Co-hosted by:

Integrated Benefits Institute

American College of Occupational

And Environmental Medicine

Workforce Health and Productivity Summit:A Blueprint for Action

November 5-7, 2008

• Summit Backdrop

• Health & Productivity Primer

• Blueprint for Action– Consensus Statements– Recommendations

• Employer Best Practices

• Q & A

Agenda

• Hosted by ACOEM and IBI

• Funding by sanofi-aventis

• Held Nov. 5-7, 2008

• More than 40 U.S. leaders

• Consensus Statements and Recommendations issued

• Final report in March, 2009

About the Workforce Summit

John Agos

Catherine Baase, MD

Steve Barger

Douglas Benner, MD

Ann Brockhaus

Schumarry Chao, MD

Helen Darling

David Deitz, MD

Nancy Desmond

Gary L. Earl

Dee W. Edington, PhD

Barry S. Eisenberg, CAE

Franz Fanuka

Ronald Goetzel, PhD

Paul B. Handel, MD

Stacy Hodgins

John Howard, MD

Warner Hudson

Pamela Hymel, MD

David Kasper

Vincent E. Kerr, MD

Ronald Kessler, PhD

Matt Kinkead

Ronald Leopold, MD

Garry Lindsay, MPH, CHES

Ronald R. Loeppke, MD, MPH

Bryon MacDonald

Robert K. McLellan, MD

Summit Participants

Chris McSwain

Kenneth Mitchell, PhD

Thomas Parry, PhD

Kenneth R. Pelletier, PhD, MD

Dennis Richling, MD

Andrew Scibelli

David Sensibaugh

Archie Simons, Jr.

Mary Tavarozzi

Peter Wald MD, MPH

Kim Jinnett, PhD

William Molmen, JD

Doris Konicki, MHS

Michael Taitel, PhD

• Four moderated work groups

• Free-flowing discussions

• Large-group synthesis of ideas

• Final Consensus Statements and Recommendations

How it was Organized

• U.S. health care/entitlement systems are in crisis

• “Silver Tsunami” coming– 80 million boomer retirees

• Chronic disease rising in the workplace– More than half of Americans have

a chronic disease

Why is a Summit Needed?

Why is a Summit Needed?

The Impact of Chronic Illness– 83% of Medicaid cost and 96% of Medicare cost is due to chronic illness– Obesity drove 27% of all medical cost increases between 1987 and 2001– 2/3 of increase cost in U.S. since 1980 relates to increase in prevalence and

acuity of chronic illness

The Rise of the Burden of Risk and the Burden of Illness– An estimated 127 million adults in the U.S. are overweight, 60 million obese,

and 9 million severely obese– Approximately 40% of all deaths in the U.S. are premature – at least 900,000

deaths annually – due to unhealthy lifestyle choices– 80% of Heart Disease is preventable– 40% of Cancer is preventable– 80% of Type 2 Diabetes is preventable– Current Adolescents may be the first generation to not have a longer life span

than the generation preceding them

Ken Thorpe, PhD, ACPM Prevention 2008 Conference, Austin, Texas, Feb 21, 2008; Prevention for a Healthier America, TFAH, NY Acad Med, Robert Wood Johnson Foundation , Sep, 2008

Ken Thorpe, PhD, ACPM Prevention 2008 Conference, Austin, Texas, Feb 21, 2008; Prevention for a Healthier America, TFAH, NY Acad Med, Robert Wood Johnson Foundation , Sep, 2008

• These trends put U.S. productivity at risk

• Much at stake for employers– Est. health-related productivity

costs = $13,000 per employee– Overall impact = $1.7 trillion

• Studies show clear link between health/productivity

Why is a Summit Needed?

• The health of the workforce is inextricably linked to the productivity of the workforce, and therefore, to the health of the economy.

• Human capital is a resource to be invested in – not a cost to be managed. A 3% increase in human capital would offset all financial capital losses in the global markets in the past year.

• Human capital is 80% of the entire capital of the world.

A Health and Productivity Primer

Michael Milken, October 30, 2008

• Health-related productivity costs can be both direct and indirect (hidden).

• Key factors to understand are absenteeism and presenteeism.

• Successful H&P strategies focus on accurate measurement first, followed by implementation of evidence-based and value-based health enhancement programs.

• Studies show results (JOEM: “Health and Productivity as a Business Strategy.”)

A Health and Productivity Primer

• For every $1 spent on medical/pharma costs, employers absorb up to $4 in health-related productivity costs.

• When FULL costs are considered (direct and hidden), some health conditions are far costlier to employers than realized.

• Examples include depression, fatigue, and back/neck pain.

A Health and Productivity Primer

Source: JOEM – “Health and Productivity as a Business Strategy,” July, 2007

Health Risks Impact Productivity

% of Workplace Productivity Loss

0-2 risks

3-4 risks

5+ risks

14.7%

20.9%

26.9%

6.4 Days

9.3 Days

12.6 Days

1 risk 3 risks 4+ risks

Work days lost / Person / Year

STD Days / Year

0-1 risks

2- 3 risks

4+ risks

2.4 Days

5.3 Days

13.1 Days

Sources: Burton, et al, JOEM: Vol. 47. No. 8, August, 2005; Wayne Burton, MD, IHPM North American Summit Meeting 2000; also Tsai, et al. JOEM: Vol. 47, No. 8, August, 2005

Top 10 Medical Conditionsby Annual Total (Med/Rx + Productivity) Cost/1000 FTEs

Back/N

eckD

epressionFatigue

Chronic Pain

Sleeping ProblemH

igh Cholesterol

Arthritis

Hypertension

Obesity

Anxiety

$500,000

$400,000

$300,000

$200,000

$100,000

$0

Source: Loeppke R, et.al., “Health and Productivity as a Business Strategy”, Journal of Occupational and Environmental Medicine. Vol 49, No. 7, July, 2007. Pages 712-721.

OutpatientInpatient DrugAbsenteeismPresenteeism

for Four Employers (N=15,380)

14

Problem: Increasing Total Health Related Costs driven by converging trends

Solution: Reduce the Burden of Risk/Illness and enhance the Health and Productivity of

our Human Capital

Re-thinkingWorkforce Health

1. How can we move workplace health toward a model that dramatically increases the emphasis on wellness, prevention and savings in lost time and lost productivity in concert with the treatment of illness and the management of disability?

Summit Key Questions

2. What role should Evidence-Based Medicine (EBM) play in workforce health and productivity?

Summit Key Questions

3. In the workplace of the future, what would effective health and productivity management (HPM) programs look like?

Summit Key Questions

4. How do we encourage employers/payers to embrace health and productivity enhancement as a long-term strategy?

Summit Key Questions

1. The health of the workforce is inextricably linked to the productivity of the workforce and therefore ultimately linked to the health of the economy.– Include H&P strategies/metrics in legislative initiatives– Validate and disseminate H&P best practices– Recognize exemplary H&P programs– Encourage public-private technical assistance– Emphasize a real culture of health and safety– Expand supply of health professionals with H&P training– Initiate pilot studies to test innovative H&P models

Summit Recommendations

2. Continuing the status quo of current health care strategies in the workplace is not a sustainable option; the realities of the economic burden of health risks and health conditions, rising total costs and an increasingly competitive global marketplace require an urgent shift to integrated health and productivity improvement strategies.– Create awareness-building for shift to H&P strategies– Compile evidence and tools for transition to a “culture of

health” paradigm

Summit Recommendations

3. A strong body of evidence has emerged in recent years, offering employers proven strategies for more effectively managing the health of the workforce and recognizing the strong link between health and productivity.– Structure and communicate evidence to stakeholders– Drive employer adoption of H&P initiatives– Create an inventory of effective H&P interventions– Develop H&P evidence base through further research and

case studies

Summit Recommendations

4. Successful integrated health and productivity improvement initiatives are built upon well-established, recognized principles.– Management promotion of “healthy company” culture– Organizational and employee risk assessment– Evidenced-based interventions, for near-term and long-term– Aligned incentives/resources for H&P improvement– Integration of initiatives with other stakeholders – Workplace environment and policies for healthy lifestyles– “Full value” measurement/evaluation, beyond financial ROI– Integration across “silos”: one H&P strategy and budget

Summit Recommendations

5. The impact of a healthier, more productive workforce is quantifiable; when combined with other business measures it helps determine the overall economic value of an enterprise.– Raise business awareness of relationship between

workforce health, productivity and employer profitability– Educate business community on benefits of H&P assets– Assist business in developing valuation methods that

include H&P metrics to judge value of workforce health

Summit Recommendations

6. As an evolving discipline, integrated health and productivity measurement methodologies should be studied continuously, improved and more consistently applied.– Practitioners of H&P improvement should establish

common terms/definitions and better defined processes– Methods should be refined for documenting the positive

effects of workplace health, adverse effects (health risks, unhealthy behaviors and health conditions), promising interventions, full-cost effectiveness and ways to monitor integration, scalability and sustainability over time

Summit Recommendations

7. Employers need to have a consistent, ongoing approach for measuring and benchmarking their results as they design and implement integrated health and productivity improvement initiatives.– Create benchmarking data sets and tools to help employers

evaluate their health-related costs– Place emphasis on data/tools from published research,

objective and self-reported measures of presenteeism and absenteeism and integrated H&P warehouses

– Promote H&P strategies that can be achieved by small- and medium-sized businesses

Summit Recommendations

8. The concept of evidence-based medicine has grown more commonplace in U.S. health care. However, the evidence used to determine best practices needs to include impacts on health and productivity.– Integrate H&P metrics into evidence-based outcomes,

including absenteeism, return-to-work, lost days, impaired work performance (presenteeism), total health-related costs and patient satisfaction

– Include this “expanded” view in ROI/purchasing decisions– Promote awareness of H&P costs with providers/consumers– Align stakeholders (pay-for-performance and medical home)

Summit Recommendations

9. Engagement and participation of the workforce is essential to successful design and implementation of health and productivity improvement initiatives.– Incent the workforce to engage in H&P initiatives– Implement communications that increase engagement and

participation of employees/family members– Encourage the strategic selection of high-performance

suppliers that agree to H&P measures when evaluating the full impact of interventions

– Integrate community resources with workplace initiatives

Summit Recommendations

10. Health is determined by a wide range of factors, some of which cannot be addressed through medical and/or behavioral intervention. Broad social and environmental determinants – ranging from food and transportation systems to cultural practices– can influence health.– Encourage employers to consider a multi-faceted approach

to integrated H&P strategies, including addressing the social determinants of health

– Acknowledge that good health is influenced by many factors– Recognize that wellness is more than the absence of illness

Summit Recommendations

• Caterpillar Health Partnership Program• Cisco LifeConnections Health Center• Dow Chemical Health & Human Performance Mgmt.• Florida Power & Light FPL-WELL Program• Johnson & Johnson

– Employee Assistance Program– Healthy People Program

• Pepsi Bottling Group Healthy Living• USAA “Take Care of Your Health”• We Energies Health Enhancement Initiative

Employer Best Practices

• Without a healthy, able and available workforce, the United States will find it impossible to thrive in an increasingly competitive global marketplace.

• The workplace offers unique resources and infrastructure for addressing U.S. health care problems overall.

• Health promotion and health protection measures aimed at the nation’s workforce could have significant long-term impact, potentially saving billions in costs.

Why The Summit Matters

• Share Summit findings with your internal audiences• Join the Summit’s advocacy effort as we seek action

from lawmakers and policy leaders• Assess your own health and productivity efforts,

using tools– ACOEM website: Health and Productivity Management

Center, HPM Toolkit & CHAA– IBI website: various tools and resources

• Build a healthier, more productive workforce• Share results and learn from best practices

How You Can Help

• www.acoem.org

• www.ibiweb.org

• http://hpm.acoem.org/

• www.chaa.org

For More Information