Workforce Health and Productivity Summit:
A Blueprint for Action
November 5-7, 2008
Co-hosted by:
Integrated Benefits Institute
American College of Occupational
And Environmental Medicine

Agenda
• Summit Backdrop
• Health & Productivity Primer
• Blueprint for Action
– Consensus Statements
– Recommendations
• Employer Best Practices
• Q&A

About the Workforce Summit
• 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

Summit Participants
John Agos Paul B. Handel, MD Chris McSwain
Catherine Baase, MD Stacy Hodgins Kenneth Mitchell, PhD
Steve Barger John Howard, MD Thomas Parry, PhD
Douglas Benner, MD Warner Hudson Kenneth R. Pelletier, PhD, MD
Ann Brockhaus Pamela Hymel, MD Dennis Richling, MD
Schumarry Chao, MD David Kasper Andrew Scibelli
Helen Darling Vincent E. Kerr, MD David Sensibaugh
David Deitz, MD Ronald Kessler, PhD Archie Simons, Jr.
Nancy Desmond Matt Kinkead Mary Tavarozzi
Gary L. Earl Ronald Leopold, MD Peter Wald MD, MPH
Dee W. Edington, PhD Garry Lindsay, MPH, CHES Kim Jinnett, PhD
Barry S. Eisenberg, CAE Ronald R. Loeppke, MD, MPH William Molmen, JD
Franz Fanuka Bryon MacDonald Doris Konicki, MHS
Robert K. McLellan, MD Michael Taitel, PhD
Ronald Goetzel, PhD

How it was Organized
• Four moderated work groups
• Free-flowing discussions
• Large-group synthesis of
ideas
• Final Consensus Statements
and Recommendations

Why is a Summit Needed?
• 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?
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

Why is a Summit Needed?
• 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

A Health and Productivity Primer
• 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.
Michael Milken, October 30, 2008

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

Health Risks Impact Productivity
Work days lost / Person / Year
12.6
Days
% of Workplace 9.3
Days
Productivity Loss 6.4
Days
26.9%
20.9%
1 risk 3 risks 4+
risks
14.7%
STD Days / Year 13.1
Days
0-2 3-4 5+
risks risks risks
2.4 5.3
Days Days
Sources: Burton, et al, JOEM: Vol. 47. No.
8, August, 2005; Wayne Burton, MD, IHPM
North American Summit Meeting 2000; also 0-1 2- 3 4+
Tsai, et al. JOEM: Vol. 47, No. 8, August,
2005 risks risks risks

Top 10 Medical Conditions
by Annual Total (Med/Rx +
Productivity) Cost/1000 FTEs
for Four Employers (N=15,380)
$500,000
Outpatient
Inpatient
$400,000 Drug
Absenteeism
Presenteeism
$300,000
$200,000
$100,000
$0
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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.

Re-thinking
Workforce Health
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
14

Summit Key Questions
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 Recommendations
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

Employer Best Practices
• 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

Why The Summit Matters
• 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.

How You Can Help
• 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

For More Information
• www.acoem.org
• www.ibiweb.org
• http://hpm.acoem.org/
• www.chaa.org