1

Employee Wellness Employee Wellness ProgramsPrograms

ASSE Breakfast October 19, 2006ASSE Breakfast October 19, 2006

Presented by:Presented by:

Amanda HessAmanda Hess

Business DevelopmentBusiness Development

Genesis Occupational Genesis Occupational HealthHealth

2

Why are medical costs Why are medical costs out of control?out of control?

TechnologyTechnology

Medicare/Medicaid ReimbursementMedicare/Medicaid Reimbursement

Longer Life Spans/Aging Population (90yrs. by Longer Life Spans/Aging Population (90yrs. by

2050)2050) In the year 2010, the proportion of the workforce In the year 2010, the proportion of the workforce

greater than 54 years of age will equal the proportion greater than 54 years of age will equal the proportion under 25 years of age, i.e., 19 percent. (April 18, 2002, under 25 years of age, i.e., 19 percent. (April 18, 2002, Edward J. Bernacki, MD,Edward J. Bernacki, MD, President of the American President of the American College of Occupational and Environmental Medicine College of Occupational and Environmental Medicine (ACOEM)(ACOEM)

Increases in Chronic DiseasesIncreases in Chronic Diseases

3

Healthcare CostsHealthcare Costs

““We at HHS, and employers everywhere, We at HHS, and employers everywhere, recognize that poor health means lower recognize that poor health means lower productivity and higher health insurance productivity and higher health insurance costs. Government, businesses and especially costs. Government, businesses and especially individuals must do more to lead healthy individuals must do more to lead healthy lifestyles. Our physical health and our lifestyles. Our physical health and our economic health depend on it.”economic health depend on it.”

Tommy G. ThompsonTommy G. ThompsonSecretary of Health and Human ServicesSecretary of Health and Human Services

US Department of Health and Human ServicesUS Department of Health and Human Services

““Prevention Makes Common Cents (September 16, 2003)”Prevention Makes Common Cents (September 16, 2003)”

4

Rising Chronic DiseasesRising Chronic Diseases More than 1.7 million adultsMore than 1.7 million adults in the US in the US

die of chronic diseases every year - 70% die of chronic diseases every year - 70% of all deaths in the US are due to chronic of all deaths in the US are due to chronic conditionsconditions

5 major chronic diseases5 major chronic diseases Heart diseaseHeart disease StrokeStroke CancerCancer Chronic Obstructive Pulmonary Diseases Chronic Obstructive Pulmonary Diseases

(COPD)(COPD) DiabetesDiabetes

5

QC Health Initiative - 2002 Survey QC Health Initiative - 2002 Survey www.qchealthinitiative.orgwww.qchealthinitiative.org

Heart diseaseHeart disease Leading cause of death in Scott CountyLeading cause of death in Scott County Higher average death rates than Iowa and the nation Higher average death rates than Iowa and the nation 1 in 4 adults in Scott & RI have high blood pressure1 in 4 adults in Scott & RI have high blood pressure

CancerCancer Second leading cause of death in Scott CountySecond leading cause of death in Scott County Higher rates than the state and the nation Higher rates than the state and the nation 2/3 attributable to lifestyle- diet, tobacco, alcohol, 2/3 attributable to lifestyle- diet, tobacco, alcohol,

sedentarysedentaryStroke Stroke

Ranks third in causes of death locallyRanks third in causes of death locallyObesityObesity

Over 64% of adults in Scott & RI are overweight or Over 64% of adults in Scott & RI are overweight or obeseobese

6

Diabetes EpidemicDiabetes Epidemic

Diabetes Diabetes CostsCosts

Healthcare Healthcare costs due to costs due to diabetes rose diabetes rose by $98 billion by $98 billion dollars from dollars from 1997 to 2002.1997 to 2002.

Annual Diabetes Costs

$34

$134

$0

$50

$100

$150

Billions of

Dollars

Diabetes Cost 1997

Diabetes Costs 2002

7

Healthcare CostsHealthcare CostsObesity-related Healthcare Costs Obesity-related Healthcare Costs (major contributor to musculo-skeletal (major contributor to musculo-skeletal

injuries/conditions)injuries/conditions) TOTAL $13 billion in 1994 TOTAL $13 billion in 1994 $8 billion in health insurance costs$8 billion in health insurance costs $2.4 billion for sick leave$2.4 billion for sick leave $1.8 billion for life insurance$1.8 billion for life insurance $1 billion for disability insurance$1 billion for disability insurance

Direct and Indirect costs for overweight or obese Direct and Indirect costs for overweight or obese individualsindividuals TOTAL $117 billion estimated for 2003TOTAL $117 billion estimated for 2003 Approx. 300,000 die in US each year due to weight -related Approx. 300,000 die in US each year due to weight -related

illnessillness

**U.S. Department of Health and Human Services, “Prevention Makes Common Cents,” U.S. Department of Health and Human Services, “Prevention Makes Common Cents,” Secretary Thompson’s Latest Report to the Nation, September 16, 2003.Secretary Thompson’s Latest Report to the Nation, September 16, 2003.

8

Healthcare CostsHealthcare Costs

Diabetes (safety story - construction Diabetes (safety story - construction worker)worker) $13, 243 per person vs. $2,650 per persons $13, 243 per person vs. $2,650 per persons

without without DiabetesDiabetes Medical expenditures were more than 2 times Medical expenditures were more than 2 times

greater for those with Diabetesgreater for those with Diabetes Diabetes, if untreated or undiagnosed, is a Diabetes, if untreated or undiagnosed, is a

leading cause of blindness, kidney failure, heart leading cause of blindness, kidney failure, heart disease, and stroke.disease, and stroke.

**U.S. Department of Health and Human Services, “Prevention Makes Common Cents,” U.S. Department of Health and Human Services, “Prevention Makes Common Cents,” Secretary Thompson’s Latest Report to the Nation, September 16, 2003.Secretary Thompson’s Latest Report to the Nation, September 16, 2003.

9

Healthcare CostsHealthcare Costs

Tobacco Use (safety - lung disease - resp. Tobacco Use (safety - lung disease - resp. wearers)wearers) Over Over $75 billion$75 billion in direct medical costs in direct medical costs 440,000 deaths each year440,000 deaths each year Single most preventable cause of death and diseaseSingle most preventable cause of death and disease

Heart Disease and Stroke (safety story - Heart Disease and Stroke (safety story - truck driver)truck driver) EstimatedEstimated $351 billion$351 billion for 2003 for 2003

$209 - Direct & $142 - Indirect$209 - Direct & $142 - Indirect #1 KILLER of men and women#1 KILLER of men and women

10

The Iceberg The Iceberg Direct & Indirect CostsDirect & Indirect Costs

Direct Costs:Direct Costs: Medical BenefitsMedical Benefits Workers’ CompensationWorkers’ Compensation Short-term DisabilityShort-term Disability Long-term DisabilityLong-term Disability AbsenteeismAbsenteeism OutpatientOutpatient InpatientInpatient

Indirect Indirect Costs:Costs: OvertimeOvertime Hiring/TrainingHiring/Training Lost ProductionLost Production Decreased Decreased

PerformancePerformance Decreased Decreased MoraleMorale Increased Error Increased Error &&

ReworkRework

Wellmark, 2003

11

Healthcare Costs & Lost Healthcare Costs & Lost Time Local Estimates Time Local Estimates

20032003 Severe Cardiovascular Disease (One Heart Attack)Severe Cardiovascular Disease (One Heart Attack) Stress testing = $359 + physician feesStress testing = $359 + physician fees Cardiolite Stress & Rest Scans = approx. $3,000Cardiolite Stress & Rest Scans = approx. $3,000 Diagnostic Cardiac Catheterization = approx. $6,000 Diagnostic Cardiac Catheterization = approx. $6,000 Cardiac Catheter with Stent = $25,000 or moreCardiac Catheter with Stent = $25,000 or more Coronary Bypass = $30,000 minimumCoronary Bypass = $30,000 minimum Cardiac Rehab = $2,300 for 36 session (12 weeks)Cardiac Rehab = $2,300 for 36 session (12 weeks)

Total Cost of One Heart Attack = over $66,659 Total Cost of One Heart Attack = over $66,659 Over $100,000Over $100,000 with physician fees and with physician fees and

medicationsmedications Lost timeLost time - 6 days inpatient w/12 week - 6 days inpatient w/12 week

rehabilitationrehabilitation

12

Healthcare Costs & Lost Healthcare Costs & Lost Time Local Estimates Time Local Estimates

20032003 Preventable Costs - per person per yearPreventable Costs - per person per year Diabetes Diabetes - complications and treatments can cost - complications and treatments can cost

well over $100,000 (dialysis for kidney failure = well over $100,000 (dialysis for kidney failure = $50,000 per year)$50,000 per year)

CancerCancer - radiation therapy costs $12,000 (not - radiation therapy costs $12,000 (not including radiologist fees) and includes 6 weeks of including radiologist fees) and includes 6 weeks of treatments, (chemotherapy is thousands to tens of treatments, (chemotherapy is thousands to tens of thousands more)thousands more)

COPDCOPD (Chronic Obstructive Pulmonary Disease)- (Chronic Obstructive Pulmonary Disease)- medications$5,000-$10,000 per year + Pulmonary medications$5,000-$10,000 per year + Pulmonary Rehabilitation (permanent maintenance) often Rehabilitation (permanent maintenance) often leads to permanent disabilityleads to permanent disability

Sleep DisordersSleep Disorders - can lead to injuries at work & - can lead to injuries at work & decreased productivitydecreased productivity

13

Benefits of Employee Benefits of Employee WellnessWellness

The Bottom LineThe Bottom Line Research indicates that comprehensive Research indicates that comprehensive

employee wellness programs can:employee wellness programs can:

Improve employee morale and dedicationImprove employee morale and dedication Increase productivityIncrease productivity Reduce absenteeismReduce absenteeism Improve employee recruitment and retentionImprove employee recruitment and retention Allow greater control over health care costsAllow greater control over health care costs Reduce healthcare utilization (injuries & Reduce healthcare utilization (injuries &

illnesses)illnesses)

14

Measuring OutcomesMeasuring OutcomesTangible BenefitsTangible Benefits

Reduced Health Care Utilization Reduced Health Care Utilization - long term (3-5 years)- long term (3-5 years) Reduced Absenteeism due to illness Reduced Absenteeism due to illness - short & long term- short & long term

HRAs - Self-Reported and/or Company RecordsHRAs - Self-Reported and/or Company Records Reduced # and severity of risk factors - Reduced # and severity of risk factors - short & long short & long

termterm

Health Screens - Blood Pressure, Cholesterol, Body Fat Health Screens - Blood Pressure, Cholesterol, Body Fat etc.etc.* Steelcase Study 1980’s tied reduced risk factors to reduced * Steelcase Study 1980’s tied reduced risk factors to reduced claim dollars.claim dollars.

Intangible BenefitsIntangible Benefits Increased morale Increased morale - short & long term - short & long term Increased productivity Increased productivity - short & long term- short & long term Improved company image Improved company image - short & long term- short & long term

15

Case StudiesCase StudiesCaterpillar Caterpillar - - Healthy Balance ProgramHealthy Balance Program

projected long-term savings = $700 million by yr. projected long-term savings = $700 million by yr. 20152015

MotorolaMotorola $4:$1 ROI: $4:$1 ROI: More then 45,000 employees - disease More then 45,000 employees - disease

management, flu vaccinations, cancer and other management, flu vaccinations, cancer and other screenings, smoking cessation & telephonic nurse screenings, smoking cessation & telephonic nurse counseling counseling

Northeast UtilitiesNortheast Utilities - - WellAware ProgramWellAware Program Employees & spouses Employees & spouses includes HRA & follow-up initiatives includes HRA & follow-up initiatives reduced preventable (lifestyle-related) medical reduced preventable (lifestyle-related) medical

claims by $1.4 million in 24 monthsclaims by $1.4 million in 24 months**U.S. Department of Health and Human Services, “Prevention Makes Common Cents,” U.S. Department of Health and Human Services, “Prevention Makes Common Cents,”

Secretary Thompson’s Latest Report to the Nation, September 16, 2003.Secretary Thompson’s Latest Report to the Nation, September 16, 2003.

16

Case StudiesCase StudiesBank of AmericaBank of America

$5.96/$1 ROI$5.96/$1 ROI Target Population - RetireesTarget Population - Retirees Methods - Health Risk Assessments, self-care Methods - Health Risk Assessments, self-care

guide books guide books & other educational materials& other educational materials

* Chapman, Larry, “Proof Positive: analysis of the Cost Effectiveness of * Chapman, Larry, “Proof Positive: analysis of the Cost Effectiveness of Worksite Wellness,” Summex Corporation, 1996.Worksite Wellness,” Summex Corporation, 1996.

Pacific Bell Pacific Bell FitWorksFitWorks $3.10/$1 ROI: $3.10/$1 ROI: Reduced absenteeism by .8%, Reduced absenteeism by .8%,

saved $2 saved $2 million in one year; Reduced days million in one year; Reduced days spent on short-term spent on short-term disability by an average of disability by an average of 3.3 days, which saved $4.7 million3.3 days, which saved $4.7 million

* Blair, Susan, “The FitWorks Savings Story,” Pacific Bell, 1996.* Blair, Susan, “The FitWorks Savings Story,” Pacific Bell, 1996.

17

Case StudiesCase StudiesDuPontDuPont

2 year study2 year study Blue Collar workers at participating sites Blue Collar workers at participating sites

enjoyed enjoyed 14% reduction in disability days14% reduction in disability days vs. a vs. a 5.8% reduction at sites not participating in the 5.8% reduction at sites not participating in the comprehensive wellness program. Net comprehensive wellness program. Net reduction in disability days was 11,726.reduction in disability days was 11,726.*Bertera, R. “The effects of Workplace health Promotion on *Bertera, R. “The effects of Workplace health Promotion on Absenteeism and Employee Costs in a Large Industrial Population”. Absenteeism and Employee Costs in a Large Industrial Population”. American Journal of Public Health, September 1990: 1101-1105.American Journal of Public Health, September 1990: 1101-1105.

Other organizations with positive outcomes:Other organizations with positive outcomes:Steelcase, BankOne, Progressive Corp., Xerox, Steelcase, BankOne, Progressive Corp., Xerox, General Motors, Johnson & Johnson, General General Motors, Johnson & Johnson, General Mills, Blue Cross/Blue Shield of IndianaMills, Blue Cross/Blue Shield of Indiana

18

Successful Programs Successful Programs Behavior ChangeBehavior Change

AwarenessAwareness

Skill BuildingSkill Building

Social SupportSocial Support

Environmental SupportEnvironmental Support

Follow-up/MaintenanceFollow-up/Maintenance

Incentives, Evaluation, Incentives, Evaluation,

ModificationModification

19

How to begin... What to How to begin... What to include...include...

First Step:First Step: Tool for program planning, Tool for program planning, evaluation & outcomes measurement with evaluation & outcomes measurement with Baseline & Follow-up DataBaseline & Follow-up Data Health Risk Assessment (On-line & On-site)Health Risk Assessment (On-line & On-site) On-site Health ScreeningsOn-site Health Screenings One-on-one Follow UpOne-on-one Follow Up

Ongoing: Top-Of-Mind AwarenessOngoing: Top-Of-Mind Awareness On-site & On-line Educational ClassesOn-site & On-line Educational Classes Self Care ProgramsSelf Care Programs

Ongoing: Builds Skills & Promotes ActionOngoing: Builds Skills & Promotes Action Fitness, Nutrition & Tobacco ChallengesFitness, Nutrition & Tobacco Challenges Weight Management ProgramsWeight Management Programs Walking ProgramsWalking Programs

20

Genesis Occupational Genesis Occupational Health WellPower ProgramHealth WellPower ProgramIncentivesIncentives Points SystemsPoints Systems Three-month CyclesThree-month Cycles Monetary vs. Non-MonetaryMonetary vs. Non-Monetary Seasonal CampaignsSeasonal Campaigns Tie In w/ Benefit Plans (e.g. Discounts on Tie In w/ Benefit Plans (e.g. Discounts on

Contributions, Flex Spending Accounts)Contributions, Flex Spending Accounts) Tierd Programs (Offer Variety of Values... Tierd Programs (Offer Variety of Values...

Participation vs. Meeting Goals & Changing Participation vs. Meeting Goals & Changing Behaviors)Behaviors)

21

Things to ConsiderThings to Consider ComprehensiveComprehensive Programs (Address all stages Programs (Address all stages

of change & levels of awareness)of change & levels of awareness)

Confidentiality Confidentiality (Third party aids credibility, (Third party aids credibility, builds employee trust & ensures builds employee trust & ensures confidentiality of PHI)confidentiality of PHI)

On-site ServicesOn-site Services (Provide optimal convenience (Provide optimal convenience & access for better participation)& access for better participation)

Follow UpFollow Up (Entails customized education, (Entails customized education, referrals & resources to assist & manage high referrals & resources to assist & manage high risk individuals)risk individuals)

22

Thank you!Thank you!

Visit Visit www.gohweb.comwww.gohweb.com to learn more! to learn more!Proudly serving Illinois & Iowa employers for more Proudly serving Illinois & Iowa employers for more

then 18 years... then 18 years...

Amanda HessAmanda HessBusiness DevelopmentBusiness Development

Genesis Occupational HealthGenesis Occupational Health(563) 324-0696 ext. 307(563) 324-0696 ext. 307

hessa@genesishealth.comhessa@genesishealth.com