Everyone gets sick once in awhile. It’s inevitable. But the only way to keep the lid on what could potentially be rising, out-of-control costs is by keeping a watchful eye on two important areas. And they are:

Rising Medical Costs and Prescription Drugs… Medical costs continue to soar and it can be attributed to several factors which are, in some ways, related. In many states, employers let the employees choose what doctor they want to see when injured, and employees are most likely to choose their family doctor. The problem here is the family physician sees the worker as their client. So if the employee asks for a week off, the doctor will grant it. Why not? Most family physicians have no experience with occupational medicine or the importance of getting employees back to work.

Another area of growing concern is the type of drugs being prescribed to injured workers and their long-term effects. According to a recent article in USA TODAY, the biggest drug problem in America isn’t the heroin being mainlined in a back alley or the cocaine being ingested in some run-down crack house. In actuality, it’s the prescription painkillers sitting in a medicine cabinet in Middle America, to the point that they kill 18,000 people per year. And don’t think this hasn’t raised an eyebrow to workers’ compensation payers, who are on the lookout to ensure that addictive drugs that are over-prescribed by doctors aren’t affecting workers’ comp cases. Evidence has shown that some doctors are prescribing pain medication usually targeted for cancer patients for simple back strains.

According to Gregory L. Johnson, a health care management consultant, “There is an increase in medical costs as a percentage of all claims; there is an increase in pharma as a percentage of all medical costs. And there is an increase in opioids as a percentage of pharma. So it’s driving a lot of overall loss results in workers’ comp.”

Another industry expert contends that employers may find themselves not only paying for the medication but also funding detox programs, drug overdose claims and treatment for long-term side effects. It’s imperative that employers, doctors, claimants and insurance carriers all get on the same page to make sure such abuse does not occur.

The Need for Wellness Plans…. Healthier employees lead to lower premiums. If companies can help their workers improve their health without cutting benefits or shifting more premium costs to employees, why aren’t smaller companies using this proven method to lower their health care costs?

Randy Boss, a Risk Architect with Ottawa Kent Insurance in Grand Rapids, MI, helps companies implement successful wellness programs. And he says he can understand how employers feel.  “They’re frustrated because most likely they have tried things that didn’t work,” says Boss. “Businesses tend to think short-term and not long-term, and expect to see solid and immediate savings on their healthcare costs.”

Yet, the benefits of having healthy workers transcend reduced health care costs, including Workers’ Compensation and lower absenteeism. Healthy workers are less prone to injury and when injured, they recover quicker than less healthy workers. If workers change and modify their lifestyle and reduce their health risks, medical costs decline.

A University of Michigan study of a Midwest utility company’s workplace wellness program found that over nine years, the utility company spent $7.3 million for the program and reaped $12.1 million in savings. Medical and pharmacy costs, time off and Worker’s Compensation factored into the savings. The study, which took into account a number of costs, including indirect costs of implementing wellness programs, such as recruitment and the cost of changing menus, showed that wellness programs work long-term even though employees aged during the course of the study.

Companies need to make a commitment to helping their employees stay in better shape. Says Randy Boss, “If companies don’t have the ability to fire all their old workers and hire young workers, then they need to concentrate on what they can control…the risk factors. That’s where a health & wellness program comes in. But to be successful you need high participation… preferably over 85%. We’ve been fortunate to have a 94% record without having to pay employees to participate.  We do this by motivating and educating employees so they take the action steps to get the results.”

An effective wellness plan only works if implemented from the top down. “We see participation rates up to 70%-80% with management support and incentives, but only 10%-20% without it,” says Susan Butterworth, director of Oregon Health Sciences University Health Management Services.