More than health promotion - How employers manage health and productivity


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More and more, employers are managing the costs of healthcare and lost productivity by health and productivity management (HPM) efforts to promote workforce wellness, prevention, and disease and disability management. IBI surveyed 450 employers to detail the prevalence of such interventions, employers’ plans over the next two years, the goals for these programs, the measurements used to assess key program outcomes and their view of how well HPM initiatives are meeting their desired goals. The survey finds that some form of HPM is almost universal, employer HPM efforts are and will expand, and employers broadly plan to put more resources into existing programs.

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  • ABOUT THE SURVEYSummer 2009 IBI worked with HarrisInteractive – best known for the Harris Poll – to survey nearly 500 ERs on their health and productivity management (HPM) initiatives.To identify employers to be surveyed, IBI worked with its member companies, and partners such as NBCH, DMEC and ACOEM, and a variety of employer healthcare coalitions across the country.The survey includes 26 HPM practices spanning: health promotion, disease management and disability/RTW mgmt.Describes what Employers are doingPlanned HPM investment strategies Intended outcomesDetail on “important practices” Effectiveness of practices in meeting goalsMeasurement used, and Challenges.Not a generalizeable, random sample of employersBut -- not limited to larger employers either, are so many other surveys of this typeEmployers participated from across the U.S., from a variety of industries and size classes, and in both for-profit and non-profit sectors.
  • Nearly all of the ERs in this survey have some form of HPM in place: 99% have at least one practice - virtually universal adoption nearly 80% have at least one practice in each of health promotion, disease management and disability/return-to-work management. More specifically: 98% are engaged in some form of health promotion, 91% in disease management and 85% in disability/return-to-work management.On average employers adopt almost half or more of the available practices in each program.9.9 of 14 in health promotion3.3 of 5 in disease management3.4 of 7 for disability/return-to-work management On average, small employers with fewer than 500 employees adopt 10.6 of the 26 practices, large employers with 5,000+ employee adopt 18.2 practices and mid-sized adopt 16.3 practices.
  • For disease management, IBI surveyed 5 practices Referrals to specialists, health risk coaching, chronic disease management, self-care tools and implementation of value-based designs.9 in 10 employers have adopted at least one disease management practice.Employers adopt 3.3 of these 5 practices, on average.Leading the list, more than 3/4ths of the group are referring employees to specialists for care, 2/3rds are managing chronic diseases and not quite 40% implement a value-based design.But, employers identified value-based designs and chronic disease management as the most important disease management practices in reaching health and productivity goals16% of respondents plan to add value-based benefits design in the next two years – 2nd highest in the survey
  • Over the entire sample, 17 of 20 employers adopt some form of disability/RTW management practice.Overall, these employers adopt, on average, 3.4 of these seven practices. Leading the way in prevalence are A) nurse case management to optimize disability duration, B) transitional return to work and C) disability duration guidelines. Early disability reporting is not far behind.Relatively underutilized are the remaining 3 practices: RTW education, RTW incentives and chargebacks.Most effective practices in meeting respondents’ health and productivity goals? Transitional return to work – with a prevalence of 60%Followed by nurse case managementPractices in this program appear low in prevalence of adoption, but only in comparison to those commonly in the medical silo. 60% of employers with transitional work programs seems like a healthy proportion of employers This is especially true, given the focus in corporate cultural that transitional work programs require for the employer, supervisors and co-employees.
  • We extended the model beyond medical and pharmacy spend and asked employers to focus on how their HPM practices impact productivity outcomes: i.e., sick/disability days; presenteeism and lost productivityKey finding: depending on the outcome of interest, between about 32% and 42% simply don’t know how their practice affects the outcome. Overall, one in three employers measure none of the outcomes for its HPM initiatives.Five years ago, 85% of IBI survey respondents (Beyond Cost Containment – 2004) said that in the next five years that want to link health and group medical data to broader outcomes, such as employee absence, disability, lost productivity and company financial performance. We have failed as a healthcare system to deliver the integrated measurement employers asked for.Suppliers seeking to distinguish themselves in the marketplace will find that improving expertise in measuring such outcomes will be an important step.A strong majority of those with an opinion report that outcomes from their HPM practices have improved Only a small proportion say they have worsened.The survey also found that when opinions are framed by actually measuring the results that there is a significant improvement in positive responses.
  • More than health promotion - How employers manage health and productivity

    1. 1. IBI’s Survey of HPM Practices<br />Research by the Integrated Benefits Institute<br />January 2010<br />Source: More Than Health Promotion: How Employers Manage Health and Productivity, Integrated Benefits Institute, January 2010<br />
    2. 2. IBI Research on Employers’ Experience with Health & Productivity Management<br />Purpose:Detail HPM program prevalence, future plans, program goals, performance measures and success in meeting employer goals.<br />Key Insights:<br /><ul><li>Some form of HPM is nearly universal and practices are diverse across health promotion, disease management and disability/RTW management.
    3. 3. Employers show a robust interest in expanding resources for current practices and adding new ones.
    4. 4. Although reducing medical/drug costs is the top outcome sought, almost as many seek health-related productivity improvement, but not as ardently.
    5. 5. Prevalence of practices adopted doesn’t track with importance.
    6. 6. A large proportion don’t know if important practices achieve productivity-related goals and one in three measure no lost-time outcomes.
    7. 7. When they have an opinion of the efficacy of their practices, they are most likely to say HPM practices improve productivity-related outcomes.</li></ul>The full study is available to members of IBI. <br />Commentary is available in Notes view of downloaded presentation.<br />
    8. 8. HPM Practices are Almost Universal<br />Average 9.9/14<br />Average = 15.6 practices<br />Average 3.3/5<br />Average 3.4/7<br />3<br />
    9. 9. Health Promotion Programs<br />Mean = 9.9 practices<br />4<br />
    10. 10. Disease Management Programs<br />Mean = 3.3 practices<br />5<br />
    11. 11. Disability/RTW Management<br />Mean = 3.4 practices<br />6<br />
    12. 12. Expand/Reduce Financial Resources-- For Existing Practices -- <br />7<br />7<br />
    13. 13. Desired Outcomes for Important HPM Practices<br />97%<br />90%<br />62%<br />57%<br />33%<br />16%<br />8<br />
    14. 14. Do Practices Achieve Productivity-related Outcomes?<br />9<br />