Keeping employees healthy top workforce issue in 2009 Challenges for Health Care in Uncertain Times, Hewitts Associates 10th Annual Health Care Report concludes that “keeping employees healthy” has become the primary workforce issue in 2009 with employers shifting focus from managing costs to managing health risk – a cost driver. Recognizing the relationship of employee behavior and health risks to costs, employers now rank “promoting employee accountability” the number one prevention component of health care strategies in 2009. How does this affect the way employers approach their health benefits and Workers’ Compensation programs? One major shift is that more employers are targeting specific health conditions for their employee population than in previous years. Companies targeting asthma, cardiovascular disease, depression, and diabetes increased at least 20% compared to last year. In addition, more organizations are targeting more than one condition. In 2008, only 52% of organizations reported targeting specific conditions, whereas in 2009 the figure increased to 80%. While employers are recognizing that obesity, diabetes, high blood pressure and other common health conditions are having an enormous impact on the cost of health care, they may be less aware of the impact these conditions can have on the duration and cost of recovery of workplace injuries. Preliminary research findings of an upcoming report by the National Council on Compensation Insurance (NCCI) on obesity shows that Workers’ Comp claims unresolved for one year cost three times as much when the injured employee is obese and claims that are unresolved for five years are five times more costly when involving an obese claimant. The cost differential is even greater for smaller claims, in some cases as high as 30 times. In the past, Workers’ Compensation has focused on treating specific injured body parts and not put much emphasis on co-morbidity factors, such as obesity, that can increase claim duration and costs. In addition, the stigma associated with obesity, concerns about privacy and lawsuits and the sensitivity of the issue has meant that obesity is addressed in health plans and wellness programs; however, not in Workers' Comp claims, even though it may affect Workers’ Comp claims. This is changing, however, according to a recent article by Robert Cencineros in Financial Week, “Obesity Supersizing Workers’ Comp Costs.” Martin Wolf, an economist with NCCI Holdings Inc. in Hoboken, N.J. is quoted, “One thing we have been seeing a little bit is that when a claim is filed, insurers are gathering additional information on body mass index and weight and height to see if people who show up as obese need additional medical treatment to more effectively address their injury.” Some employers even are collecting obesity data to help fend off future claims that may not be work-related, particularly those involving police and firefighters who must take pre-employment physicals and whose heart attacks and other ailments often are presumed to be work-related, according to Glenn Backus, senior vice president for Alternative Service Concepts L.L.C., a Reno, Nev.- based claims administrator. Preliminary findings of the NCCI report also note that the percentage effect of obesity on claim costs is lower in states where mandatory utilization review and mandatory bill review stipulations are in place. Increasingly Workers’ Comp case managers are incorporating an injured employee’s health condition into case planning and looking for resources to help the employee address the problem, particularly when it relates to return to work outcomes. This points out the need for a more holistic approach to health and Workers’ Comp. Too often, the programs are managed in different departments, independent of one another, with risk and safety managers overseeing Workers’ Comp and HR administering group health and wellness programs. Yet, it stands to reason if you can eliminate bad health habits in the workforce, you will save on Workers’ Comp costs. “Quit smoking, lose weight, get the right medical tests at the right time—these will help lower Workers’ Comp costs,” says Robert Hartwig, president of the New York City-based Insurance Information Institute (I.I.I). “When there’s an injury on the job, healthier workers tend to recover more quickly, which then benefits the employer through less loss of productivity and so on.” A comprehensive, integrated look at the health of the workforce means that risk and safety managers should be an integral part of the development of programs to make the workforce healthier. Wisconsin-based printing company, Quad/Graphics found that individuals with low back pain were much more likely to be overweight and smokers, so they turned to their wellness program to address the issue. Employers have done an exceptional job of making the workplace safe; now is the time to focus on the health of the worker. An unhealthy worker is going to cost more in terms of absenteeism, lost productivity and recovery time. Employers who create a wellness culture are better positioned not only to treat injuries effectively, but also incentivize the employee to deal with the root of the problem.