September 29, 2023
This year’s Global Summit brought 90 global benefits leaders and industry partners together on September 12 and 13 in Washington, DC, to share best practices and challenges related to global consistency; health equity; mental health; cost; and communication. With an evolving health care landscape and the unique challenges multinational employers face managing the health and well-being of their employees across many geographies, cultures and contexts, the summit provided a world of opportunities to consider in developing strategies to make an impact across the globe.
Global consistency requires a focus on providing comparable and equitable benefits and experience. To effectively deliver on this approach, employers need to recognize and address local culture, norms and regulations.
Many sessions covered the challenges and opportunities employers face in delivering a truly global benefits strategy. Themes that emerged from conversations included:
- The importance of global inventories and gap analysis: These tools are critical to understanding what employers offer and where.
- The role of data: Data is crucial to springboarding a global effort, which requires employers to push their vendors and brokers to provide relevant and actionable information related to their populations.
- Use of a captive insurance model: This option can jump-start the process of creating consistency by providing better and more timely data as well as flexibility about certain health equity issues related to exclusions and preexisting conditions.
- Understanding local markets and ever-changing regulations: Having a firm grasp on these issues is a necessary though time-consuming requirement in creating a consistent benefits approach.
- Using pilots: They enable employers to test a program, learn and adjust it on a smaller scale, ensuring that there is a pathway for sustainability should the program become permanent.
- The value of enhanced vendor capability: This is necessary to provide better multinational solutions that meet local needs.
- Developing core standards: These are helpful guideposts in creating consistency. Areas employers mentioned include family forming and caregiver leave.
The pandemic highlighted the differences between how care is delivered across the globe and gaps in what many leaders perceive should be covered. Addressing health equity is a multifaceted challenge, and strategic approaches by employers can have profound impacts for employees and their families.
Top areas of discussion included:
- Employee resource groups (ERGs) are key stakeholders in health equity considerations, as they can be leveraged to identify gaps and promote culturally relevant resources and programs to specific employee populations.
- Employers are exploring implementing specific population programs in alignment with organizational priorities, where legally and culturally possible, such as gender-affirming care, menopause support, family-forming benefits and education.
- As with global consistency, a health equity strategy begins with an assessment of the quality and accessibility of care available at the country level; for example, preexisting exclusions and coverage caps.
- The lack of insight into what is covered or not covered at the government level through state-run health systems adds an extra layer of complexity when trying to design consistent and equitable benefits across multiple countries.
- Health equity may be perceived differently by HR and business leaders. As a result, some senior leaders are often unaware of health equity gaps until they move to another country and experience firsthand the standard and availability of care in their new country of residence.
- Having access to data would allow employers to evaluate health behaviors and outcomes to identify disparities.
Mental Health and Emerging Culturally Conscious Strategies
With 12 billion workdays lost globally to mental health, employers continue to prioritize mental health in the workplace. They are looking for ways to reduce stigma and create a culture of belonging that enables a compassionate, caring and kind workplace.
Opportunities for employers to consider include:
- Creating a strategy that includes psychological safety: Psychological safety refers to employees’ ability to show up and express ideas without fear of being ridiculed or shamed. It is the foundation of a supportive workplace, leading to social connectedness and fostering a culture of innovation.
- Providing leader/manager support: Training can help managers identify signs employees are struggling with mental health issues and then provide appropriate interventions. It is important to recognize that managers are employees and sometimes need support as well.
- Recognizing stress signals: Poppy Jaman, OBE, Global CEO, Mindforward Alliance, shared that everyone has a “stress signature” which may be different between work and home. Understanding an individual’s stress signals can help managers and employees identify and prevent burnout as well as help the stressed employee obtain needed support.
- Overcoming stigma: Creating organizational openness to talking about challenges, including leaders sharing their own experiences, goes a long way toward encouraging employees to seek help. In fact, stigma is associated with many health conditions, including mental health, cancer and menopause. The more we talk about these conditions, the more comfortable the conversations become, leading to a sense of belonging and inclusion.
Data, Outcomes, Value and Cost
While discussions on access to data, outcomes, value and cost have been more prevalent in the U.S., there were many discussions on the growing need for elements of this information in developing global strategies.
Actionable takeaways include:
- Where feasible, employers benefit from leveraging a global database to track programs offered and premium spent.
- Many employers are considering implementing a captive that will provide more insight regarding claim data, including top conditions, enabling employers to make decisions for their populations and leveraging any savings for future benefit investments.
- To manage future costs, it is important to set expectations upfront. Inform brokers, consultants and vendors of expectations regarding the type of data and timeliness needed to meet strategic objectives.
- As the array of health care services evolves, employers should assess the sustainability of coverage options globally while balancing the needs of members. This is particularly relevant when new, high-cost cell and gene therapies are introduced into markets.
- Where feasible, focus on “value” in health care. Business Group on Health defines health value as the sum of quality + outcomes + patient experience divided by the cost of care. High-value health care can drive cost savings through reduced duplication of services, increased integration and better competition in global markets.
- Employers can have an impact by asking for what they want. As Sarah Emond, President Elect from the Institute for Clinical and Economic Review stated “Don’t underestimate the power you have to push for policy solutions to this problem.” Outcomes data exists outside of the U.S. as well; for example, the International Consortium for Health Outcomes Measurement (ICHOM) and Global Coalition for Value in Healthcare are making great strides in diabetes care.
Effectively communicating with employees is critical to any benefit strategy. Throughout the summit employers shared approaches that have proven to be effective in helping employees become knowledgeable about the benefit programs available to support them.
Best practices identified include:
- Simplify messaging to employees: Employees receive numerous communications daily. To increase employee engagement, ensure that communications from the benefits team are simple and to the point.
- Ensure cultural competence in messaging: In a global workforce, correct translation from English to the local language is imperative. There are vendors who specialize in translating for local nuances. In addition, leveraging someone in the local country for a review and working with Diversity, Equity, Inclusion and Belonging (DEIB) teammates and ERGs can be beneficial.
- Create peer-to-peer connections: Providing a safe space for employees to share their lived experiences and connect with others who’ve had similar experiences has a tremendous impact on reducing stigma and fear related to job security.
- Foster inclusion and belonging in the workplace: Address topics that have historically not been discussed in the workplace – cancer, menopause, fertility, mental health. These discussions encourage dialogue and learning and enable employees to be their own advocates in receiving the care they need. They are also part of employers’ investment in building and fostering a safe and positive environment. To accelerate comfort with these topics, encourage leaders to openly share their own experiences.
- Develop a strategy to inform employees about local issues: Understanding local regulations can be challenging. Education can help employees navigate the legal, financial and cultural challenges related to receiving benefits in their home country as well as when they cross borders for care.
- Be transparent: In today’s climate of global uncertainty, leaders can take the opportunity to ensure that information is shared – both good and bad – across their employee populations to build trust, safety and security and allow their workforces to better prepare for and adjust to decisions that may directly impact their day-to-day work.
As the role of global benefits leaders continues to grow along with the ever-changing needs of their diverse workforces, a myriad of opportunities exist to deliver meaningful programs to meet those needs. While each employer is at a different stage in its strategic journey, strong governance (assessing current and desired state, identifying gaps in data, partnering across the organization and reiterating expectations with external partners) is paramount in successfully achieving a truly global benefits strategy.