Your New #1 Priority: What You Need to Know about Tackling Behavioral Health IssuesJenny Schneider, M.D., M.S.Chief Medical OfficerCastlight Health

Brian Gifford, Ph.D. Director, Research & DevelopmentIntegrated Benefits Institute

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Crystal Lake Speakers Talk Heroin Epidemic in Chicago Suburbs, Tips to Fight Drug Abuse_____________________________________________________

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Behavioral health disorders among most prevalent. Most of those suffering go untreated

25% of employees have a diagnosable mental health issue

Sources: National Study on Drug Use and Health, OAS, SAMHSA, HHS, 2009. Workplace Mental Health, The Standard, 2013.

Sources: National Study on Drug Use and Health, OAS, SAMHSA, HHS, 2009. Workplace Mental Health, The Standard, 2013.

Behavioral health disorders among most prevalent. Most of those suffering go untreated

>70%of impacted employees go untreated

What employees are searching for

Primary care for adults

Obstetrics and Gynecologic Care

Dermatologist Visit

Eye Doctor Visit

Psychological and Psychiatric Care4

1

2

3

5

Stress Substance abuse

Caregivers DepressionComorbid conditions

What Behavioral Health Means to EmployersBrian Gifford, Ph.D. Director, Research & Development Integrated Benefits Institute

About IBINational, not-for-profit organization representing 1,100 organizations with 20 million employees

• Business value of workforce healthLinking absence, employee performance and productivity to business metrics.

• Better measurementProviding practical measurement strategies for linking employee health, care delivery and business outcomes.

• Modeling toolsTo give employers a way to estimate the economic burden of illness when they don’t have all the data.

• Practical evidenceUsing case studies to show employers what leading employers have done and how they’ve done

it.

A New Employer Setting

•ACA: Transition from tactics to strategy

• Show the C-suite the value of improved workforce health

•Dead end: attempting to control claims costs in separate

program silos

• Looking for new strategies to improve workforce health,

reduce lost time, enhance productivity and impact business

• Limited data, time and dollars

What I’ll cover

•What’s at risk for employers: the economic impact of poor health

• Behavioral health issues from the employee’s view

• The productivity impact of behavioral health

What’s at Risk Economically for Employers?

Modeling the Economic Impact of Poor HealthEmployer: 10,000 Life Hospital System

Model data sources

Nicholson, Pauly,

Polsky, et al.

Case profile

Professionals Service WorkersFemale Age 35-54

Employer: 10,000 life hospital system

63,600 Days of Illness-Related Absence

Sick days Short Term Disability

Long Term Disability

Workers' Comp

FMLA_x000d_(stand alone)

0

5

10

15

20

25

30

35Unpaid absences - 23.0K days

Paid absences - 40.6K days

Th

ou

san

ds

Employers Incur Lost Productivity Costs for Each Absence

•Wage replacement payments

• Lost revenues and excess compensation costs to the extent that:• It is difficult to find equivalent substitutes for absent employees• Employees have time sensitive outputs• Team productivity depends on an employee who is absent

• For hospitals, additional costs are about 45% higher than daily wages

** Source: Sean Nicholson, Mark Pauly, et al., "Measuring the Effects of Work Loss on Productivity with Team Production," Health Economics 15: 111-123 (2006).

Wage replacements and lost productivity for illness-related absences cost almost $21M

Sick days Short Tem Disability

Long Term Disability

Workers' Comp

FMLA_x000d_(stand alone)

$0

$2

$4

$6

$8

$10

$12

Productivity lost - $8.1M

Wage replacement payments - $12.8M

Mil

lio

ns

What about reduced performance?

79% of this workforce is

estimated to have at least one of 26 chronic illnesses.

2.3% of each workday is lost to underperformance for chronically-ill employees, compared to employees with no chronic illness.

$16.3 million in lost productivity due to presenteeism of chronically-ill employees.

On top of $20.9 million for absence lost productivity

100%

22%

14%Medical/pharmacyWage replacements

Distribution of costs for employees: Healthcare as silo

bv

Distribution of costs for employees: Adding payments to absent workers

73%

27%14%

Medical/pharmacyWage replacements

Distribution of costs for employees: Adding absence lost productivity

62%

23%15%

Medical/pharmacyWage replacementsAbsence lost productivity

Distribution of costs for employees: Including reduced performance

48%

18%11%

23%Medical/pharmacyWage replacementsAbsence lost productivityPerformance lost productivity

The bottom line for this employer

63,600 illness-related absences per year

$20.9 million in resources are unavailable for productive use because of illness-related absences

$16.3 million in reduced performance – presenteeism

$1.08 in lost productivity costs for every dollar spent on medical and Rx treatments

Behavioral Health Issues from the Employee’s View

Self-Reported Conditions in HPQ/HPQ-Select

Depression

Chronic fatigue

Anxiety

Allergies/hay fever

Chronic back/neck pain

Obesity

Heartburn/GERD

Chronic sleeping problems

Irritable bowel disorder

Headaches

Migraine

Chronic pain

Arthritis

High cholesterol

Hypertension

Urinary/bladder issues

Asthma

Diabetes

Cancer

Coronary heart disease

Ulcer

Bronchitis/emphysema

COPD

Behavioral Health Issues are Common

43%

17%

34%

40%Depression_x000d_5

7% untreatedChronic

Fatigue_x000d_83% untreated

Anxiety_x000d_66% untreated

Chronic sleeping problems_x000d_61

% untreated

7%

2%5%

2%

9%

12%

10%

4%

16%

14%16%

6%

PrevalenceUntreated

% o

f all

em

plo

ye

es

57% untreated

83% untreated

66% untreated

61% untreated

Behavioral Health Issues are Complex

0

1

2

3

4

5

6

5.15.5

4.8

5.9

# o

f ad

dit

ion

al

co

nd

itio

ns

Behavioral Health Issues are Costly

Depre

ssio

n

Chron

ic fa

tigue

Anxie

ty

Allerg

ies/ha

y fe

ver

Chron

ic b

ack/

neck

pai

n

Obesit

y

Heartb

urn/

GERD

Slee

ping

pro

blem

s$0$2$4$6$8

$10$12

Mil

lio

ns

Allerg

ies/ha

y fe

ver

Chron

ic ba

ck/n

eck

pain

Obesit

y

Heartb

urn/

GERD

Slee

ping

Pro

b-

lem

sAnx

iety

Dep

ress

ion

Chro

nic

fatigu

e

IBI Condition Profiles

Metabolicsyndrome

Depression

Heartconditions

Low backpain

Cancer

$0 $20,000 $40,000 $60,000 $80,000 $100,000

Costs per 100 EEs

Comparing Chronic Conditions

Depression

Sick Days

Performance

Short Term Disability DaysLong Term Disability DaysWorkers’ CompensationMedical Treatments

How Can HR & Benefits Professionals Make the Case? Communicate the prevalence of behavioral health issues

in your workforce Especially from the employee’s perspective

Understand corporate leaders’ strategic vision What metrics do they value? How does high-performing human capital fit in?

Get condition-specific reports form your vendors on the same basis

Make a business case for your need to integrate data across programs at the employee level

Questions?

Thank You