The long-term care industry is facing an employment crisis, and providers must go beyond traditional compensation and benefit offerings to solve them.

This industry’s employee demographic operates with unique characteristics that influence their needs and desires from an employer. Employers must consider their employees’ social determinants of health in order to build a customized incentive, compensation and benefit plan that fits their needs.

For example, increasing an employee’s wages or making changes to the organization’s health insurance plan may be among strategies a traditional employer would deploy. However, in long-term care, some employers are increasing their starting wages from $12 to $14 per hour to $15 to $25 per hour for starting caregivers and still not getting applicants for open roles. Others are making significant changes to their health plans and still getting only 40% of their employees to enroll in health insurance. This implies that changes to health insurance aren’t enough.

Today, creativity is necessary to get people in the door to apply for open roles. At a moment in society where employers in many industries are struggling to find employees who can (or are willing to) work a productive number of hours, addressing employees’ social determinants of health can help long-term care employers meet workers where they are.

What are social determinants of health?

This concept says the conditions in the place where people live, learn, work and play affect a wide range of health risks and outcomes. (Source: CDC) The concept is important for employers to understand, as it highlights the areas in which they need to adjust benefits (beyond wages and health insurance) to positively impact their specific employee population, encourage tenure and promote a healthier work environment.

There are generally four modifiable factors impacting the health of employees:

  • Social and economic factors (local cost of living and wage adequacy, societal norms)
  • Health behaviors (likelihood of chronic disease, local diet)
  • Clinical care (quality of care available)
  • Environment (pollution, ergonomics, etc.)

About 40% of the social determinants of health of the general population are weighted to social and economic factors, however, in the long-term care employee population, this number can be as high as 80%. Unfortunately, the weight of these factors is underrated. Most employers are addressing less than 50% of the contributable cost through wellness and healthcare.

How does an insurance advisor help?

When an employer is able to identify the underlying factors affecting their desired employee population in each category listed above, they can take steps to address these factors through their benefits program offerings and position their organization as a preferred workplace in their industry.

Our framework for addressing social determinants of health with our clients looks like this:

  • Purpose – Achieve health equity by addressing health disparities of employees
  • Process – Compile and analyze data/trends to determine a baseline and develop strategies to address the social determinants of health within the employee population
  • Payoff – A healthier, engaged and fulfilled employee population carrying out the employer’s mission

This framework is supported by a solid communication strategy. Innovative insurance advisors help clients by addressing different components of the social determinants of health throughout the year, not just once a year. Example: Generation Z Employees (those under the age of 24), need short, visual modes of communication, whereas employees who may have English as their second language may need further accommodation.

How do employers address social determinants of health with benefits and compensation?

Employees are an employers’ most valued resource. Addressing social determinants of health through two different lenses lets employers identify solutions that resonate with their employee demographic and increase employee wellbeing. This impacts employee engagement and productivity, and boosts talent attraction and retention.

Lens #1: Holistic wellbeing

It’s important to see your employees’ wellbeing as a holistic concept, analyzing wellness through four factors: physical health, emotional health, financial health and social/spiritual health.

The solutions we bring to our clients impact each of these areas in order to generate a holistic result that actually improves the lives of employees, addresses their social determinants of health, and strengthens their alignment with the employers’ mission and values.

Lens #2: Subsidies and caps

Employers also need to understand how government subsidies and caps can influence the number of hours an employee works, the benefits that are important to them, and what changes employers need to make to their benefit and compensation plan to meet employees where they are. Perhaps more importantly, employers need to understand what changes they need to make to support their employees’ career development. What is specifically getting in the way of an employee accepting a promotion or additional hours?

How forward-thinking providers are addressing social determinants of health

As I’ve mentioned, social determinants of health do not have a one-size-fits-all solution. In fact, it’s right there in the name of the concept. The solutions are determined by the different social factors employee populations are experiencing.

My recommendation is to work with an insurance consultant who understands your industry, how it’s changing, and your unique culture – one who can also analyze your population health data and bring forth opportunities for improvement. I have found many providers are dealing with a growing percentage of part time employees who aren’t benefit eligible. Moreover, the majority of benefit eligible employees aren’t taking the health insurance, therefore employers are looking at reallocating the traditional spend for the benefits and compensation package.

Below are a few examples of how providers are supplementing, based on the social determinants of health of their employee population:

Emotional health

  • Employee assistance programs that are coordinated with health, wellness and workers’ compensation (safety) programs
  • Mental health benefit via telehealth
  • Mindfulness or meditation education and support

Financial health

  • Tuition assistance
  • Earned wage access
  • Offering a stipend and/or group rates for cell phone, auto insurance, etc.
  • Budget and financial planning assistance

Physical health

  • No-deductible health coverage
  • Integrating workers’ compensation, disability and FMLA
  • Encouragement or rewards for annual physician visits, wellness programs and virtual visit promotion (a low cost alternative)

Social/spiritual health

  • Matching mission with culture
  • Team building & resilience training
  • Establishing mentorship programs
  • Diversity, equity and inclusion plan
  • Engaging/employing persons with disabilities, youth or international workers
  • Training/education on trauma informed care principles for residents and employees

Employers in every industry, but particularly the long-term care industry, must be aware of the social determinants of health that can impact their employees’ willingness or ability to work at a high-level and for consistent periods of time.

Employers seeking to increase talent attraction and retention during current employment crises must re-evaluate their benefit and compensation programs to ensure they assist their employee population with issues that matter to them.