You think YOU’VE got it bad? Non-occupational health and disability costs Andrew Newman Research Director Integrated Benefits Institute WC Research Colloquium May 1, 2003 Copyright 2003, Integrated Benefits Institute

About the Institute National, non-profit 540 members Employers represent 90%+ Research, full-cost studies, education Focus on the management of EE benefits across traditional silos

Today Occ vs. non-occ spill-over Overwhelming concentration of benefits costs in non-occ Lessons drawn from WC: RTW

Study -- data 300 unionized employers, NY, ’92-’95 WC vs. STD/Group Medical claims Created WC-like medical/disability claims records for non-occ Same body parts—similar occ and non-occ diagnoses

Study -- context Max weekly disability benefits 24% higher for occ claims STD max duration 6 mos.; no LTD Group medical fee schedules ¼ lower Poor labor market Strong incentives to file under WC system

Study -- results Med-only rate similar for occ and non-occ 12% lost-time WC claims incidence vs. 2.1% STD claims incidence 9.1 avg medical visits for WC vs. 5.7 for non-occ Understanding benefits costs and results requires examining the interplay of benefits systems, contexts

Median Full Cost Magnitude Medical care for employees and dependents

Average Full Cost Magnitude

Benefit Program Contributors (average)

Benefit Program Contributors (median) medians

RTW Universal agreement: RTW is key to absence management Over ¾ in IBI benchmarking studies have WC RTW Still relatively rare for STD. Why?

Not the MDs’ fault IBI Physician Survey (2001) 304 physicians Occ & non-occ experience

RTW Is Good Medicine

Physician Resource Needs