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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 Percent of Adults aged > 18 years who were current smokers by age group. Source: National Health Interview Survey, United States 2005-2011 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 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 Andrew J. Seter, M.D. [email protected]