We are proud to announce Spring and our consultants have been recognized for multiple awards from Captive Review’s Cayman Awards 2025. We look forward to continuing to do excellent captive work in all domiciles, including but not limited to the Cayman Islands.

Spring has been awarded for:

Obesity is not a choice or a moral failing. It is a chronic, multifactorial disease with metabolic, behavioral, psychological, and environmental underpinnings. As employers, benefits managers, and health plan stewards, you must ask: Do you have all the pieces you need to manage obesity effectively? Offering a single tool will rarely suffice.

What Is a Weight Management & Metabolic Health Program?

A weight management and metabolic health program is a coordinated intervention set designed to address obesity and its underlying metabolic irregularities over time. These programs typically combine:

• Clinical evaluation of metabolic markers (for example, insulin resistance, lipid profiles, inflammation) ¹
• Nutritional counseling customized to metabolic needs
• Frequent and ongoing monitoring, follow-up, and adjustment
• Behavior change support, including coaching and psychological or mental health resources
• Physical activity and exercise guidance to preserve muscle and improve metabolism
• Medication support when clinically appropriate (including GLP-1 or including obesity GLP-1 agonists and other weight loss agents) ³

A high-performing program does not treat obesity simply as excess weight. Instead, it views obesity as a chronic disease that requires continuous management and adaptation.

Direct Primary Care

Obesity affects more than 40 percent of U.S. adults and is a major contributor to type 2 diabetes, cardiovascular disease, nonalcoholic fatty liver disease, certain cancers, osteoarthritis, and sleep apnea¹. Recognizing obesity as a disease rather than a behavioral failure shifts the paradigm. It demands a coordinated multi-pronged strategy, not a simplistic “eat less, move more” approach.

The causes of obesity are complex. Genetic predisposition, hormonal dysregulation, gut microbiota, psychosocial stressors, sleep disruption, food environment, and socioeconomic factors all play roles². Because of this complexity, no single solution such as a pill or injection can resolve the disease in isolation.

GLP-1 medications such as semaglutide and tirzepatide have demonstrated promising results in clinical trials for weight loss and improvements in metabolic health markers³. However, real-world adoption, drug discontinuation, and weight regain remain significant challenges. One analysis found that more than 50 percent of patients using GLP-1s for weight management stopped treatment within 12 months³. After discontinuation, biological adaptations lead many to regain much of the lost weight within a year. These patterns underscore that GLP-1s are powerful but only one piece of a broader strategy.

The Cost and Employer Dilemma

Employers contemplating coverage for GLP-1s face a difficult tradeoff. On one hand, these medications are expensive and can significantly increase pharmacy spending. A recent survey indicated employers are rethinking their strategy and many employers covering these medications today are considering a change. High discontinuation rates and uncertain long-term value make ROI calculations complex.

On the other hand, effective obesity management and improved metabolic health can reduce downstream costs associated with diabetes, cardiovascular disease, joint issues, and productivity loss⁴. Employers must decide whether to cover GLP-1s, and if they do not, how else to invest in comprehensive wellness and chronic condition management programs.

Benefits to Patients and Providers

For Patients

• Improved metabolic outcomes, including better insulin sensitivity and blood pressure
• Sustainable weight loss when combined with behavioral interventions
• Reduced risk of obesity-related comorbidities
• Enhanced quality of life, mobility, and mental well-being
• Lower likelihood of requiring invasive procedures such as bariatric surgery

Programs that integrate behavioral and psychological support help patients address emotional eating, stress, and motivation, which are often critical to long-term success.

For Providers

• Structured care pathways for chronic obesity management
• Data and feedback loops that allow for continuous monitoring and early intervention
• Clearer alignment with evidence-based best practices
• More efficient coordination between primary care, nutritionists, and behavioral specialists

Providers participating in holistic programs are better positioned to support patients in achieving sustainable outcomes rather than focusing solely on short-term weight loss².

Key Questions for Your Point Solution

When evaluating or designing a weight management and metabolic health program, consider the following questions:

1. Does the program address underlying metabolic dysfunction rather than just weight loss?
2. Are healthy behaviors supported over time, not only during initial engagement?
3. Is psychological or behavioral support part of the design?
4. If medications such as GLP-1s are offered, are they integrated within a structured clinical framework?
5. Does the program emphasize preservation of lean muscle mass through physical activity and nutrition?
6. Is there flexibility to adapt the program as patient needs and results evolve?
7. Do providers have sufficient training and resources to sustain engagement?
8. Is there a clear cost-benefit analysis and a defined measurement strategy for ROI?

Takeaways & Recommendations

Effectively addressing obesity requires viewing it through the same lens as other chronic diseases, with a long-term management strategy rather than a quick fix. Employers, providers, and health plan leaders must recognize that no single intervention can succeed in isolation. A comprehensive weight management and metabolic health approach combines medical treatment, behavioral support, nutrition, and ongoing engagement. While GLP-1 therapies have shown promise, they are only one component of a multifaceted solution. Without lifestyle changes and behavioral health integration, the long-term success of these medications is limited. Employers evaluating whether to cover GLP-1s should consider both the financial implications and the broader care framework necessary for success. Those that do offer coverage can maximize outcomes by ensuring these medications are paired with coaching, nutritional counseling, and continued follow-up. For those unable to include them, investing in alternative wellness initiatives and chronic condition management programs can still demonstrate support for employee health. Ultimately, effective obesity management depends on aligning all available tools (clinical, behavioral, educational, and organizational) to create a system that promotes sustainable metabolic health over time⁵.

¹FAIR Health. (2024). Obesity and GLP-1 Drugs: A FAIR Health White Paper. Retrieved from https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/Obesity%20and%20GLP-1%20Drugs%20-%20A%20FAIR%20Health%20White%20Paper.pdf
²McKinsey Health Institute. (2025). The Path Toward a Metabolic Health Revolution. Retrieved from https://www.mckinsey.com/mhi/our-insights/the-path-toward-a-metabolic-health-revolution
³American Journal of Clinical Nutrition. (2025). GLP-1 Clinical Trial Findings. Retrieved from https://ajcn.nutrition.org/article/S0002-9165%2825%2900240-0/fulltext
⁴Cigna/Evernorth. (2024). Employer Strategies for Sustainable GLP-1 Coverage. Retrieved from https://newsroom.cigna.com/employer-strategies-for-sustainable-glp1-coverage
⁵Luminare Health. (2025). GLP-1s and the Cost of Obesity. Retrieved from https://www.luminarehealth.com/site/media/Files/LH-3270-White-Paper_GLP-1s.pdf

High-cost claims, and the claimants incurring those expenses, are arguably the biggest cost pressure self-insured employers face within the healthcare ecosystem. Solutions are complicated, multi-faceted, and ideally implemented before a claim occurs. Although these solutions only impact a small percentage of the population, their overall effect is significant, and once established, the savings compound.

Employers should begin by defining high-cost claims for their organization and verifying the clinical drivers. From there, solutions can be considered that will directly impact current claims and future cost mitigation.

Defining High-Cost Claimants

The definition of high-cost claims is not uniform. Many employers use a targeted dollar threshold (for example, $100,000) to pinpoint high-cost claims, which are embedded in the insurance model through stop-loss contracts. While that benchmark makes reporting consistent, it is often more practical to consider plan size and risk tolerance when defining high-cost claims.

The National Alliance of Healthcare Purchaser Coalitions (2024), of which our client edHEALTH is a member, estimated that 1.2% of health plan members are high-cost claimants, making up approximately 33% of total healthcare spend. These individuals absorb 29 times the average member cost, with an average of $122,382 per claimant. By stratifying data, employers can start to pinpoint which individuals are high-cost claimants now, and who may become one in the future, and implement solutions to mitigate spend.

Clinical Drivers

When examining data across our book of business at Alera Group, oncology and specialty pharmacy conditions, such as rare diseases, are the top diagnoses associated with high-cost claims. Other common drivers are cardiovascular disease, newborn and infant care, and musculoskeletal disorders.

According to Sun Life’s 13th Annual High-Cost Claims and Injectable Drugs Trend Analysis (2024), cancer again tops the list as the most frequent and costly condition, nearly three times the cost of the second-leading condition, cardiovascular disease.

Employers should start by analyzing their own data and focusing on where they can make the most impact. Industry data, assuming the sample is broad, can serve as a helpful benchmark when developing a strategy, but understanding internal data is critical to success. In nearly all cases, specialty care is where savings will be found, and following the path of comorbidities often leads to the best outcomes. In addition, employers should implement broad market shifts and tactical actions that work together to address current costs and reshape future spending.

Cost Saving Through Broad Market Shifts

Self-insured employers seeking opportunities for savings related to high-cost conditions, claims, and claimants should consider the following broad shifts in thinking:

• Ownership of Plan Governance:
  Self-insured employers govern their plans but often do not build an internal structure, instead relying on vendor partners. Employers looking to target innovative solutions should maintain ownership of plan rules and understand the flexibility of their partners.
• Oversight of Steerage and Utilization Management:
  Plan management is complex, and vendor partners frequently revise rules related to steerage, utilization review, and care management. Understanding where flexibility exists allows employers to manage emerging therapies and carve-outs in the best interest of the plan.
• Value-Based Specialty Arrangements:
  Value-based arrangements create aligned goals and greater transparency, though they are less common in specialty care. Contract language should be carefully reviewed.
• Specialty Medication Solutions:
  Employers and their vendor partners must begin having detailed conversations about specialty medications, especially as the pipeline for these treatments expands beyond rare diseases.
• Partnering with Aligned Vendors:
  Some vendor partners may not have goals that align with employers. Those serious about managing high-cost claims should find partners willing to focus on value-based care, centers of excellence, and network management.
• Data and Analytics:
  Understanding plan data is a fundamental requirement for managing high-cost claims. It starts with utilization and baseline information but must extend to member-level analysis and predictive reviews that consider demographics and comorbidities. The goal is to establish protocols before claims are incurred so they can be proactively managed.

Tactical Actions Targeting High-Cost Claimants

At a tactical level, employers must be focused on opportunities that deliver savings at the condition level and continuously monitor results. This can be done with a partner, but if incentives are not aligned, methodology and key performance indicators should be established in advance.

Key first steps often include:

• Stop-loss design
• Prior authorization for top cost drivers
• Vendor contracting
• Centers of excellence
• Disease-state initiatives focused on prevention, care navigation, and overall management (for example, oncology, infusion site of care, cardiology, prenatal/neonatal, behavioral health, musculoskeletal, and others)

High-cost claims will continue to be a defining challenge for self-insured employers in higher education and beyond. Addressing them effectively requires a balanced approach that combines strong governance, meaningful data analysis, and proactive partnership with vendors and providers. Employers who invest the time to understand their data and align their strategies accordingly are best positioned to control costs while improving outcomes for their members. The goal is not only to manage high-cost claims when they arise but to build a framework that anticipates and prevents them wherever possible.

Sources:
National Alliance of Healthcare Purchaser Coalitions. High-Cost Claims Report, 2024.
Sun Life. 13th Annual High-Cost Claims and Injectable Drugs Trend Analysis, 2024.
Kaiser Family Foundation. Employer Health Benefits Survey, 2024.

Primary care providers—originally general practitioners who would later specialize into modern internal and family medicine physicians—served as lone practitioners for much of the 20th century, playing a central role in both the healthcare system and their local communities.¹ After World War II, the prominence of PCPs declined as specialty care expanded, influenced by changes in medical education, reimbursement models, technology, and public demand². Today, rising healthcare costs, workforce shortages, and systemic pressures have highlighted underinvestment in primary care. The market is seeking solutions that remove barriers, enhance education, and support population health management³.

Shifts in Primary Care

Primary care remains a core component of all health plans, but fee structures and market pressures have changed the patient–provider relationship. Patients often face rushed appointments, long wait times, low reimbursement rates, and high administrative burdens. These factors contribute to burnout among PCPs and have led the Association of American Medical Colleges (AAMC) to project a shortage of 17,800 to 48,000 primary care physicians by 2034⁴. Insurance requirements, market consolidation, and operational pressures limit PCPs’ ability to deliver optimal care. Patients are also demanding broader access, digital solutions, self-service options, and hybrid care models. In response to these growing challenges, Spring Consulting Group’s client edHEALTH, a captive health coalition serving educational institutions, is proactively pursuing primary care solutions to meet the evolving needs of its member schools. Direct primary care (DPC) has emerged as a strategic tool for employers seeking to improve access, enhance preventive care, reduce avoidable acute care utilization, and generate a return on investment⁵.

Direct Primary Care

At the core, direct primary care provides patients with unlimited access to a primary care team for a flat monthly fee, typically outside of traditional health plan coverage. Most DPC solutions guarantee same-day or next-day appointments, longer visit times, higher patient satisfaction, and bundled care for preventive, chronic, and acute conditions⁶.

DPC models vary depending on vendor capabilities and employer priorities. Options include onsite or near-site clinics, virtual-first networks, retail clinics, preferred-access arrangements, navigation and concierge support, digital tools such as AI and wearables, incentives for engagement, and plan design levers to drive utilization. Providers include retail brands, technology-driven platforms, and employer-focused businesses leveraging onsite, near-site, and virtual-first care models.

DPC emphasizes relationship development and improved access rather than gatekeeping. It positions primary care as a strategic entry point, controlling downstream utilization, referrals, and chronic disease management. Separating primary care from traditional insurance networks may allow patients to access the best available care, facilities, and providers. DPC models can also incorporate risk-based approaches, including capitation or partial-risk arrangements.

Patients increasingly expect convenience, engagement, and integrated behavioral health. DPC partners are responding with retail-style access, care navigation, and satisfaction-focused services. Employers can align DPC partnerships with broader human resources initiatives, such as curated networks, direct contracting, and programs addressing social determinants of health.

Virtual-First Primary Care

In addition to DPC, other access models such as virtual-first primary care and urgent care clinics are shaping the future of healthcare delivery. Virtual-first primary care models are increasingly being adopted as a complementary approach to in-person care. These models prioritize digital access by encouraging patients to connect with their care team through telehealth visits, chat, or app-based platforms before turning to in-person appointments. Virtual-first care can improve access, reduce wait times, and support patient engagement, particularly for populations who may struggle with transportation or scheduling barriers.

When integrated effectively, virtual-first models can serve as a gateway to coordinated care by addressing routine concerns, managing chronic conditions, and promoting preventive health measures. However, challenges such as continuity of care, patient trust, and integration with existing electronic health records must be carefully managed to ensure quality outcomes. For employers, virtual-first networks can complement direct primary care by expanding access and helping to balance costs without sacrificing patient experience.

Market Shifts and Employer Considerations

Employers, particularly self-funded ones, must increasingly shape their healthcare strategy to maximize value. Primary care represents a relatively small portion of overall healthcare spend, and immediate savings may be limited. However, long-term investment in DPC can yield measurable benefits over three to five years. Successful DPC implementation requires attention to challenges such as geographic coverage gaps, referral coordination limitations, regulatory uncertainty, and member education. Employers should prioritize integration with existing health plan solutions, coordinate utilization and data tracking to ensure savings are captured accurately and deploy clear communication and engagement strategies.

When implemented effectively, DPC models shift the healthcare narrative toward value-based care, improve access, strengthen care coordination, and enhance patient satisfaction, ultimately supporting both employee health and organizational objectives.

¹Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of primary care to health systems and health. The Milbank Quarterly, 83(3), 457–502.
²Bodenheimer, T., & Pham, H. H. (2010). Primary care: Current problems and proposed solutions. Health Affairs, 29(5), 799–805.
³Petterson, S., Liaw, W. R., Tran, C., & Bazemore, A. W. (2015). Estimating the residency expansion required to avoid projected primary care physician shortages. Annals of Family Medicine, 13(2), 107–114.
⁴Association of American Medical Colleges. (2023). The complexities of physician supply and demand: Projections from 2023 to 2034.
⁵Rosenthal, T. C. (2012). The medical home: Growing evidence to support a new approach to primary care. JAMA, 308(21), 2335–2336.
⁶Direct Primary Care Coalition. (2022). What is direct primary care? Retrieved from https://www.dpcare.org/

The political landscape has seen significant developments in healthcare reform, notably with the enactment of the One Big Beautiful Bill Act (OBBBA) on July 4, 2025¹. This legislation introduces changes that may reshape healthcare policies, employee benefits, and overall benefits packages. Understanding these changes is crucial for employers to navigate the evolving landscape effectively¹,².

What Is the “Big Beautiful Bill”?

The “Big Beautiful Bill,” officially known as the One Big Beautiful Bill Act, is a substantial piece of legislation encompassing tax, spending, and healthcare provisions¹,³. The law focuses on deregulation of healthcare, expansion of private insurance options, tax incentives for both employers and employees, and modifications to certain provisions of the Affordable Care Act (ACA)¹,⁴. At its core, the law aims to increase competition and choice in healthcare, with the objective of reducing premiums and expanding access³.

How Will the Bill Impact Employee Benefits?

Changes to ACA Compliance

The OBBBA includes provisions that modify certain aspects of the ACA²,³. While the law does not eliminate the ACA, it introduces changes, such as new reporting requirements for certain Medicaid enrollees and restrictions on federal financial assistance for those enrolled in the ACA Marketplace². Employers offering health insurance may encounter fewer regulatory requirements around employee health plans but could face challenges if employees opt out of company-sponsored coverage due to more affordable individual insurance options or if employees lose government-sponsored coverage³.

Expansion of Health Savings Accounts (HSAs)

The law expands Health Savings Accounts (HSAs) by broadening the definition of a high-deductible health plan (HDHP) to include bronze and catastrophic plans²,³. This allows taxpayers to save and invest more money tax-free for healthcare expenses². For employers, these expanded accounts present an opportunity to provide more customizable healthcare benefits, potentially reducing administrative costs while empowering employees to manage healthcare expenses more effectively³. The OBBBA also designates Direct Primary Care arrangements as qualified medical expenses eligible for HSA coverage within limits².

Shift Toward Private Insurance

The legislation includes adjustments to Medicaid and changes to the ACA marketplace, which may result in fewer individuals relying on government-run plans²,³. This shift encourages employers to refine benefit packages to provide more personalized private insurance options that better align with employee needs³. Increased competition among private insurers may also influence employer-sponsored insurance premiums².

Tax Incentives for Employers

The OBBBA introduces new tax provisions, including a permanent increase to the standard deduction¹,². While healthcare-specific tax incentives for employers are not as clearly detailed as individual tax changes, the general focus on tax relief and cost reduction is intended to encourage companies to reassess benefit offerings and consider new ways to support employee health and well-being².

Potential Impact on Wellness Programs

The law’s emphasis on individual choice and competition may encourage employers to invest more in wellness programs²,³. Health and wellness incentives, such as gym memberships, mental health services, and preventative care, could become more prevalent as employers aim to improve employee health outcomes and reduce long-term healthcare costs³. These programs can also enhance employee engagement and satisfaction².

What Can Employers Do to Prepare?

Given the significant changes brought by the OBBBA, employers should remain informed and proactive. Key strategies include:

1. Stay Updated on Legislation:
   Employers should regularly monitor updates on the law, particularly regarding ACA regulations, HSA contributions, and tax incentives²,³. Joining professional organizations or subscribing to policy newsletters can help employers stay current.
2. Review Employee Benefits Packages:
   Employers should evaluate current healthcare offerings and consider adjustments to remain competitive and cost-effective, particularly with expanded HSAs and private insurance options²,³. Supplemental private plans or partnerships with brokers may help diversify options for employees².
3. Communicate with Employees:
   Transparent communication is essential. Employers should educate employees on changes to benefits, HSAs, and wellness programs, and explain potential impacts on premiums or out-of-pocket costs²,³.
4. Consult with Benefits Advisors and Legal Counsel:
   Navigating healthcare reform is complex. Consulting advisors and legal counsel ensures compliance and appropriate plan design under the new law²,³.
5. Prepare for Tax Adjustments:
   Employers should reassess benefits strategies to maximize available tax incentives, adjust structures as necessary, and ensure overall compensation remains competitive¹,².

The Road Ahead for Employers

The One Big Beautiful Bill Act has introduced substantial transformations to the healthcare landscape¹,². Its impact on employee benefits is becoming clearer as provisions are implemented. Healthcare is likely to become more individualized, with greater responsibility falling on employers to navigate benefits packages effectively²,³. By staying informed, reassessing offerings, and planning proactively, employers can adapt to the evolving regulatory environment while continuing to support employee health and well-being²,³.

¹Congress.gov. (2025). H.R.1 – One Big Beautiful Bill Act 119th Congress (2025-2026). https://www.congress.gov/bill/119th-congress/house-bill/1
²Ballard Spahr. (2025, July 14). The OBBBA’s impact on employee benefits and executive compensation. https://www.ballardspahr.com/insights/alerts-and-articles/2025/07/the-obbbas-impact-on-employee-benefits-and-executive-compensation
³McDermott Will & Emery. (2025, July 7). Employee benefits provisions of the One Big Beautiful Bill Act. https://vitacompanies.com/blog/employee-benefits-provisions-of-the-one-big-beautiful-bill-act
⁴Johns Hopkins Bloomberg School of Public Health. (2025, July 30). The changes coming to the ACA, Medicaid, and Medicare. https://publichealth.jhu.edu/2025/the-changes-coming-to-the-aca-medicaid-and-medicare

In today’s fast-paced world, the conversation around mental health has taken center stage in workplace wellness initiatives. As employers strive to create a more supportive and resilient workforce, integrating mental health resources into employee benefits and absence strategies has never been more critical.

According to the National Institute of Mental Health, nearly 1 in 5 U.S. adults live with a mental illness¹. That number rises significantly among working-age adults, especially in high-stress professions or environments lacking psychological safety and support. This increased prevalence of mental illness leads to more time away from work, reduced ability to perform while present, and an increase disability claims incidence rates.

The Insurance Impact: Disability & Mental Health Claims

From a disability insurance standpoint, behavioral health-related disability claims are a major concern for Benefits and HR teams across the country. Mental health conditions like anxiety, depression, PTSD, and burnout are now among the leading causes of short term and long term disabilities.

A significant area of concern and recent discussion pertains to the common inclusion of a 24-month lifetime limitation for mental health-related claims in long term disability (LTD) policies. The consequence of this provision is that an employee whose disability stems from a mental health condition becomes ineligible for continued LTD benefits after a lifetime combined 24 months, even if they continue to meet the plan’s definition of disability. These limitations stand in contrast to individuals experiencing other types of disability, who are not subjected to an equivalent restriction. While the rationale for such limitations includes mitigating plan risk exposure by capping the duration and encouraging a return to work before prolonged disengagement, these provisions undeniably create a disparity in the treatment of individuals with different types of disabilities. Furthermore, they are frequently perceived as being at odds with the array of mental health initiatives that employers are increasingly implementing to address the escalating incidence of mental health issues within their workforce.

Tools to Help: Leveraging Absence and Benefits Strategy

Employers have the opportunity and, some would argue, the responsibility to take a proactive role in supporting mental health. Integrating meaningful mental health resources into leave and benefits programs is no longer optional. It is a critical business imperative. Leading organizations are stepping up to close the gap in several ways.

1. Employee Assistance Programs (EAPs) and Virtual Behavioral Health Programs

EAPs are often an underutilized resource, despite their potential to have a real, immediate impact. EAPs are employer-sponsored programs that are designed to help support employees’ health habits and well-being. Some common examples include counseling, substance abuse support, financial guidance, and legal advice. By actively promoting EAPs and embedding access points and reminders to employees throughout the leave process, employers can help support an employee’s mental health challenges.

To further assist employees with mental health concerns, employers can offer virtual Behavioral Health programs. These programs can significantly enhance employee mental health by expanding access to care and offering convenient and confidential support from anywhere. This accessibility helps overcome traditional barriers like stigma, travel, and scheduling conflicts, enabling earlier intervention and consistent engagement with mental health services. Ultimately, these programs empower employees to manage their well-being proactively, leading to improved overall health and productivity.

2. Financial Wellness Resources

Financial stress significantly impacts mental health. When employees grapple with issues like debt, budgeting difficulties, or unexpected expenses, they often experience heightened anxiety, reduced focus, and even physical symptoms². This direct link underscores the importance of addressing financial well-being as a component of overall mental health support.

Employers can play a crucial role by offering financial counseling, whether through specialized vendors or as part of a broader EAP. This type of support helps employees navigate their financial challenges, which in turn can alleviate the associated mental burden. When an employee takes leave for mental health reasons, integrating recovery resources with financial guidance can create a more holistic approach, promoting greater well-being and facilitating a smoother return to work.

3. Integrated Absence Management Programs

Forward-looking integrated absence management programs take a holistic view of why an employee may be absent from work, coordinating federal protections such as the Family Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA), state leave programs, and employer-specific offerings. Taking an integrated approach not only streamlines compliance, but also allows for early intervention and triage, ensuring that mental health needs are identified and addressed as part of the overall leave experience.

The Bigger Picture: Prevention and Culture

Prevention remains the most cost-effective approach. Employers can have an impact by building a workplace culture where mental health is normalized and where resources are visible and accessible. Communication is also key. In addition to formal programs and benefits, employers can provide employees with education and resources such as Alera Group’s Mental Health Awareness Toolkit, which provides employers with email templates, campaigns, and more to help support employee wellbeing and keep their colleagues informed about what resources they have.

Employers that prioritize mental well-being as part of their overall strategy are seeing positive results across the board. These include shorter claim durations, higher employee engagement, and reduced turnover. Mental health challenges are not going away, and the workplace plays a key role in both creating and addressing these issues. By utilizing tools like EAPs, virtual Behavioral Health programs, financial counseling, and integrated absence programs, employers can reduce the long-term costs and disruptions of behavioral health-related absence, while helping their employees lead healthier lives.

¹National Institute of Mental Health (NIMH), “Mental Illness,” 2023. https://www.nimh.nih.gov/health/statistics/mental-illness
²Debrosky, “Why Are Mental Health Disability Claims Denied More Often? Insights from Mark DeBofsky on Main & Wall” 2024. https://www.debofsky.com/articles/denied-mental-health-disability-claims/#:~:text=Most%20long%2Dterm%20disability%20policies,which%20creates%20an%20unfair%20distinction.
³American Psychological Association (APA), “Stress in America: The State of Our Nation,” 2023. https://www.apa.org/news/press/releases/stress

Substance use disorder (SUD) is often discussed in relation to student health and wellness across colleges and universities. Just as important, but sometimes overlooked, are faculty, administrators, and staff who may be silently struggling with substance use or supporting loved ones who are.

When schedules are demanding and support systems may be limited, institutions can better support their workforce by offering comprehensive and stigma-free solutions related to SUD and recovery.

Understanding Substance Use Disorder

Substance use disorder is a chronic condition affecting millions of Americans.  It’s often characterized by the compulsive use of substances such as alcohol, prescription medication, or illicit drugs despite harmful consequences, with impacts felt across all socioeconomic, professional, and educational backgrounds.

According to the National Survey on Drug Use and Health, about one in eleven full-time workers struggles with SUD, and nearly 12 percent of U.S. adults live with someone in recovery. ¹

Why It Matters

Workplace cultures that reward overworking, multitasking, and perfectionism may add to the pressure.  In education specifically, faculty and staff may silently manage stress or avoid disclosing personal struggles out of fear for their careers or a desire to prioritize student health. Since academic institutions influence the broader community, unaddressed employee struggles can impact student experience, productivity, and retention.

Supporting recovery is more than a wellness initiative, it is a cultural responsibility and a strategic investment in employee wellbeing.

What Recovery-Supportive Workplaces Can Offer

Limitless options exist in supporting employees with substance use disorders or those who are caregivers for family and friends with similar challenges.  The most common is to provide programs that focus on this area, but perhaps even more important is to foster a culture that allows employees to take advantage of these programs and feel supported. 

Programs that should be considered include, but not be limited to, the following:

Employee Assistance Programs (EAPs)

EAPs can provide free counseling, treatment referrals, and crisis support. Promoting awareness and confidentiality is essential to building trust in these services.

Recovery-Focused Benefits Platforms

Some employers partner with vendors to provide treatment matching, sobriety coaching, medication-assisted treatment, and caregiver resources.

Flexible Leave Policies

Non-punitive leave for treatment and recovery can make it easier for employees to seek help. Review existing policies to ensure they support behavioral health needs.

Caregiver Support

Employees supporting a loved one through addiction need resources, too. Solutions that offer navigation support, stress management, and mental health care can ease the burden.

Training for Managers and HR

Educating leadership on how to recognize signs of SUD and refer employees to resources ensures the first response is supportive, not disciplinary.

Campus Recovery Communities

Some colleges have launched employee recovery groups or partnered with local organizations like AA or NA to provide safe, supportive spaces.

Breaking the Stigma

Regardless of the programs implemented, the culture within your organization can directly impact success.  Stigma remains one of the greatest barriers to seeking help. Misconceptions that SUD is a moral failing rather than a health condition prevent many from accessing support. This is especially true in academia, where self-sufficiency and achievement are often prioritized.

Using person-first language—such as “person with a substance use disorder” instead of “addict”—can help humanize and normalize these experiences. Institutions that model this language in policy and communication help shift the culture.

If this bias exists, it likely extends beyond SUD to all mental health or substance use concerns. Therefore, adopting a culture that actively works to break the stigma will help all employees.

¹Substance Abuse and Mental Health Services Administration. 2022 National Survey on Drug Use and Health (NSDUH).
²SAMHSA National Helpline: https://www.samhsa.gov/find-help/national-helpline
³Shatterproof Treatment Atlas: https://treatmentatlas.org

Rapidly emerging technologies are now guiding patients through the complexities of the healthcare system and helping them receive care that best fits their individual needs. Artificial intelligence (AI) is being used to bridge gaps in healthcare access by supporting patient navigation, ensuring patients understand their options and are directed to the most appropriate providers, care settings, and treatment paths. Although many tools are working behind the scenes, the benefits to patients and providers are vast, but must be carefully monitored to avoid inadvertent consequences. 

Patient Data Management

Electronic health records (EHRs) store vast amounts of information, much of which is unstructured. Natural language processing (NLP), a subset of AI, can interpret and extract meaningful insights from these notes, making them useful for predicting diagnoses and delivering individualized care recommendations. This significantly improves data accessibility, especially when extracting information from scanned documents, which have long posed challenges. It also contributes to cost reduction and enhanced care quality. The ability to mine patient data will allow providers to more quickly assess care and make recommendations, sometimes based on systematic analysis.

Automated Communication

AI-powered chatbots and virtual health assistants are transforming communication in healthcare, enabling instantaneous, 24/7 interactions that improve patient engagement. These tools can respond to routine inquiries, offer care options, provide health advice, and remind patients about appointments or medications. This kind of around-the-clock support enhances convenience and personalization, making healthcare navigation more user-friendly and patient-centric.

Provider Matching and Scheduling

AI-driven scheduling platforms and algorithms help patients identify and access the most appropriate healthcare services while also improving operational efficiency for providers. These tools match patients with in-network providers based on personalized criteria such as location, insurance, and specialty. AI and machine learning applications can find appointment slots that meet patient needs, factoring in provider availability and urgency of care. One powerful feature is real-time adaptability, which enables appointment reallocation to accommodate urgent cases with minimal disruption. The result is reduced wait times, better resource allocation, greater transparency, and improved patient satisfaction.

AI Detection

AI is highly effective in identifying patterns and correlations to aid in the prediction and diagnosis of diseases. Several case studies highlight AI’s growing role in early detection and risk prediction for conditions such as cancer, diabetes, and heart disease, as well as other chronic illnesses. As machine learning and NLP algorithms are exposed to more data, their accuracy and reliability continue to improve. Early identification helps shape the course of treatment and enables timely intervention. Another cutting-edge advancement is symptom analysis and virtual triage, where patients can conduct self-assessments and receive guidance on when and where to seek care. This empowers patients with accessible information and helps reduce unnecessary visits to the emergency room.

The Future of AI-Powered Care Navigation

The use of AI in healthcare navigation will continue evolving and further revolutionize the patient experience. One major trend is the movement toward highly personalized care, with AI tailoring guidance to each patient’s unique needs. Future developments may include enhanced AI features in medical imaging for diagnostics and greater integration with wearable health monitoring technologies. While AI-powered navigation tools have already made significant progress, there remains vast potential to further streamline the patient journey and break down access barriers. This will ensure timely, effective, and patient-centered care.

Source: Maleki Varnosfaderani, S., & Forouzanfar, M. (2024). The Role of AI in Hospitals and Clinics: Transforming Healthcare in the 21st Century. Bioengineering (Basel, Switzerland), 11(4), 337. https://doi.org/10.3390/bioengineering11040337

CAs focus continues to grow on mental wellbeing and diversity, the concept of neurodiversity has garnered increasing attention. Neurodiversity refers to the range and variation in how human brains function, and includes conditions such as autism, ADHD, Tourette’s, dyslexia, dyspraxia, social anxiety disorders, and more. Recognizing and supporting these differences can foster inclusivity, innovation, and personal wellbeing. Cognitive wellness tools are playing a crucial role for employers looking to help all employees thrive.

Neurodiversity challenges the idea of a single “normal” brain type. It highlights that neurological differences are not deficits, but rather variations in processing, communication, and learning. While the potential benefits of hiring a diverse workforce are high, reports estimate that the unemployment rate in the U.S. for neurodivergent individuals is between 30% and 40%.[1] Embracing neurodiversity promotes equity in education, work, and healthcare by acknowledging the unique strengths and needs of each person. In addition, neurodivergent individuals may be highly skilled, more productive, and exhibit different strengths than neurotypical individuals, such as attention to detail or direct communication skills.

To address this gap, various tools—often referred to as cognitive wellness tools—have emerged. Cognitive wellness focuses on supporting brain health and functionality through personalized strategies. For neurodivergent individuals, this may include tools that assist with executive function, focus, emotional regulation, and sensory processing. Investing in cognitive wellness has been shown to reduce burnout and improve productivity—not just for neurodivergent individuals, but for all employees.

There are a variety of tools available:

1. Digital Apps: Tools like MindMeister, Todoist, and Calm help with organization, mindfulness, and task management.
2. Assistive Technology: Speech-to-text software, noise-canceling headphones, and screen readers enhance accessibility.
3. Therapeutic Supports: Cognitive Behavioral Therapy (CBT) adapted for neurodivergence, occupational therapy, and coaching foster self-understanding and practical skills.
4. Workplace & Educational Tools: Flexible work arrangements, sensory-friendly environments, and universal design principles empower success in diverse settings.

In addition, employers must comply with laws such as the Americans with Disabilities Act (ADA), which may extend to certain neurodivergent conditions, including autism or ADHD. This means that employers may be required to engage in the interactive process to ensure employees and prospective employees are provided with fair opportunities to succeed. Possible accommodations include:

• Sharing interview questions in advance; keeping them short and direct; avoiding evaluation based on tone, body language, or expressions
• Using explicit, written communication when possible
• Manager support in creating weekly plans
• Flexible deadlines or additional time to complete tasks
• Consistent job roles, routines, and team structures
• Scheduled breaks
• Adjustments to sensory elements such as temperature, noise, or scents

Supporting neurodiversity through cognitive wellness tools is more than just a trend—it’s a necessary evolution. By integrating technology, therapy, and systemic accommodations, we can empower neurodivergent individuals to thrive and contribute their full potential in the workplace.

¹ https://imagine.jhu.edu/blog/2022/10/05/neurodivergence-at-a-glance/