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. About IBI. National, not-for-profit corporation 674 corporate sponsors Employers: 90% of IBI’s members - PowerPoint PPT PresentationTRANSCRIPT
Connecting Health, Productivity and Business
Thomas Parry, Ph.D. President
Integrated Benefits Institute
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
“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.”
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
What’s at Risk for Employers? Even in the US, health-related lost
productivity is a big deal
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
Full Cost Components
Medical Wage replacementsAbsence LP Performance LP
8%48%
28%
16%
A View of the Canadian Workforce
Prevalence of Chronic Disease
No chronic
condi-tion
s (25%)
>= 1
chronic
condi-tion (75%)
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
Treatment of Chronic Disease
Cur-rentl
y treated (27%)
Never treated (37%)
Treated only in
the past (36%)
Prevalence of Co-Morbidity
None (25%)
One (23%)
Two (17%)
Three
(12%)
Four (8%)
>= five (15%)
The View from the C-Suite
Linking Health, Productivity & the Bottom Line
Strong link61%
Weak link7%
Moderate link32%
CFO Survey, IBI, 2002
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.
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
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
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).
Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007
RA Study Population
• 5,483 employees with RA• Ave. age: 51 years (14%
under 40 and 14% over 60)• 41% Male; 59% female
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 --
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 --
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 --
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 --
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 --
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
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
New Report: Linking VBBD and Productivity
Health Risks & Job Performance
Co-Morbidity and Absence
Prevalence across broad condition clusters among those with at least one chronic condition
Annual Absence DaysSingle vs. Co-Morbid Condition Clusters
Annual Presenteeism DaysSingle vs. Co-Morbid Condition Clusters
Annual Lost DaysAbsence and Presenteeism
Transitioning from ROI to Value of Investment
Key Health Dimensions• Financial• Program participation• Biometric screening• Health risks• Utilization• Preventive care• Chronic conditions• Lost worktime• Lost productivity• Employee engagement
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
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
Thinking about Metrics as Hierarchies
Dashboard metrics
Component metrics
Contributing metrics
