Transcript Medical Strategies in Dealing with Aging, Dr. Seter-4-11-14

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]