National Labor Office Meeting

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National Labor Office Meeting

• Increasing Productivity
• Decreasing Absenteeism
• Key Issues and Trends in the Management of Human
  Capital

Presented by Jim Curcio National Business Group
on Health
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You cannot escape the responsibility of
tomorrow by evading it today. Abraham Lincoln
16th president of US (1809 - 1865)
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About The Business Group

• The Business Group is the only national,
  non-profit organization exclusively devoted to
  representing the perspective of large employers
  and providing practical solutions to its members'
  most important health care problems.

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Council on Employee Health Productivity (CEHP)
Aon Consulting Ascension Health Boston
Scientific Cisco Dell EDS Emdeon General
Electric GlaxoSmithKline Hannaford Bros. H-E-B
Grocery IBM
Ingenix Johnson Johnson JPMorganChase LewisCo Lo
ckheed Martin Mercer HR Consulting Pitney
Bowes QuadGraphics Sedgwick CMS UPMC Verizon Watso
n-Wyatt
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Presentation Questions

• What are the issues that employers and union
  members should be focusing on in relation to
  productivity and absenteeism?
• What metrics are being used?
• How are employers and unions collaborating to
  effectively manage productivity and absenteeism?
• What can health plans do to help in this area?

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Question 1 Employer Union Issues

• What are the issues that employers and unions
  should be focusing on in relation to productivity
  and absenteeism?

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HP Issues Facing Employers

• Chronic conditions account for 26 of STD medical
  episodes, but total 56 of STD medical costs
  (CIGNA study)
• 77 of employees say they show up at work when
  ill, according to a recent poll by ComPsych
  Corporation (benefitnews.com)
• Avoidable sick days due to sub-optimal care
  equaled 40.9M lost days (NCQA)
• Time-off and disability costs 15 of member
  wages and total 39 lost days/year (Mercer Human
  Resources Consulting)

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Family Medical Leave (FML)

• 75 percent say that administering FML is a
  problem
• Which affects efficiencies in measuring and
  managing workforce productivity
• Outsourcing FML Administration is on the Rise
• To reduce internal burden on employer

Staying_at_Work
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HP Costs Are Up
Staying_at_Work
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Number of Issues Are Affecting Productivity
Staying_at_Work
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The Next Big Thing Is Focus on HP
Areas Where Changes Will Be Made in the Next Year
Staying_at_Work
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HP Programs Are on the Rise

• A growing number of employers are boosting
  efforts to improve workers health and
  productivity

Percentage of employers incorporating health and
productivity in health care planning
Staying_at_Work
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HP The Value Proposition

• Employers that implement several health and
  productivity practices achieve greater results
• Investments across the board (i.e., more is
  better)
• Costs
• Satisfaction and workforce health
• Integration of programs
• Costs and lost time
• Workforce health

Staying_at_Work
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Some Best Practices Are Used Widely
Staying_at_Work
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Investing in More Practices Helps Achieve Outcomes
Staying_at_Work
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The Basis for Employers and Unions - Going Forward
Staying_at_Work

• Health care and associated time off are linked
• Support for programs that impact HP is
  increasing
• Effective costing tracking better results

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Question 2 Metrics

• What metrics are being used?
• How are employers applying the results of the
  metrics?
• How are members reacting to these new measures?

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Why the Need for Sound Metrics?

• Necessary for companies to measure and improve
• Productivity
• Return to work
• Communications
• Job satisfaction
• Benefit investment
• Member health

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NBGHs Quality Metrics Project

• Idea was born in 2001 with formation of Council
  on Employee Health and Productivity (CEHP)
• Led by employer demands which
• Addressed lack of standardized metrics to
  effectively compare absence management program
  success

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The Branding of EMPAQSM
The Branding of EMPAQSM
Employers, Insurers, TPAs, Brokers, Consultants
and Academia all provided input to create
the chosen brand name
(E) mployer (M) easures of (P) roductivity, (A)
bsence and (Q) uality
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• Supported by numerous supplier partners
• Provides a set of standardized metrics for
  critical areas of program management
• Built around established training and
  certification
• Serves as a foundation for meaningful
  benchmarking programs

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Categories and Metrics

• Cost
• 1. Benefit Cost per Employee
• 2. Average Benefit Cost Per Claim
• 3. Benefit Cost as a of Payroll
• Productivity Outcomes
• 4. Lost Days per 100 Employees
• 5. Average Claim Duration
• 6. Annual Claim Incidence
• 7. Employee Satisfaction
• 8. Return to Work Effectiveness
• 9. Family Medical Leave Measures

Administrative Effectiveness 10. Timeliness of
Claim Payment 11. Accuracy of Payment of
Benefits 12. Timely Decision of Claim
Acceptance 13. Accuracy of Decision of Claim
Acceptance
These protocols serve as recommendations to
employers to measure various claim services. At
this time, data are not collected and reported on
these protocols
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EMPAQSM Inside Value Proposition

• Employers will
• Obtain confidence that their data was gathered
  utilizing established criteria that ensure data
  integrity
• Obtain current, comparative cost results
• c.  Participate in a uniform reporting
  methodology

• Suppliers can
• a.   Provide value and confidence to clients
  that data reported is certified accepted by the
  industry
• b. Set uniform standards for measurement that are
  Employer/Client focused Outcome Driven
• c. Enhance service delivery

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Participation Summary

• Since 2003
• Over 500 Employer Supplier
• Representatives Trained Certified
• 310 employers submitted data
• 696 data sets collected
• 15 different industry sectors represented
• In 2006
• 1400 data sets collected by Supplier Data
• Consortium, implemented by IBI

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Sample ofParticipating Companies

• AOL
• Ascension Health
• The Auto Club Group
• The Boeing Company
• Campbell Soup
• Coca Cola Bottling
• Coors Brewing Co.
• First Energy
• General Electric Co.
• General Motors Corp.
• Georgia-Pacific Corp.
• Hannaford Bros. Co.
• H. E. Butt Grocery Co.
• Highmark

• Honda of America Mfg.
• IBM
• Kraft Foods
• Levi Strauss
• Microsoft
• PepsiCo
• Pitney Bowes
• Qwest Communications
• Safeway
• Target Corporation
• 3M
• UnitedHealth Group
• US Steel Corp.
• Wells Fargo Company

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Certified Suppliers
As of January 2007
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15 Different Industry Sectors

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• EMPAQ standardized metrics will play a key role
  in employers ability to sustain continual
  improvement in their absence and productivity
  management programs.
• Risk and Insurance Magazine
• June 2006

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Sponsors Partners

Business Group CEHP Founding Sponsor
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Question 3 Partnering with Labor

• How are employers and unions collaborating to
  effectively manage productivity and absenteeism?
• Success Stories on Partnering with Labor To
• Educate Members On Health and Disability
• Integrate the Management and Administration of
  all Health-related Time-off programs

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and the
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Committee Structure

• CWA Members
• Bargaining Agent (2)
• Health Benefit Coordinator (2)
• 7200 Local President
• 7011 Exec. VP
• IBEW Member
• Business Manager Local 206

• Qwest Members
• Sr. Director, Employee Benefits
• Director, Disability Programs
• Labor Relations (2)
• Benefits Professional (2)

• Sub Committees Plan Design, Disability, and
  Communications
• The Health Wellness Advisory Committee (HWAC)
  also oversees the Committee on Substance Abuse

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Subcommittee Structure
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A little history . . .

• The Committee
• Deals with health care and disability claim
  issues for members.
• Successfully prepared program plans for previous
  bargaining sessions.

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Lessons Learned in 1998 . . .

• Health care is too complex to solve during
  regular contract negotiations.
• Experts from the Employer and the Union need to
  work together on identifying issues and
  solutions.
• There is not one permanent solution to address
  health care concerns. It requires ongoing
  commitments to work together.

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2003 and Beyond

• Negotiations led to agreement to various
  co-payment increases.
• Early negotiations caused some departure from
  Plan Design Subcommittees recommendations.
• Qwest and CWA committed to
• Continue to work on ways to deliver high-quality
  health care.
• Participate on the National Coalition on Health
  Care.

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From Disability Issues . . . To Solutions

• Return-to-work Process
• Member Satisfaction/Customer Service
• Single point of contact for escalations
• Supervisor Training

• Re-establishing credibility of program
• Appeals
• Denial Rates
• Physician Reviews
• Use of Independent Medical Examinations

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Member Satisfaction Surveys

• Disability is an emotional issue punctuated by
  anecdotal case examples.
• Having a valid measurement tool allows parties
  to more objectively demonstrate improvements to
  members and union representatives.
• Use of EMPAQSM Satisfaction Survey for
• Initial Disability Claim Application Process
• Claim Administration and Payment
• Return-to-Work
• Overall Experience
• See Business Insurance article,
  June 2004

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END RESULTEffective Active Committees

• Resolve complex issues outside of bargaining
• Establish proactive communication
• Subject Matter Experts from both sides can review
  data and formulate strategies
• Constant pulse for feedback and trending
• Co-branding of communications

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their Suppliers,
Collaboration between
Employers,
and Unions
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Top Concerns of Organized Labor

• Job security
• Access to quality healthcare
• Wage protection
• Protection of retirement benefits

Sedgwick CMS Presentation to the Joint Forum
on Health, Productivity Absence Management,
November 30, 2006
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Typical Process Improvement
Is It Working?
YES
NO
Did You Mess With It?
Dont MessWith It!
YES
You have trouble!
NO
Will it Blow Up In Your Hands?
Anyone Else Knows?
YES
YES
You Have Problems!
Can You Blame Someone Else?
NO
NO
NO
Hide It
Look The Other Way
Yes
NO PROBLEM!
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Perspective
Labor
Management

• Impact on business
• Defers to plan administrator/claims administrator
  for decisions
• Predictability of service
• Healthy return to work

• Impact on membership
• Defers to attending physician for disability
  certification
• Predictability of service
• Healthy return to work

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Collaboration Strategy

• Imperative to Involve all Stakeholders (Union,
  Management, Claims Administrator)
• Discuss workflow and process
• Find win-win opportunities on enhancing
  productivity and managing absences
• Establish metrics (EMPAQSM) to ensure consistency
  of delivery
• Provide escalation appeal process
• Provide proactive operations updates!!!

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Improved Approach
Do I have a clear understanding of the problem?
Ask for input anyway you never know what a new
outlook might bring!
Is the problem within my total control?
YES
NO
NO
YES
YES
Have I communicated my plan to others?
Am I involving the right people as I work
through the problem?
RALLY the TEAM!! Union Management Stakeholders
NO
NO
YES
YES
NO
NO
NO
Am I being creative in my search for
answers? Is this a new solution?
Have I developed good reasons for what I am
doing?
Have I considered how my solution could impact
other areas?
YES
YES
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Outcomes
New England states MA, ME, NH, RI and VT
Approximate membership 11,675
IBEW

• Mid-Atlantic states DC, DE, MD, NJ, PA, VA and
  WV
• Approximate membership 35,000

CWA

• Primary Callers Union Representatives
• Healthcare Benefit Coordinators (HCBC) 2 in New
  England and 6 in Mid-Atlantic. Represent 63 of
  all calls 2006 YTD.
• Other callers Business Agents, Union Presidents,
  Union Local Stewards

Central Reporting Information Line
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Most Frequent Claim Issues
Pay-Related Issues Indemnity benefits Payroll/Taxe
s 28 of total call volume in 2006 YTD
Claim Status Updates

Medical Bill Payment (WC)
Information Requests

• All calls are logged and categorized by issue
  type
• Trends are identified and reports are submitted
  to Management twice monthly reviewed with
  Unions

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Union Liaison
Client/ Employer
Union/ Member
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Union Liaison Impact

• Build/maintain working relationships with union
  representatives
• Resolve issues at TPA level
• Help reduce arbitration, litigation
• Reduce escalation to management
• Cut down on duplication of efforts
• Quantify activity related to union issues through
  call logs, management reports

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Collaboration Achievable Outcomes
AdministrativeProcess Changes
Appeal Process Alternatives

• First level claims administrator Second to
  plan administrator
• Process where union can appeal to both claims
  administrator or plan sponsor
• Union and Plan Sponsor have a joint committee to
  review and discuss all appeals

• To workflow (additional time and/or contacts)
• Formal return to work and accommodations process
• In benefit plan design
• In plan communications
• In Revised/formal escalation process

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Question 4 Health Plans

• What can health plans do to help employers manage
  their health as well as their workforce
  productivity and absences?

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The Health-Related Data Solution--The Challenge
to Suppliers--
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Health Plans Can

• Promote Use of Best Practices
• Especially those not as universally
  used/implemented as others
• Help employers and unions effectively utilize
  available education tools
• Continue to work with employers and their unions
  to aggressively implement Consumerism/Account
  Based Healthcare strategies

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Projected Results from Health Plan Intervention

• Overall Results
• Decreased program costs duration
• Increased productivity from workforce human
  capital
• Increased satisfaction and workforce health

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Managing Productivity Absence
Conclusions

• Implementing, integrating, and measuring a mix of
  HP practices result in successful outcomes
• Barriers exist, but organizations that best
  capture, track, and manage costs have better
  results
• Accountability for health is a belief, but it has
  yet to be incorporated into health and
  productivity strategies
• employers and unions can both call for this

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Managing Productivity Absence
Conclusions

• Absence, disability and health care are
  inter-related
• Harnessing any existing data across the health
  continuum will provide informed decisions for
  employers and union members
• Different segments and stakeholders require
  different approaches

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For More Information

• About the
• Business Group
• CEHP
• Joint Forum on Health, Productivity and Absence
  Management or
• EMPAQSM
• Please visit
• http//www.businessgrouphealth.org

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QUESTIONS?