Slide 1

Report
Health Risk Management
Today’s Presentation
•
•
•
•
Define Health Risk Management (HRM)
Our vision
The bottom line impact of poor Health Risk Management
The scope of a proactive HRM study
•
•
•
Elements
Program
Partnerships
• Long term study strategy
• Our enrollment progress to date
Health Risk Management
• A worksite-based proactive approach to helping identify and
reduce specific health risk factors through healthier lifestyle
choices.
•
•
•
•
Assessment
Coaching and education
Specific interventions
Reporting
Our Vision
To reduce workers’ compensation costs and
provide measurable benefits to policyholders
by improving employee health and productivity.
Core areas of opportunity
–
–
–
–
Workers’ compensation cost and trend improvements
Increased productivity for employers
Improved health and wellness status of employees
Be a leader in the application of health risk management
in workers’ compensation
Why Health Risk Management Now?
Workplace
Safety
Medical
Management
1970s
Employer Behavior
1980s
Organizational
Culture/Structure
1990s
Operational Behavior
Health Risk
Management
2010
Employee Behavior
The Bottom Line Impact of Poor
Health Risk Management
• Workers’ Compensation Costs
• Productivity
• Health Insurance Claims
Medical 22%
Disability 4%
DIRECT
Total Cost of Poor Employee Health
Workers’ Compensation
Indemnity Costs
Medical Costs
Sick Leave
Other Wage Replacement
Loss 74%
OTHER COSTS
Lost Productivity
Productivity
Health Care Costs
Medical Care
Hospitalization
Pharmacy
Diagnostic Testing
Behavior Health
Physical Therapy
Absenteeism
Temporary Staffing
Replacement Training
Adverse Bottom Line Impact
Presenteeism
Turnover
Missed Deadlines
Overtime Pay
Sub Par Quality
Employee & Customer Dissatisfaction
Workers’ Compensation: Direct Cost
• A greater than 8-fold difference in w.c. costs between
recommended weight and obese workers. Duke University
• A 7-fold difference in w.c. costs between high and low risk
workers. University of Michigan
•
A 23% decline over 2 years in w.c. claims costs and 18% decline in
w.c. claims volume among companies engaging in HRM. Wellsource
Health Solutions
• Health risks have a compounding impact on w.c. costs
• Obese claims are 2.8 times more expensive than non-obese claims at
the 12-month maturity. The cost difference climbs to a factor of 4.5 at
the three year maturity and to 5.3 at the five year maturity.
National
Council on Compensation Insurance (NCCI), 2009
The most obese have 13 times more lost
workdays than healthy weight workers
Duke Study
200
183.63
11.65
10.80
160
140
100
117.61
7.05
5.53
8
5.80
75.21
80
60
10
8.81
120
12
6
60.17
4
40.97
40
2
14.19
20
0
0
BMI<18.5
(Underweight)
18.5 – 24.9
(Healthy Weight)
25 – 29.9
30 - 34.9
35 – 39.9
40+
(Overweight) (Obese Class I) (Obese Class II) (Obese Class III)
Lost Workdays
Source: Ostbye, T., et al, “Obesity and Workers Compensation,”
Archives of Internal Medicine, April 23, 2007.
Claims
Claims per 100 FTEs
Lost Workdays per 100 FTEs
180
14
Duke Study
$51,091
$70,000
$60,000
$59,178
Indemnity costs are 11 times
higher for the most obese workers
than for healthy weight workers.
$23,373
$23,633
$13,569
$5,396
$7,503
$3,924
$10,000
$7,109
$20,000
$13,338
$30,000
$19,661
$40,000
$34,293
$50,000
$0
BMI<18.5
18.5 – 24.9
(Underweight) (Healthy Weight)
25 – 29.9
30 - 34.9
(Overweight) (Obese Class I)
Medical Claims Costs
Source: Ostbye, T., et al, “Obesity and Workers Compensation,
” Archives of Internal Medicine, April 23, 2007.
35 – 39.9
40+
(Obese Class II) (Obese Class III)
Indemnity Claims Costs
Productivity
• Employers, on average, have $3 of health-related
productivity costs for every $1 of medical or pharmacy
claims costs. (Journal of Occupational & Environmental Medicine July
2007)
• Lost productivity represents 7.9% of total corporate
earnings and 5.3% of human capital costs. (Health and Human
Capital Foundation)
• The most costly conditions related to productivity are often
not the same as the most costly conditions related to
medical treatment costs. Taking an integrated approach to
health and productivity results in more cost-effective
interventions. (Journal of Occupational & Environmental Medicine
July 2007)
Look Beyond Health Insurance Costs
Back/Neck Pain
Depression
Fatigue
Other
Chronic Pain
Sleeping Problem
High Cholesterol
Arthritis
Hypertension
Obesity
Anxiety
$0
$100,000
Medical
JOEM July 2007
$200,000
Drug
$300,000
Absenteeism
$400,000
Presenteeism
$500,000 $600,000
Impact of Health Insurance
• The vast majority of Pinnacol policyholders have fewer than
25 employees
• We assume the rate of uninsured status, from a health care
perspective, mirrors the state as a whole
• Approximately 50% of our participants are likely to have no
health insurance
• Placing HRM in a worksite environment rather than a health
insurance environment is a key differentiator
We Believe
In the future, Health Risk Management will be as fundamental to
managing risk as safety is now.
Pinnacol HRM Components
•
•
•
•
3-5 year timeframe
Partnering with key agencies
Free HRM services to policyholders
3,000 participating policyholders representative of Colorado’s
workforce (Small and medium sizes of employers are a critical
component)
• 30,000 enrolled members
Pinnacol’s HRM Program
•
•
•
•
Health Risk Assessment for employees
Health education and coaching
Specific interventions and programs
Reporting on participation and outcomes
•
•
•
•
Policyholders
Agents
Pinnacol
Colorado/national
Pinnacol’s HRM Partnerships
Service Delivery - Interventions
Wellsource Health Solutions (WHS)
Reporting
WHS: Health risk profile
Integrated Benefits Institute: HPQ-Select Productivity Survey
(Harvard-WHO tool)
Data/Evaluation
IBI, Thomson Reuters/Emory University/local universities
HRM Study Strategy
• Use outside independent evaluators to conduct a peer review
quality assessment of the long term impact of HRM on:
•
•
•
•
Health risk profile of our policyholders and their employees (based on trended
HRA results)
Monetized changes in productivity (based on trended results of HPQ-Select)
Changes in Workers’ Compensation (based on participant pool versus Pinnacol
control group)
Changes measured over 3 – 5 years
• Work with local universities and researchers to identify other
relevant issues and make data available for non-Pinnacol
initiatives
Progress Toward our Study Goals
Enrolled Policyholders
105 of 3,000
Enrolled Employees
9,148 of 30,000
Data as of 8/27/2010

similar documents