Managing Total Risk & Total Cost: Workers Compensation & Employee Benefits
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Transcript of Managing Total Risk & Total Cost: Workers Compensation & Employee Benefits
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Managing Total Risk & Total Cost: Workers Compensation & Employee Benefits
Why Wellness, Why Now? May 17, 2011 Joe Picone, Chief Claim Officer, Willis
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Agenda
Cost of Workers Compensation and Employee Benefits
Today’s Workforce
Employee Benefits vs. Workers Compensation vs. Wellness
The Wellness Solution
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WC Lost Time Claims: Indemnity
NCCI, WC Symposium 2010
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WC Lost Time Claims: Medical
NCCI, WC Symposium 2010
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WC Medical Costs Rising
NCCI, WC Symposium 2010
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“Presenteeism”
The measurable extent to which health symptoms, conditions
and diseases adversely affect the
productivity of individuals who
choose to remain at work.
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Why is Health Care So Expensive? (Employee Benefits
Version) Rise in spending for treated diseases (37%)
Innovations / advances in technology New / better medicines New treatments Delivery costs of newborns have increased 5X (1987-2002)
Rise in prevalence of disease (63%) ¾ of all spending in US focused on patients who have one or
more chronic conditions. Chronically ill patients receive only 56% of clinically
recommended preventive health services. 27% of the rise in health care costs is associated with increased
rates of obesity.
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Why is Health Care So Expensive? (Workers
Compensation Version) Increasing Severity – Decreasing Frequency
Attempts to maximize income by some
Failure to properly manage utilization
Wrong measures: savings vs. paid
Trends in our society: Obesity Age Cultural Mental Health
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Time and Effort You Invest When Buying
A Car?
A House?
A College?
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How much time do we take to research our own health
decisions?Have you ever… Never Yes, once Yes, >once
Brought internet info to medical visit to discuss? 60% 20% 20%
Taken notes during a visit to help remember what the doctor or nurse said?
55% 21% 29%
Brought along friend/family as your advocate? 44% 21% 35%
Brought along a list of questions to ask? 28% 23% 49%
During a visit, have you ever held back questions because…
You were unsure how to talk about your medical problems or how to ask your question?
59% 19% 22%
The doctor seemed rushed? 59% 16% 25%
Source: NBGH online survey, September 2007 N=1,558
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Today’s Workforce
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Some Facts About Today’s Workforce: Current
AmericansGI Generation 1905-1925 50,000,000
Silent Generation 1926-1945 35,000,000
Baby Boomers 1946-1964 78,000,000
Generation X 1965-1982 65,000,000
Millennials 1983-2002? 80,000,000
*US CENSUS 2006
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More Facts About Today’s Workforce: Current
Workforce
Silent Born before 1946 5%
Boomers 1946-1964 40%
Gen X 1965-1981 30%
Millennials 1982-2001 25%
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Why It’s Important to Understand Generational Differences
•Boomers are larger than two previous generations
•One out of every three adults over 21 is a boomer
•Boomers have tremendous work ethic
•10,000 Boomers per day are turning 50
•13,000 people will reach the age of 60 every day for the next 20
years
•Boomers will work longer than in past
•By 2050, the median age worldwide will be 38, up from 28 in 2000 and 24 in 1950.
•In the US, the median age in 2050 will be 41, in Italy it will be 53!
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The Workers: What are they like?
Generation Shaping Events Traits
Baby Boomers TV, Cold War, Space Race, MLK, JFK,
Vietnam, Civil Rights, Prosperity, Rock N
Roll
Work Ethic, Driven, Entitlement, Optimism, No to Status Quo, Health and Wellness
Generation X Latchkey Kids, Single Parents, Reagan, Berlin
Wall, MTV, Computers,
Parents Divorce Rate
Risk Takers, Independent, Task Driven, Consumers
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Fact: We have an aging workforce that:
Likes to work hard - motivated
Independent
Will retire later
Will be dependent on dual incomes
Are entitlement dependent
Are generally optimistic about how long they will live and how they will live
Have been hit hard by recent recession in home values and savings for retirement
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What We Anticipate Will Happen To Our Workforce
Low claim frequencyHigh claim severityIncreased fallsLonger healing timesMore severe musculoskeletal disordersCertain claim types will increase
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Common Age-Related InjuriesChanges with Age Type of Injury
Loss of Strength Strains and sprains; tendonitis
Loss of muscular flexibility Strains and sprains; falls
Diminished postural steadiness Slips, trips, falls; fractures, sprains, strains
Reduced grip strength Repetitive motion disease; tendonitis, bursitis, epicondylitis; carpal tunnel syndrome
Reduced balance Falls, Slips
Reduced nervous system responses Decreased reaction times, being struck by objects; fractures, dislocation, death
Reduced cardiovascular capacity Greater risk for heart attack and stroke
Reduced visual capacity Greater exposure to safety hazards, falling injuries
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The years ahead could be the best for your workers…
•Laura Ingalls Wilder wrote her first book at the age of 65.
•Colonel Sanders took to franchising Kentucky Fried Chicken Restaurants, starting at age 65.
•Orville Redenbacher launched famous popcorn at age of 63.
•Ronald Wilson Reagan became President of United States at age of 70.
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Can we agree on one major point?
Our Workforce is Getting Older!
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Cost of Obesity: Duke University Medical Center Study
–Obese workers filed 2X the number of workers' compensation claims
–Obese workers had 7X higher medical costs
–Obese workers lost 13X more days of work from work injury or work illness than did non-obese workers.
–The average medical claim costs per 100 employees were $51,019 for the obese and $7,503 for the non-obese.
–John Hopkins and NCCI released similar studies
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Obesity & Workers Compensation Duke Study
5.8
11.65
0
2
4
6
8
10
12
NormalBMI (18 -
25)
BMI >= 40
WCClaims
Claims Per 100 FTEs
14.19
183.63
0
50
100
150
200
Normal BMI(18 - 25)
BMI >= 40
Lost WorkDays
Lost Work Days per 100 FTEs
Truls Østbye, MD, PhD; John M. Dement, PhD & Katrina M. Krause, MA (2007). Obesity and Workers' Compensation Results From the Duke Health and Safety Surveillance System, Arch Intern Med.167:766-773.
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Claims most strongly affected by Body Mass Index (BMI):
Lower extremity Wrist or hand Back Pain/inflammation Sprain/strain Contusion/bruise Falls/slips Lifting Exertion
Obesity & Workers Comp
Truls Østbye, MD, PhD; John M. Dement, PhD & Katrina M. Krause, MA (2007). Obesity and Workers' Compensation Results From the Duke Health and Safety Surveillance System, Arch Intern Med.167:766-773.
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2001-What shape were we in?
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2002 - What shape were we in?
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2003 - What shape were we in?
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2004 - What shape were we in?
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2005 - What shape were we in?
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2006 - What shape were we in?
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2007 - What shape were we in?
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2008 - What shape were we in?
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2009 - What shape were we in?
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Can we agree on two major points?
Our current workforce is (1) older and, (2) more obese when compared to past
years.
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Non-English Languages Spoken at Home
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“Ljestve moraju biti ispravno osiguran prije….” That was an important safety message but did you understand it?
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Can we now agree on three major points?
Our current workforce is (1) older (2) more obese and (3) is
experiencing an increase in cultural (fear) barriers.
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What has the “Employee Benefits” Side Identified as the Top 2 Drivers of Overall
Health Care Costs?
Stress Mental Health
More workers are absent from work because of stress & anxiety than because of physical illness or injury
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Work-related Stress is a Growing Health Concern
33% of the 40.2 million workdays lost by illness and injury are from stress, anxiety, and depression.
Stress can be a hidden trigger behind cardiovascular problems, musculoskeletal disorders, obesity, depression, and violence.
National Safety Council - News Release September 21, 2005
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Impact of Mental Illness
Recent economic trends have affected stress levels
Recession Layoffs, foreclosures, loss of investments & savings Impact on disposable income
Increased risk of stress-induced health concerns Depression Anxiety Compulsive behaviors (over-eating, excessive gambling,
spending) Substance abuse
Substance Abuse and Mental Health Services Administration, April 2009
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Effect of Single Risk Factors on Sick Leave Absenteeism
Mental Health
Back Pain
Stressed
No Exercise
Obesity
0% 100%50% 150%
N = 35,451 Source: Serxner, S., et al., (2001). The impact of behavioral health risks on worker absenteeism. JOEM, 43(4), 347-354
150%
140%
131%
118%
116%
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Can we agree on four major points?
Our workforce is (1) older (2) more obese (3) more chance of encountering a language barrier and, (4) has more mental health issues.
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Why Wellness and WC Have Not Mixed
Many employers haven’t seen correlation
Wellness typically focuses on Employee Benefits only
Some companies keep WC in Risk Management and Employee Benefits with HR…Wellness Message Not Shared
Carriers slow to make correlation
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Strongest Force in Universe – Resistance to Change
•Why don’t people change?
•Think of one “risk” factor you could eliminate:–Why don’t you eliminate it?–What are cons of not making change?–What are pros of making change?–What support can you get?
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Why don’t people change?
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Rate Your Driving Skills
Excellent
Above Average
Average
Below Average
Poor
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Optimistic Bias
“An earthquake of 9.2 won’t hit here?”
“The Titanic is the greatest ship ever made, it’s unsinkable.”
“I’ll quit tomorrow or soon.”
“I don’t have the time to exercise.”
“It’s so hard to eat good when you’re traveling.”
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Health Risks & WC Costs
Low OWS
Smoking
Poor Health
No Exercise
Low Life Satisfactio
n0% 1000%500
%1500%
1989%
1243%
836%
556%
255%
N = 3,388 X 4 YearsSource: Musich, S., et al., (2001, June). The Association of Health Risks with Workers’ Compensation Costs, JOEM, P. 534-541
2000%
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< 35 35-44 45-54 55-64 65+
0-2 Risks
5+ Risks
$3,432$4,130
$6,664
$9,221
$10,095
$2,025
$2,741
$3,601
$5,445
$7,268
$1,247 $1,515$1,920
$3,366
$4,319
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
Surviving the Perfect Storm; D.R. Anderson, PhD
Source: StayWell Data analyzed by University of Michigan N=43,687
Analysis of Risks, Age and Cost
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The Wellness SolutionConverging healthcare trends affecting employers: Ballooning costs – demand for new solutions Increased focus on productivity Talent retention / competition Consumerism, cost sharing Aging workforce
Shifting costs does not always lead to lower costs or help address the problems causing increasing costs
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ROI in Worksite Health Promotion
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Why Now?
"There's no question that workplace wellness is worth it. The only question is whether you're going to do it today or tomorrow. If you keep saying you are going to do it tomorrow, you'll never do it. You have to get on it today."
- Warren Buffett
1. Focus on productivity – doing more with less
2. Proactive cost-containment approach
3. Investment in human capital
4. Increased stress levels due to economic climate
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Wellness Implementation Barriers Still Remain
Willis Wellness SurveyThe op three barriers to implementing a wellness program:
Budget constraints 61%
Not enough time/staff to devote 42%
Employees in various geographic locations 25%
Think investment - not cost.
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What are Employers Doing?
Willis Wellness Survey
Weight management 64%Physical activity 65%Smoking cessation 71%Medical screenings 49%General health website 52%Disease management 47%Periodic health fairs 41%Health risk assessments 50%
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Management’s Perspective
Willis Wellness Survey
94% of leadership is committed to improving employee
health.
94% of management believe that employee health can be
directly linked to absenteeism and productivity.
86% of management are committed to improving the
work-life balance of employees.
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Wellness StrategyGroup Health Programs Worker’s Compensation
Loss Prevention
Wellness Programs Health Risk Assessments/ScreeningsWellness Committee
Create a safe working environmentErgonomic Assessment, safety audits, pre-work stretchSafety Committee
Loss Reduction Condition ManagementEducation: medical self-care, consumerismBehavior change programs
Claims managementEducation: safety practices & proceduresTransitional return-to-workProvider Discounts
Risk Transfer Fully insured alternativesCoordination of BenefitsDefined Contribution
Insurance Contract reviewRetrospective plans
Risk Financing Direct Contracting, Networks, Tiered plan
Program Design
Benefit Structure/Pricing
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Willis – Wellness Strategy
Willis
Tools & Resources
Turnkey wellness
Diet content
Fitness content
Health coaching
Virtual health fair
Reward tracking
Reward delivery
Productivity
Moral
Employee Engagement
Work-Life Balance
Absenteeism
Turnover
Healthcare Cost
WorkplaceAccidents
Wellness Strategy Goals
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Worksite Wellness
A strategic business initiative designed to maximize the health of the workforce.
Policies & Cultural Support
Early Identification of Risk
Behavior Change
Ongoing Efforts to Maintain & Improve Health
More than a Vendor Relationship
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Conclusion
Do Homework: Analytics on Obesity, Aging, Mental Health Impact, Cultural Barriers
Know your Demographics: Risk Pool
Combine Disability, Medical and WC data
Bridge Gap: Joint Strategy with Workers Compensation and Employee Benefits
Wellness Strategic Risk Planning Session
Measure ROI
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Managing Total Risk & Total Cost: WC & Employee BenefitsWhy Wellness, Why Now? April 12, 2011
Questions?