Understand and Leverage the Link Between Employee Wellness and Workers Compensation

Transcription

1 Understand and Leverage the Link Between Employee Wellness and Workers Compensation Presented by: Amy Richter, Wellness Consultant John Fuhs, VP Business Development

2 Would You Agree? Healthier people are healthier employees Healthier employees have fewer health claims Healthier employees cost the district less Healthier employees have fewer job-related injuries

3 Objectives Help you connect the dots of workers compensation and employee wellness Discuss supporting evidence for building wellness into your risk management plan Review critical elements needed to get started Outline steps for building and implementing a wellness/work comp strategy Suggest methods for measuring outcomes

4 CONNECTING THE DOTS

5 Understanding the Components Risk Management Workers Compensation Experience Modification Factor OSHA Recordability Rates Worksite Wellness Modifiable Risk Factors Health Plan Claims / Rates Absenteeism Disability Costs

6 Market Trends Workers compensation is the loss leader in property/casualty segment 120% combined loss ratio expected in 2012 Business non-renewed Risk appetite suppressed Insurers pushing rate increases Dividend plans reduced/not offered

7 Call for a Strategic Response Frequency improvements no longer sufficient to offset increases in medical costs and severity of claims. Medical costs per claim continue to increase Expensive surgical procedures Co-morbidities related to obesity and aging workforce increasing Increase in number of PTD claims

8 If Food Were Health Care

9 Population Management Risk factors per every 100 employees 31 use alcohol excessively 6 are diabetic 30 have high cholesterol 26 have high blood pressure 25 have cardiovascular disease 21 smoke 24 don t exercise Risk Factors 20 are over age don t wear seatbelts 44 suffer from stress 38 are overweight Source: Department of Health and Human Services

10 Median 12-Month Medical

11 Obesity Trends* Among U.S. Adults (*BMI 30, or about 30 lbs. overweight for 5 4 person) Source: Center for Disease Control (CDC) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%

12 Study Says: Obesity Increases Workers' Compensation Costs A Duke University Medical Center analysis found that obese workers: Filed twice the number of workers' compensation claims Had seven times higher medical costs from those claims Lost 13 times more days of work from work injury or work illness than did non-obese workers

13 Obesity NCCI Study WC medical claims open for one year cost three times as much when the injured employee is obese Claims that are open for five years are five times more costly when involving an obese claimant Cost differential can be even greater for smaller claims

14 Why at the Worksite? Worksite may contribute to the problem Reduce/control costs Decrease absenteeism Improve productivity Improve recruitment and retention efforts Captive audience

15 The Many Advantages of Wellness A study by U.S. Corporate Wellness says the average results of an employee wellness plan include: Drop in workers compensation and disability claims by as much as 30 percent. Decrease in short-term sick leave by as much as 32 percent Savings of between $3 and $6 for every $1 invested

16 Need for Wellness & Disease Management Population Health Care Resources ($) 18% 80% Well 25% 33% 14% Episodic 5% Chronic 1% Catastrophic 24%

17 Wellness/Disease Management 80% of the Members 20% of the Costs Healthy Members Wellness Benefits Immunizations Physical Exams Mammograms Prostate Screenings Member Programs Health Information Line EAP Maternity Management Mail Order Drugs Internet Personal Pages Special Incentive Programs 20% of the Members 80% of the Costs Unhealthy Members Disease Management Diabetes Heart Disease Asthma Low Back Pain COPD Care Management Solutions Pre-cert/CSR/Case Management Organ Transplant Program Proactive Outreach Health Information Line Behavioral Health Managed Pharmacy Decision Support Network Contracting

18 The Bottom Line A healthy employee is/has - More productive - Fewer injuries - Less absenteeism - Improved quality of work Let s focus on getting started

19 GETTING STARTED

20 Safety & Wellness Program An organized, employer-sponsored program that assists and encourages employees (and dependents) in making lifestyle and behavioral changes that: Improves health and reduces injury risks Teaches participants to be better health care consumers Enhances productivity, moral, and overall wellbeing Helps employers manage health care and workers compensation costs Facilitates quicker return to work

21 Goals of a Safety & Wellness Program Keep the Healthy Healthy and reduce injury Focus Efforts Moving at risk individuals to make behavior changes through awareness, participation, and education Reducing leading causes of workplace injury and improving return to work timeline

22 Basic Benchmarks to a Successful Program 1. Leadership Support 2. Creating Cohesive Teams 3. Gathering Data 4. Creating a Plan 5. Choosing Appropriate Interventions 6. Creating a Support Environment 7. Evaluation Outcomes

23 1. Value of Leadership Support Multi-level support Motivate engagement Lead by example Define a corporate culture of safety / wellness and allocate resources Shape benefits and policy to support safety, wellness, stimulate greater productivity, reduce health care costs, reduce workers comp claims and generate worker satisfaction

24 2. Creating a Cohesive Team Add wellness initiatives to current safety committee Or, have safety committee liaison on wellness committee Call for volunteers Or, special project for emerging leaders Include a road blocker

25 Your Pool of Partners Your Brokers Insurance Carriers EAP Associations Internal Experts Equipment Vendors Ergonomic Companies

26 3. Gathering Data Data can be collected from sources such as: Health screenings Health-risk appraisals Health insurance claims Workers' compensation records Absenteeism rates Employee satisfaction surveys / cultural audits OSHA logs / loss history Wellness interest survey Program history All of these sources of data can indicate where safety & wellness resources should be focused.

27 Basic Benchmarks to a Successful Program 1. Leadership Support 2. Creating Cohesive Teams 3. Gathering Data 4. Creating a Plan 5. Choosing Appropriate Interventions 6. Creating a Support Environment 7. Evaluation Outcomes

28 4. Creating a Plan & 5. Choosing Interventions Mission Goals/Objectives (S.M.A.R.T) Rationale (data) Budget Evaluation Multi-year strategy

29 Wellness Programs: What Works? The programs that work: Regarded as strategic investments Comprehensive in scope Ongoing & part of the culture Focused on specific and measurable goals The ones that do not: Overly ambitious at the outset Flavor-of-the-month programming Stop at health education or awareness events Participation is required

30 Every Little Bit Helps Comfort Mats Stretch Breaks Create walking tracks w/ tape Decorate staircases Volunteer at Recess Tobacco-free policies 10-minute group exercise breaks during lunch Parking farther away Birthday/Anniversary treat makeover Vending machine overhaul

31 6. Supportive Environment Lead by example Policy changes Healthy vending Tobacco-free Culture shift the norm Focus on benefit to employee

32 7. Evaluation Survey group Ask for testimonials Review data trends Participation results

33 Wellness Program Legal Issues HIPAA ADA OSHA GINA TAX LAW

34 Basic Benchmarks to a Successful Program 1. Leadership Support 2. Creating Cohesive Teams 3. Gathering Data 4. Creating a Plan 5. Choosing Appropriate Interventions 6. Creating a Support Environment 7. Evaluation Outcomes

35 Part of End Game

36 The Bottom Line... Changing co-morbidity risks will have a positive impact on many levels Healthy people cost less Healthy people are more productive Healthy people add more to the bottom line!

37 Questions?