Strategies for Dealing With the Aging Worker Population

Andrew J. Seter, M.D.Sensia Wellness

Working Longer in Life• 73 Year Old Construction Worker Buried In

Work-Site Avalanche• 100 Year Old Doctor Still Practicing• 91 Year Old Yoga Instructor Going Strong• Retirement Being Delayed• The Recession• Health Insurance/Benefits

Outline• The Problem

– US Population and Workforce is Aging– Disease Prevalence Increases with Age– Injury Rates and Medical Costs Based Upon Age– Work Comp Costs Are Rising

• The Solution– On-Site Medical Care– Comprehensive Wellness Services– Ergonomics/Job Design– Human Resource Policy

Not All Is Bad

• Experienced, Knowledgeable• Dedicated, Loyal• Higher Retention• Lower Absenteeism• Lower Rate of Injury• Higher Motivation• Attention to Quality

US Census Data 2010

• US Population 309,000,000 in 2010• Growth of 9.7% Since 2000• Rate of Growth

– Under 18 – 2.8%– 18 to 44 – 0.6%– 45 to 64 – 31.5%– Over 65 – 15.1%

• 45 and Older – 39.4%

US Census Data 2010

Statistics• Median Age US – 37.2• Median Age WI – 38.5• 15th Oldest State by Age• Projections

– By 2030 – 20% will be 65 and older– Current 25% with Care Giving Roles– By 2020 – 50% with Care Giving Roles

Obesity Rates by Age

Obesity Statistics

• Increases Overall Morbidity and Mortality• Cost 2-3X Non-Obese Patient• High Correlation With Diabetes, OHD, HTN,

Colon CA, Breast CA, Ortho• Higher Absenteeism, Lower Productivity• Work Comp: 2x Claims, 7x Expense, 13x Lost

Workdays

Diabetes Rates by Age

Source: Centers for Disease Control and Prevention.

Diabetes Statistics

• Directly Related to Obesity• Epidemic of Diabetes• Cost 2-3x’s Non-Diabetic• Disease of Small Blood Vessels• Accounts for 20% of Total US Healthcare Cost• 3 to 9 Medications Daily• Higher Absenteeism, Lower Productivity

Smoking Rates by Age

Source: National Health Interview Survey, United States 2005-2011

Percent of Adults aged > 18 years who were current smokers by age group.

Smoking Statistics• #1 Cause of Preventable Death and Disease

Worldwide• Attributable to 90% of Lung CA and COPD• High Correlation with CAD, CVA, MI, CA• HC Visits 6X Non-Smoker• Hospital 2X Non-Smoker• Increase Absenteeism/Decrease Productivity• Slower Healing Process

Health Status by Age• Vision

– Loss of Acuity, Luminance, Glare• Hearing

– 2-3.5% Loss Per Year, Background Noise, Speech Recognition

• Muscle Mass– Gradual Annual Loss, Decrease Strength/Flexibility,

Loss of Balance• Cognition

– Decreased Ability to learn, Multitask, Speed• Shift Work, Heat Stress

Activity Limitations by Age

Fall Rates by Age

Source: Centers for Disease Control and Prevention.

Injury Statistics for Older Workers• Rate of Injury Similar or Lower Than Younger• Longer Duration of Time Off Work• Significantly Higher Cost Per Case• Highest Rate of Fatal Injuries• Highest Rate of Falls and Fractures

Worker’s Compensation Costs

Worker’s Compensation Costs

Rotator Cuff Injuries

• Series of 4 Muscles• Common Work Comp Injury• MRI ASX’ic Shoulder

– 13% 50-59, 20% 60-69

• Med Costs $50,000-75,000– Facility, Surgeon, Rehab

• 5% PPD $8050• 1 Month TTD

Lumbar Spine Injuries

• Most Expensive Diagnosis• MRI with High Rate of Abnormalities• Discectomy $65-80,000

– TTD Variable, Six Month Recovery

• 5% PPD Per Level $16,100• Lumbar Fusion $100-125,000

– TTD Extended, One Year Recovery

• 10% PPD Per Level $32,100• Vocational Rehab $40-50,000• Loss of Earning Potential

Summary

• Work Force is Aging• Increase Obesity, Infirmity• Higher Cost Per Injury• WC Trends are Troublesome• Affordable Care Act

Who in the Healthcare Community is Looking Out for

Your Best Interests?

The Solution

• Commitment from Management• On-Site Medical Provider(s)• Comprehensive Wellness Services• Ergonomics/Job Site Safety• Human Resource Policy• Incent Employees for Referrals

On-Site Medical Care

• MD, NP, PA, RN or Combination• Start Small and Expand• Scalable Scope of Services• 50 Employees or Greater• Self Insured or Pooled

Equipment/Cost

• Office Supplies• Medical Equipment• Medical Supplies• Computer/Phone• Internet Access• Initial Investment <$6,000• Staffing Charges

wipricepoint.com

On-Site Medical Care

• Improve Access to Healthcare• Treat Common Injuries/Illnesses• Medical Consultation• Supplement PCP• Most with No PCP• Avoid ER/Urgent Care Expenses• Referrals

Comprehensive Wellness Services

• HRA’s• Health Coaching/Wellness Coordinator• Smoking Cessation• Nutrition/Stress Counseling• Exercise Participation• Incentive Tracking• Year Round Programming

Human Resource Policy

• Safety Committee• Ergonomics/Job Design• Hiring/Drug Testing Policies• Flexible Scheduling• Shift Work• On-Site Stretching• FFDE

FFDE• Can Request Independent Medical

Assessment• Job Performance, Safety• Medico-Legal Right• Employee Obligated to Participate• Information, Information, Information• Cover Letter, Job Description,

Medical Records

To Do List

• On-Site Medical StaffFacilitiesEquipmentStaffing

• Wellness ServicesHRAHealth CoachingCash IncentiveIncentive Tracking

• ProgrammingSmoking CessationExercise LogNutritionStress

• HR PoliciesSafety CommitteeStretchingErgonomicsFFDE

Andrew J. Seter, M.D.aseter@sensiawellness.com