This edition of Outcomes features findings from studies on workforce health and productivity management measures and interventions.
Calculating Employers’ Health Management Costs
To help U.S. employers better understand all of their health and productivity costs, the non-profit Integrated Benefits Institute (IBI) has developed a sophisticated new model – the Full Cost Estimator.
Because most employers manage benefits programs in multiple departments and through numerous suppliers, critical data often are missing or scattered. Additionally, real but often unmeasured costs of health-related underperformance and lost productivity are considered so complex that most organizations don’t know how to quantify them, according to IBI researchers.
The estimator enables an employer to consolidate disparate components into a single application to evaluate the effectiveness of interventions. Benchmarking parameters include industry type, workforce size and demographics, health and absence policies, and the employer’s benefits experience data. Using the estimator, a single report may feature data on:
- Sick-day absences and disability wage replacements;
- Non-concurrent family and medical leave absences;
- Occupational and non-occupational medical and pharmacy claim costs;
- Lost output due to presenteeism; and
- Lost productivity burdens from employee underperformance and lost workdays.
“As employers navigate health care reform and make the business case for health improvement, it’s important that they understand the real impact of health and its business-relevant outcomes,” said Thomas Parry, Ph.D., IBI president. “This tool can play an important role in helping employers maximize the data they do have and fill in the blanks when data are unavailable.”
The estimator draws on a number of sources, including millions of disability claims in IBI’s benchmarking databases, results from a validated health assessment survey (HPQ-Select) developed in partnership with Ron Kessler, Ph.D., a professor of health care policy at Harvard Medical School, and nationally representative databases such as the Centers for Disease Control and Prevention’s National Health Interview Survey, AHRQ’s Medical Expenditure Panel Survey, and the U.S. Bureau of Labor Statistics’ Injuries, Illnesses, and Fatalities program.
The estimator will be used by employer participants in the American Health Strategy Project, a program of the National Business Coalition on Health in cooperation with Pfizer Inc., which assists participating employers in taking a strategic approach to value-based health benefits.
Source: Visit: ibiweb.org
Presenteeism Study Hiatus Proposed
Experts say a shift in focus from individual health behaviors to lost productivity in working populations may be needed to develop more meaningful metrics on cost impacts.
In recent years, presenteeism – reduced productivity at work because of health-related issues – has become a buzzword in connection with workforce health management strategies. But now a group of experts has proposed a moratorium on presenteeism research while tools are developed to more accurately measure lost-productivity costs and savings associated with efforts to improve health, such as employee wellness programs.
An extensive literature search of presenteeism studies suggests “substantive questions remain about the measurement of presenteeism, its conversion into lost productivity and the translation of presenteeism into financial equivalents,” Dee W. Edington, Ph.D., and colleagues at the University of Michigan Health Management Research Center say in an article published in the November Journal of Occupational and Environmental Medicine. “Many aspects of presenteeism still warrant caution, especially when using presenteeism measurements to quantify economic outcomes.”
Until more reliable tools are developed, Dr. Edington’s group plans to suspend studies of presenteeism and its economic impact.
Meanwhile, they present a list of limitations and assumptions to help guide further development of tools for measuring presenteeism impacts. They also suggest that employers consider placing a greater emphasis on workforce populations (such as across a company or department) rather than on individuals when evaluating lost productivity costs and the value of health interventions.
In the article, Presenteeism: Critical Issues, they pose some key questions:
- Is there one best way to measure presenteeism?
- Are all instruments measuring quality in the same way?
- Can results be validated against objective measures of productivity?
They say these questions need to be answered before two other key issues can be addressed: the expression of lost work time converted into lost productivity and the translation of lost productivity into dollar costs.
While the “general and intuitive concept” of presenteeism has entered the mainstream, corporate leaders continue to be skeptical about it, according to Dr. Edington and his colleagues. “If health-related presenteeism is truly an important construct, then the issues raised in this paper need to be addressed and resolved.”
Reference: Brooks A, Hagen SE, Sathyanarayanan S, Schultz AB, Edington DW. Presenteeism: Critical Issues; J Occup Environ Med. 2010;52(11):1055-67.
Prevention Reduces Health Risks, Study Shows
Another newly published study in which Dr. Edington of the University of Michigan served as a co-author found prevention can be effective. Ronald Loeppke, M.D., lead author, presented selected findings at RYAN Associates’ annual national conference, just one day before the study, Prevention Plan on Employee Health Risk Reduction, was published in Population Health Management. He said the study ”demonstrates compelling health risk reduction in employee populations.”
The study evaluated the impact of The Prevention PlanTM on employee health risks after one year of primary (wellness and health promotion) and secondary (biometric and lab screening and early detection) preventive interventions. The Prevention Plan, a product of U.S. Preventive Medicine, Inc., is a benefit program that provides its members with health management tools such as a 24-hour nurse hotline, personal health coaching, health-oriented events, and incentives.
For the study, researchers measured changes in 15 health risk categories among a cohort of 2,606 employees from multiple employer groups. Participants completed a baseline health risk appraisal, blood tests, and biometric screening in 2008 and underwent a reassessment in 2009. Program participants were separated into one of three groups based on health risks such as high cholesterol, blood pressure, or stress levels. Low-risk employees were defined as having zero to two health risks, medium-risk employees three to four risks, and high-risk employees five or more risks. The findings were then compared to a “natural flow of risk transitions” model created by Dr. Edington.
Overall, there was a positive health risk transition, with net movement from higher-risk levels to lower-risk levels. The cohort showed significant reductions in 10 of the 15 health risk categories, most notably in the proportion of employees with high-risk blood pressure, fasting blood sugar, and stress levels—all risks that can be addressed through a comprehensive approach to individual and workforce health management. In addition, participants showed improvement in cholesterol levels and physical activity, and reductions in fatty food consumption and heavy drinking. The population also achieved a reduction in health-related illness days and improved personal health perceptions. After one year, 42 percent of study participants experienced a decrease in the number of health risks they faced, with 64 percent of high-risk participants lowering their risk status and 87 percent of low-risk participants maintaining their health status.
“This is scientific proof that wellness works when structured on the pillar of prevention,” Dr. Loeppke said.
Reference: Impact of the Prevention Plan on Employee Health Risk Reduction; R Loeppke, D Edington, S Beg; Population Health Management, Vol. 13, No. 5, 2010; © Mary Ann Liebert, Inc.
Medical Treatment Leading RTW Indicator
The leading predictor of return to work (RTW) is medical treatment—far exceeding other influencing factors such as job type, co-morbidities, age, and severity, according to a Work Loss Data Institute study on disability durations conducted for a leading insurance carrier.
“Different return-to-work pathways evolve within the same diagnosis, depending on the type of treatment administered,” said Pat Whelan, institute director and publisher of ODG Treatment, including Official Disability Guidelines. “Return-to-work durations are not self-defined but directly impacted by treatment; the study quantifies that impact.”
For example, the study shows that for spinal fusion for low back pain (not recommended in ODG), return-to-work time is more than 100 times as long as it is for exercise (recommended in ODG). For low back pain, job class (sedentary, light, heavy, etc.) makes almost no difference in disability duration.
Ms. Whelan said RTW guidelines “must be integrated with evidence-based medical treatment guidelines (EBM) in order to be a fair, accurate and effective RTW management tool. Further, true EBM must link to and mirror today’s science. Treatment recommendations should not vary based on the preferences of different jurisdictions, political influences, or economic agendas.”
Source: www.worklossdata.com
