Connecting Health, Productivity and Business Thomas Parry, Ph.D. President
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Transcript of Connecting Health, Productivity and Business Thomas Parry, Ph.D. President
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Connecting Health, Productivity and Business
Thomas Parry, Ph.D. President
Integrated Benefits Institute
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About IBI• National, not-for-profit corporation• 674 corporate sponsors• Employers: 90% of IBI’s members• IBI’s mission. Demonstrate the business
value of a healthy workforce through:– Independent HPM research– Measurement and modeling tools– Forum for sharing ideas and experience
• Visit www.ibiweb.org
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“The healthcare issue that connects employers all over the world – regardless of how the healthcare system is financed in their country – is time loss from work and resulting lost productivity.”
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New Employer Realities• Unprecedented economic challenges• Show the C-suite the value of improved
workforce health• Dead end: attempting to control claims
costs in separate program silos• Looking for best strategies to improve
workforce health, reduce lost time and enhance productivity
• Limited data, time and dollars
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What’s at Risk for Employers? Even in the US, health-related lost
productivity is a big deal
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The Full Costs of EE Health-- Auto Manufacturers
• Estimates based on IBI’s new FCE modeling tool
• 171,250 employees• Employer-paid claims costs only• Published as IBI Quick Study in
February 2011
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Full Cost Components
Medical Wage replacementsAbsence LP Performance LP
8%48%
28%
16%
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A View of the Canadian Workforce
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Prevalence of Chronic Disease
No chronic
condi-tion
s (25%)
>= 1
chronic
condi-tion (75%)
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Changing Importance of Top 10Prevalence Treatment
PenetrationLost Time
1) Allergies/hay fever 1) Diabetes 1) Depression
2) Back/neck pain 2) Hypertension 2) Chronic fatigue
3) High cholesterol 3) Congestive heart failure
3) Anxiety
4) Heartburn/GERD 4) Coronary heart dis. 4) Back/neck pain
5) Arthritis 5) Osteoporosis 5) Obesity
6) Anxiety 6) High cholesterol 6) Sleeping problems
7) Depression 7) COPD 7) Heartburn/GERD
8) Obesity 8) Asthma 8) Irritable bowel
9) Hypertension 9) Depression 9) High cholesterol
10) Chronic fatigue 10) Sleeping disorders 10) Chronic pain
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Treatment of Chronic Disease
Cur-rentl
y treated (27%)
Never treated (37%)
Treated only in
the past (36%)
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Prevalence of Co-Morbidity
None (25%)
One (23%)
Two (17%)
Three
(12%)
Four (8%)
>= five (15%)
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The View from the C-Suite
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Linking Health, Productivity & the Bottom Line
Strong link61%
Weak link7%
Moderate link32%
CFO Survey, IBI, 2002
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Critical Factor
4%
Moderate Degree
54%
Great Degree21%
Slight Degree18%
Not At All3%
Effect of Benefits Programs on Financial Performance
A big deal for only 25%
Source: On the Brink of Change – How CFOs View Investments in Health and Productivity. Integrated Benefits Institute. 2002.
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The Impact of Ill-Health
0%
25%
50%
75%
100%
Highermedical
Troublefocusing on
job
Moreabsence
Affectsbottom line
beyondhealthcare
Adverselyaffects other
benefitscosts
Need largerworkforce
Agree Strongly agree
96%90% 86% 84%
71%
47%
Source: The Business Value of Health: Linking CFOs to Health and Productivity , IBI, 2006
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Are CFOs Getting Information?
• Absence–51% ever get reports on occurrence–22% get reports on financial impact
• Presenteeism–22% ever get reports on occurrence–8% get reports on financial impact
Source: The Business Value of Health: Linking CFOs to Health and Productivity , IBI, 2006
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Quantifying Financial Lost Productivity*
• Lost productivity – “the financial impact on a company when employees are not at work and fully functioning”
• Two components: absence and decrements in job performance (“presenteeism”)
• The Financial Impact of Absence– Wage replacement payments– “Opportunity costs” of ER’s response
• The Financial Impact of Presenteeism– Wage and benefit “overpayments”– Opportunity costs of resulting lost time
*Source: Sean Nicholson, Mark Pauly, et al., "Measuring the Effects of Work Loss on Productivity with Team Production," Health Economics 15: 111-123 (2006).
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Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
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RA Study Population
• 5,483 employees with RA• Ave. age: 51 years (14%
under 40 and 14% over 60)• 41% Male; 59% female
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45%
0%
10%
20%
30%
40%
50%
Baseline plus $5 plus $10 plus $15 plus $20
Increase in copay - Disease modifying drug
% E
mpl
oyee
s fill
ing
at le
ast o
ne sc
ript
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
Impact of Out-of-Pocket Cost-- on medication adherence --
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45%39%
0%
10%
20%
30%
40%
50%
Baseline plus $5 plus $10 plus $15 plus $20
Increase in copay - Disease modifying drug
% E
mpl
oyee
s fill
ing
at le
ast o
ne sc
ript
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
Impact of Out-of-Pocket Cost-- on medication adherence --
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45%39%
36%
0%
10%
20%
30%
40%
50%
Baseline plus $5 plus $10 plus $15 plus $20
Increase in copay - Disease modifying drug
% E
mpl
oyee
s fill
ing
at le
ast o
ne sc
ript
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
Impact of Out-of-Pocket Cost-- on medication adherence --
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45%39%
36%32%
0%
10%
20%
30%
40%
50%
Baseline plus $5 plus $10 plus $15 plus $20
Increase in copay - Disease modifying drug
% E
mpl
oyee
s fill
ing
at le
ast o
ne sc
ript
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
Impact of Out-of-Pocket Cost-- on medication adherence --
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45%39%
36%32%
28%
0%
10%
20%
30%
40%
50%
Baseline plus $5 plus $10 plus $15 plus $20
Increase in copay - Disease modifying drug
% E
mpl
oyee
s fill
ing
at le
ast o
ne sc
ript
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
Impact of Out-of-Pocket Cost-- on medication adherence --
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45%39%
36%32%
28%
0%
10%
20%
30%
40%
50%
Baseline plus $5 plus $10 plus $15 plus $20
Increase in copay - Disease modifying drug
% E
mpl
oyee
s fill
ing
at le
ast o
ne sc
ript
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
Impact of Out-of-Pocket Cost-- on medication adherence -- Adherence
reduced 38% by $20 copay
increase
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Savings in Lost Productivity Costs-- For No-Script Group --
$12.8$14.0$17.2
$0
$5
$10
$15
$20
Baseline Reduced incidence
Reducedincidence +
duration
Lost
Pro
duct
ivity
Cos
ts ($
Mill
ions
)
-26%
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
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New Report: Linking VBBD and Productivity
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Health Risks & Job Performance
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Co-Morbidity and Absence
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Prevalence across broad condition clusters among those with at least one chronic condition
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Annual Absence DaysSingle vs. Co-Morbid Condition Clusters
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Annual Presenteeism DaysSingle vs. Co-Morbid Condition Clusters
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Annual Lost DaysAbsence and Presenteeism
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Transitioning from ROI to Value of Investment
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Key Health Dimensions• Financial• Program participation• Biometric screening• Health risks• Utilization• Preventive care• Chronic conditions• Lost worktime• Lost productivity• Employee engagement
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The Temporal Dimension• Leading indicators
– Health risks– Preventive care – Biometric screening– Chronic conditions– EE engagement
• Treatment indicators– Utilization– Program participation
• Lagging indicators– Financial– Lost worktime – Lost productivity
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Dimensions & Dashboard Metrics Dimension Summary Metric
Financial Program cost/EE
Program participation EEs participating/All EEs
Biometric screening EEs reaching target/All EEs
Health risks # of health risks/EE
Utilization # EEs getting care/All EEs
Preventive care # EEs getting screened/All EEs
Chronic conditions # EEs w/ chronic conditions/All EEs
Lost worktime # of lost workdays/EE
Lost productivity Lost productivity $/EE
Employee engagement Engagement score/EE
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Thinking about Metrics as Hierarchies
Dashboard metrics
Component metrics
Contributing metrics