Strategies for Dealing With the Aging Worker Population

1. Strategies for Dealing With the Aging Worker Population Andrew J. Seter, M.D. Sensia Wellness

2. 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

3. 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

4. Not All Is Bad • Experienced, Knowledgeable • Dedicated, Loyal • Higher Retention • Lower Absenteeism • Lower Rate of Injury • Higher Motivation • Attention to Quality

5. 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%

6. US Census Data 2010

7. 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

8. Obesity Rates by Age

9. 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

10. Diabetes Rates by Age Source: Centers for Disease Control and Prevention.

11. 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

12. Smoking Rates by Age Percent of Adults aged > 18 years who were current smokers by age group. Source: National Health Interview Survey, United States 2005-2011

13. 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

14. 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

15. Activity Limitations by Age

16. Fall Rates by Age Source: Centers for Disease Control and Prevention.

17. 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

18. Worker’s Compensation Costs

19. Worker’s Compensation Costs

20. 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

21. 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

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

23. Who in the Healthcare Community is Looking Out for Your Best Interests?

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

25. 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

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

27. wipricepoint.com

28. 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

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

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

31. 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

32. To Do List • On-Site Medical Staff • Facilities • Equipment • Staffing • Wellness Services • HRA • Health Coaching • Cash Incentive • Incentive Tracking • Programming • Smoking Cessation • Exercise Log • Nutrition • Stress • HR Policies • Safety Committee • Stretching • Ergonomics • FFDE

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