The Hidden Cost of Extended Recovery: A Wake-Up Call for Taft-Hartley Plans
When a union member undergoes surgery, Taft-Hartley health and welfare plan leaders typically focus on one number: the claim cost. But there’s a second, often overlooked financial hit that can be just as devastating to fund sustainability—lost contribution revenue.
Burning the Candle From Both Ends
Every day a member is out of work recovering from surgery, the fund faces a double financial burden:
- You’re paying out: Medical claims, follow-up care, rehabilitation, complications
- You’re not taking in: Hour-based employer contributions stop flowing when members aren’t working
This isn’t just about healthcare costs. It’s about fund solvency.
Extended recovery periods drain reserves while simultaneously cutting off the revenue stream that replenishes them. For many funds, this double hit is unsustainable.
The Math That Changes Everything
Consider a typical scenario: A member has surgery and is out of work for 90 days. At $8/hour in contributions over a 40-hour work week, that’s $960 per week in lost income to the fund—nearly $12,500 in total contribution gaps for a single three-month recovery.
Now multiply that across the approximately 6% of your membership that has surgery annually. For a mid-sized fund with 3,000 members, that’s 180 surgeries and potentially millions in lost contributions—while simultaneously paying out for those same members’ care.
A Validated Solution
Recent analysis by the Validation Institute reveals a breakthrough: Goldfinch Health’s nurse navigation program helped surgery patients return to work nearly 35 days sooner than national benchmarks—with a validated 2.54x return on investment when only considering this issue of preserving income to health and welfare funds.
Think about what 35 saved days means:
- For the member: Five weeks of income normalcy and five weeks toward healthcare eligibility for the member and family
- For the fund: Five weeks of restored contribution flow per case
The Validation Institute’s independent review examined real patient data and confirmed these results meet rigorous standards for savings validation. This isn’t marketing—it’s measurable impact on the very financial dynamics that keep Taft-Hartley funds solvent.
A New Framework for Fiduciary Responsibility
Trustees have a fiduciary duty to ensure fund sustainability. Traditionally, that’s meant negotiating better rates, implementing utilization management, or increasing employer contributions. But what if there’s more that can be done without increased rates or restricted care?
Programs that accelerate recovery don’t just reduce medical costs—they restore the contribution revenue that funds depend on. It’s preventive medicine for fund finances.
The Path Forward
Smart plans are asking what can be done to impact both the claims and the recovery?
- How long are our members typically out of work after common surgeries?
- What’s the true cost when we factor in both claims AND lost contributions?
- What evidence-based programs can we implement to accelerate safe recovery?
In this world, every day matters—and 35 days could be the difference between a sustainable fund and one that’s slowly burning out.
To learn more, visit https://goldfinchhealth.com/.
Interested in seeing how this could impact your membership? Request a no-cost Surgery Quality Analysis today.