Integrating Worker Protection and Health Promotion Programs

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Integrating Worker Protection and Health Promotion Programs

Objectives Describe the business case for moving to an integratedmodel for addressing employee health and safety Provide an overview of the integrated health and safetymodel and approach employed at Corning Incorporated Highlight benefits and challenges, current program statusand future plans2


2009 Corning Overview


Corning IncorporatedFounded:1851Headquarters:Corning, New YorkEmployees:More than 23,000 worldwide2008 Sales:$5.9 BillionFortune 500 Rank (2009):414• Corning is the world leader in specialty glassand ceramics.• We create and make keystone componentsthat enable high-technology systems forconsumer electronics, mobile emissionscontrol, telecommunications andlife sciences.• We succeed through sustained investmentin R&D, more than 150 years of materialsscience and process engineeringknowledge, and a distinctivecollaborative culture.4


Integrated Health & SafetyBusiness Case


Health, Safety and ProductivityThe Importance of Health Risks• Health risks are a leading edge indicator of population health andproductivity• As the number of health risks increase…… So, too, do medical costs, lost time and loss of productivityNumberofHealthRisksHealthcareCostsPharmacyCostsDisability&Workers’Comp+ + +Presenteeism• In health, safety and productivity, prevention is key!– Reduce risks– Detect problems early and address them– Minimize the future negative impact6


Health, Safety and ProductivityThe Importance of Changing Behavior• Corning health risks & research indicates changing behavior/individualchoice is critical to achieving prevention goals…Employee Behavior Determines50% of Health Status and Associated CostsDeterminants of Health Status50%40%30%20%10%0%Access toGeneticsEnvironment BehaviorCareDeterminants 10% 20% 20% 50%Source: IFTF, Center for Disease Control and Prevention…and the opportunityis significant!7


Comment peut-on alors évaluer la perception des fonctions du sol et l'impact environnementaldes usages du sol par les particuliers ? On a choisi le cas des personnes possédant un assainissementnon collectif qui ont un usage du sol conditionné par leur système comme nous le verrons dans lesparties suivantes.On peut alors se demander quels outils sont mis en place pour pouvoir faire cette évaluation ?Mais aussi, dans quel projet s'inscrit cette problématique ? Quels sont les fonctions et les usages dusol qui seront les plus importants pour les particuliers ? Pourquoi avoir choisi des personnespossédant un assainissement individuel ?Le travail qui m'a été confié a donc été de réaliser une enquête face à face avec la populationchoisie pour que celle- ci remplisse le questionnaire que nous avons préalablement élaboré avecOlivier Fouché et Christophe Saillé. Ensuite, après les différents entretiens auprès des particuliers,j'ai effectué des traitements statistiques des données obtenues et établi des tableaux de résultats(tome 2, annexes 5 à 10). De plus, avec l'aide de Christophe Saillé, Olivier Fouché et Martin Seidl,j'ai élaboré un second questionnaire pour décrire le rapport entre l'usager et son dispositifd'assainissement non collectif. Le but final a été d'exprimer une interprétation des résultats quimontre un portrait objectif de la population interrogée pour les deux enquêtes. Ces enquêtes ontservi aussi de campagne de sollicitation pour des prélèvements et des essais d'infiltration sur lesparcelles de terrain des particuliers (s’ils acceptaient).Ce stage est ma première expérience professionnelle dans le domaine de l'environnement et del'aménagement : il était donc important pour moi que je m'investisse dans le projet et que je sois laplus professionnelle possible. J'ai vu le stage comme l'application des connaissances acquises, aucours de mes études mais aussi comme un moyen de vérification de ces connaissances. Bienentendu, grâce au stage, j'ai acquis de nouvelles compétences notamment sur le rôle du sol commeépurateur. J'ai donc perçu ce stage comme un travail à part entière et comme une preuve deconfiance de la part d'Olivier Fouché et de Christophe Saillé. En effet, j'ai effectué seule sur leterrain les entretiens et donc, je possédais une certaine indépendance pour mener l'enquête.Je possède une formation plutôt sociale et humaine de l'environnement. C'est pourquoi, le stageme correspondait puisque le but étant de mener des enquêtes chez les particuliers et de mettre enplace un indice socio-technique. C'est donc mes qualités en relation sociale et mes compétences entechniques d'enquête qui ont été primées, notamment dans l'interprétation des questions (voir grilled'interprétation).De cette mission, il en découle alors des points importants à expliciter dans ce rapport : lapremière partie permet l'appropriation de la problématique, des éléments scientifiques et lestechniques utilisées pour assurer la mission, la seconde partie montre la méthodologie utilisés pourmettre en place les enquêtes et enfin, la troisième partie donne la présentation des résultats, avecl'interprétation au regard du projet mais aussi d'un point de vue géographique.8


Preparation – Resource Alignment• Bring together departments with shared responsibilities (i.e.Health Benefits, Workers’ Compensation, Disability,Employee Assistance Program, Safety, Medical) under onedepartment and one leader – driving shared goals andintegration• Data Warehouse – Integrate and organize data to identifyopportunities• Implement solutions (i.e. Disease Management, Self-Careetc…) and measure results• Health Care Continuum – view health holistically and ensurethat Corning has effective corporate program across thehealth care continuum especially around prevention(primary, secondary and tertiary)10


Integrated Health and Safety FunctionRealigned into the HR function1998 TodayCounseling & SupportServices/EAPRisk Management andWorkers’ CompensationNational EAP & IntegratedBehavioral Health ProgramCommunicationsIntegrated HealthTeam ManagementHealth & SafetyTotalHealthProgramsEmployeeBenefitsCorporate MedicalServicesThese functions reported to different VPs and differentareas of the organization. This structure was sub-optimal andcaused confusion to employees.Integrated DataWarehouse andReportingAbsence ManagementIntegrated with common objectives.Health & Safety/Prevention & WellnessPrograms11


Integrated Data WarehouseHealth PlansMedical/VisionDentalPharmacyBehavioral HealthEAPTotal Health ProgramsLost TimeSTDLTDWorkers’ CompensationMedstatACS/Benefits NetworkEligibilityBenefitsIntegrated Reporting:− Medical− Rx− Behavioral health− Non-occupational losttime− Workers’ CompensationDesired Outcomes:− Informed decisions− Targeted interventions− Effective vendormanagement− Better health care− Quantifiable ROI− Improved employeerelations12


Continuum of Care and Program OfferingsWell At Risk Acute Conditions Chronic or PotentiallyDisabling ConditionsFor example: Low risk,good nutrition, activelifestyleFor example: Inactivity,high stress, overweight,hypertension, smokingFor example: Pregnancy,respiratory conditions,strains, sprains,lacerationsFor example: Diabetes,coronary artery disease,depression, musculoskeletalconditionsWhat Corning OffersWellness BenefitsPreventive care*Screenings (e.g.mammography)ImmunizationsFlu vaccinationsSafety eyewearHealthful HintsTotalHealth UpdateWellness stationsRestroom brochure racksLifeWorks ®Corporate Lactation ProgramHealthforums.com/corningCorning Fitness Program10,000 Steps-a-Day WalkingProgramHealthy discount programsHealth Advocate24/7 Health & Safety TeamsHealth Risk AssessmentLifestyle Management CoachingOnline Health educationprogramsHealth education programsoffered by UnitedHealthcare andEmpire BlueCross BlueShieldMedical Department Web siteCorning EAPLifeWorks ®Smoking Cessation ProgramCorning Fitness Program10,000 Step-s-a-Day WalkingProgramHealth AdvocateHealthier at Home guide andsminar24-hour nurse help lines(Corning medical planparticipants only)Healthy Pregnancy Program**Corporate Lactation ProgramHealth plan Web sitesInternational SOS TravelProgram (medical, security andlegal assistance)Corning EAPLifeWorks ®Healthy discount programsCase management provided bymedical plansHealth AdvocateSmart Steps Disease ManagementProgram**Integrated Disability ManagementProgram (work- and non-workrelateddisability and return-to-workprograms)Case management provided bymedical plansCorning EAPLifeWorks ®Health AdvocateCatastrophicConditionsFor example: Cancer,renal disease, rarediseases, severe injuryComplex Care Managementthrough ParadigmHealth**Ayco SurvivorSupport Cancer Resource Services(UnitedHealthcare only)Transplant ProgramNeonatal ManagementCorning EAPLifeWorks ®Health Advocate13


Integrated Health and Safety ManagementAspects to be addressed to optimize employees’ safety, health, well-being andproductivitySafety issues• Mechanicalhazards• ElectricalhazardsErgonomics• Equipment layout• Task organizationPsycho-socialissues• Stress• Shift workIndustrial hygieneissues• Physical hazards• Chemical hazards• Biological hazardsEmergencypreparedness• Medical & first responseLifestyle issues• Obesity• Alcohol• Drugs14


Integrated Health & Safety ManagementVision and Strategic Objectives• Corning will provide a safe and healthful workplace that supports positive behaviors,facilitates opportunities to optimize individual and organizational health andproductivity and minimizes risk and liability.• Our Total Rewards programs will reward positive behaviors and performance.• Our employees will be focused on their health and well-being; will be productive andattentive on the job and will actively pursue safe ways of working.• Our employees will enjoy injury and illness-free careers, will feel they are beingcompensated fairly and will actively support the organization’s key strategies andinitiatives.Improvepopulation healthto drive a lower cost& more productiveworkforceProvide asafe &healthyworkplaceHelp employeesresume aproductive worklife followinginjury/illnessProvide aseamless healthcare deliverysystem15


24/7 Health and Safety Program Objectives• Promote a more holistic approach to address key drivers:– Reduce the risk of injury and illness– Reduce workers’ compensation rates and costs– Reduce unnecessary health care costs– Reduce premature mortality– Reduce lost time– Improve productivity• Use corporate and facility measures to drive opportunityidentification and result measurement• Communicate key corporate health, wellness, and safetyprograms at a local level to drive optimal participation andresults16


24/7 Health and Safety Program StructureOverall Business ObjectivesDrivers and TargetsData; Internal/External Benchmarking;Company-wide and Local PrioritiesSafety Existing InitiativesHealth Existing Initiatives24/7 Safety and Health Campaign Corporate Campaigns (e.g., musculoskeletalconditions) Local Implementation combined with localprograms and initiatives24/7 Health & Safety Teams Structure and Tools developed centrally byCorporate Local implementation with alignment acrosslocations and company-wideIntegrated Safety and Health AssessmentPeriodic measurement of leading and laggingindicators of safety, health and productivity(processes and outcomes)Stakeholder Behaviors and Business Results24/7 Corporate Team Oversee implementation ofprogram and campaign Provide metrics/dashboards tofacilities Develop company widecampaigns and providecommunications andconsultative support Enhance total health website Host 24/7 Quarterly conferencecalls Host 24/7 Annual sharing forum(Health & Safety conference)17


Participation Drives Program Impact and ROIEnrollment Engagement Achievement MaintenanceReportingIdentify ProblemsE.g. Smoking, Stress,Lack of exercise,AlcoholCOMMITMENTBehaviorChangeCOMMITMENTCOMMITMENTProgram SolutionsE.g. Smoking CessationProgram, EAP, WeightManagement Programs,Corning FitnessPrograms & 10,000 StepsProgram, DiseaseManagement18


24/7 Health and Safety Resources• Intranet site• Support fromcorporatecommunications,safety & medicalfunctions• Senior managementsite visits19


Example Facility Dashboard (Page 1 of 3)Group Health TrendsHarrodsburgFacility ActivesCorningActivesGroup Health Demographics2007 2008 2008Average Number of Employees 378 377 9,903Average Number of Members 1,084 1,075 26,585Family Size 2.9 2.9 2.7Average Employee Age 41 41 44Harrodsburg Group Health Cost DriverTrends 2007 - 2008-50% -40% -30% -20% -10% 0% 10%IP Days per 1000 MembersOP Facility Visits per 1000Members-46%-9%Facility Corning ComparedHarrodsburgGroup Health Cost DriversActives Actives to Corning2007 2008 2008 2008IP Days per 1000 Members 266 142 205 -31%OP Facility Visits per 1000 Members 896 812 1,064 -24%OP Office Visits per 1000 Members 5,822 5,911 5,892 0%ER Visits per 1000 Members 195 193 175 10%Scripts Rx % Generic 63% 64% 61% 5%OP Office Visits per 1000MembersER Visits per 1000 MembersScripts Rx % Generic2%-1%3%2008Preventive Screening RatesFacilityCorning Difference fromDifference fromHarrodsburgActivesActivesCorning Benchmark BenchmarkBreast Cancer Screening Rate 53%67%-14% 69% -17%Cervical Cancer (PAP) Screening Rate 75%74%1% 82% -7%Colon Cancer Screening Rate 31%43%-13% 56% -25%Childhood Immunization Rate 76%55%21% 81% -5%Prostate Cancer (PSA) Screening Rate 33%31%2% 35% -1%Cholesterol Screening Rate 34%32%1% 38% -4%23


Example Facility Dashboard (Page 2 of 3)Absence ManagementAbsence ManagementFacility Harrodsburg ActivesCorningActivesComparedto Corning2007 2008 2008 2008STD Lag Time (% reported under 7 days) 64% 77% 77% 0%WC Lag Time (% reported under 3 days) 68% 51% 35% 46%STD Incidence per 100 Employees 24.9 10.7 8.0 34%WC Incidence per 100 Employees 9.5 9.7 4.0 142%% of All Claims with PIIM 2% 6% 16% -62%% of Eligible Claims with PIIM 3% 7% 18% -62%WC Lost Days per 100 Employees 48 100 25 301%STD Lost Days per 100 Employees 1,095 470 432 9%Restricted Duty Days per 100 Employees 8 0 59 N/AHarrodsburg Absence DriverTrends 2007 - 2008-100% -50% 0% 50% 100% 150% 200%Harrodsburg Facility 2008 PIIMBreakdownSTD Incidence per 100 Employees-57%20%WC Incidence per 100 Employees2%% of All Claims with PIIM180%80%% of Eligible Claims with PIIM166%STD = 1 WC = 424


Example Facility Dashboard (Page 3 of 3)Profile of HA Employee Participants and Health RiskHA Participation 2007 2008Total Employees 378 401Total Hourly 224 N/ATotal Salaried 154 N/A% Participation 59% 78%% Hourly 43% N/A% Salaried 83% N/A% Low Risk 29% 30%% Moderate Risk 58% 58%% High Risk 14% 12%Risk Factors - % at Risk 2007 2008Alcohol 4% 4%Back Pain 53% 55%Driving 10% 13%Eating/Nutrition 65% 64%Physical Activity 44% 40%Smoking/Tobacco 23% 23%Stress 57% 54%Weight 74% 72%Well Being 21% 24%2008 % Missing Biometric DataBlood Pressure Cholesterol Glucose36% 63% 91%Percent of Participants100%90%80%70%60%50%40%30%20%10%0%HA Risk Trend-1.5% pts13.8% 12.3%57.6% 0.5% pts 58.1%1.0% pts28.6% 29.6%2007 2008Change in Risk ScoreLow Risk Moderate Risk High Risk• Risk Trend is based on members who completed theHealth Assessment in both 2007 and 2008.Program Participation 2007 2008Smoking Cessation 9 10Fitness Center 42 34Smart Steps Disease Management 17 15Next Steps N/A 3825


Examples26


Challenges• “Pure” safety versus integrated health & safety– Resource availability– Priority• Mandatory program versus voluntary participation• Keeping it fresh– Need to constantly engage between corporate and local teams• Global application– Same overall approach but different program elements– Health assessment completion in Europe (data privacyconcerns)27


Future Plans• Integrated metrics development• Global application– Health assessment questionnaire?• Leverage existing activities– European Network for Workplace Promotion28


Integrated Health & Safety ManagementMetrics FrameworkImprovepopulation healthto drive a lower cost& more productiveworkforceProvide asafe &healthyworkplaceHelp employeesresume aproductive worklife followinginjury/illnessProvide aseamless healthcare deliverysystem24/7 Team EngagementInput/processProgram accessS&H AssessmentPIIMUsage, costavoidance,Restricted duty daysVendor Integration,Plan designTotal Health & Safety Input/Process IndexOutputDashboard (RiskMigration),Staywell averagehealth risk score,WLQ metricInjury/illness statsWC/STDIncidence, costs,Lost workdaysThompson dataTotal Health & Safety Output Index29


Total Health & Safety Input/Process Index Measures1. 24/7 team engagement2. Population healtha. Tobacco policy & toolsb. Physical activity access and toolsc. Healthy food access and tools3. Safe & healthy workplacea. Safety & health assessment score4. Absence managementa. PIIM5. Seamless healthcare delivery systema. Health assessmentb. Preventative services30


Enabling PatientCentered MedicalHome CapablePracticesThe Challenge for Employer EngagementThe Challenge for Physician EngagementJed ConstantzSustainable Health Systems


Establishing a PCMH“Neighborhood”• Taking the Next Step• Engaging Providers• Ending “Medical Homelessness”• Indentifying the Role for Employers• Reconciling Physician Challenges• Picking up the Pace


Establishing a PCMH“Neighborhood”• Taking the Next Step• Engaging Providers• Two Key “Delivery Systems”• Small Percent of the Population• Determining the Cost/Finding the Funding• Finding the WIIFM/Enlightened Self Interest• Multispecialty Practices with Primary Care• Hospital “Owned” Primary Care


Establishing a PCMH“Neighborhood”• Taking the Next Step• Ending “Medical Homelessness”• Establishing the Value of Primary Care• Developing a Collaborative Environment• Leveraging the Culture of Wellness• Establish a Culture of Enhanced Care Coordination


Establishing a PCMH“Neighborhood”• Taking the Next Step• Indentifying the Role for Employers• Engaging Employees/Dependents as Better Consumers andPatients• Investing in Physician Services – As a Community• Making Payors/Claims Administrators More Accountable• Investing in Health Informatics• Modify Benefit Plan Design/Eliminate Fragmentation


Establishing a PCMH“Neighborhood”• Taking the Next Step• Reconciling Physician Challenges• Restoring the Financial Integrity• Creating a Culture of “Population Health”• Removing Financial Disincentives• Establish “Market Share” Accountability


Establishing a PCMH“Neighborhood”• Taking the Next Step• Picking up the Pace• Finding the Funding• Expanding the Benefits• Re-allocating Administrative Costs• Cost Effective “Transformation”• “Credentialing” the Payors• Benefit Plan Flexibility• Ability to Delegate Administrative “Carve Outs”

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