a lack of access to care but rather an ineffective approach to care. When we flip the traditional script and look at health issues gut-first, with registered dietitians collaborating with other care providers on the front line of treatment, we're often able to get results faster.

For example, many people have digestive difficulties because of specific trigger foods. Among our customers, for example, 92% say their biggest ah-ha moment is that their trigger food was something they didn't expect. For one person, it was broccoli. They were trying to eat healthy to feel better — but their daily salads were actually making their symptoms worse.

Another common finding: many people with GERD are prescribed a proton pump inhibitor, but some experts say more than half of those who are prescribed a PPI take it incorrectly

Ready access to subject-matter experts can also help those with a known diagnosis reduce symptoms between physician visits. Patients with ulcerative colitis, for example, can check in on strategies to minimize their symptoms between trips to the doctor.

Of course, these are just examples. The "right" interventions vary from person to person. In my experience, however, effective support must involve the following:

  • Evidence-based clinical pathways that are personalized to the specific needs of each patient.
  • Access to a coordinated care team who can provide guidance and support to people with both undiagnosed symptoms and diagnosed conditions.
  • Easy-to-use tools delivered through a dynamic platform so patients get the right care and the right insights at the right time.

Better outcomes start with better awareness
I started this article noting that GI issues still come with some stigma. But I truly believe that better outcomes for everyone begin with better awareness and more open conversation about how gut health impacts our work and lives. 

I'd also encourage you to go a step further and it with your colleagues to spark conversations. Eventually, these conversations will lead you to solutions that support your employees and improve their quality of life, their productivity and engagement, and the bottom line.

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