1. Connecting Health, Productivity and Business Thomas Parry, Ph.D. President Integrated Benefits Institute

2. About IBI National, not-for-profit corporation 674 corporate sponsors Employers: 90% of IBI’s members IBI’s mission. Demonstrate the business value of a healthy workforce through: –Independent HPM research –Measurement and modeling tools –Forum for sharing ideas and experience Visit www.ibiweb.org

3. “The healthcare issue that connects employers all over the world – regardless of how the healthcare system is financed in their country – is time loss from work and resulting lost productivity.”

4. New Employer Realities Unprecedented economic challenges Show the C-suite the value of improved workforce health Dead end: attempting to control claims costs in separate program silos Looking for best strategies to improve workforce health, reduce lost time and enhance productivity Limited data, time and dollars

5. What’s at Risk for Employers? Even in the US, health-related lost productivity is a big deal

6. The Full Costs of EE Health -- Auto Manufacturers Estimates based on IBI’s new FCE modeling tool 171,250 employees Employer-paid claims costs only Published as IBI Quick Study in February 2011

7. Full Cost Components 48% 28% 16%

8. A View of the Canadian Workforce

9. Prevalence of Chronic Disease

10. Changing Importance of Top 10 PrevalenceTreatment Penetration Lost Time 1) Allergies/hay fever1) Diabetes1) Depression 2) Back/neck pain2) Hypertension2) Chronic fatigue 3) High cholesterol3) Congestive heart failure 3) Anxiety 4) Heartburn/GERD4) Coronary heart dis.4) Back/neck pain 5) Arthritis5) Osteoporosis5) Obesity 6) Anxiety6) High cholesterol6) Sleeping problems 7) Depression7) COPD7) Heartburn/GERD 8) Obesity8) Asthma8) Irritable bowel 9) Hypertension9) Depression9) High cholesterol 10) Chronic fatigue10) Sleeping disorders10) Chronic pain

11. Treatment of Chronic Disease

12. Prevalence of Co-Morbidity

13. The View from the C-Suite

14. Linking Health, Productivity & the Bottom Line CFO Survey, IBI, 2002

15. Effect of Benefits Programs on Financial Performance A big deal for only 25% Source: On the Brink of Change – How CFOs View Investments in Health and Productivity. Integrated Benefits Institute. 2002.

16. The Impact of Ill-Health 96% 90% 86% 84% 71% 47% Source: The Business Value of Health: Linking CFOs to Health and Productivity, IBI, 2006

17. Are CFOs Getting Information? Absence –51% ever get reports on occurrence –22% get reports on financial impact Presenteeism –22% ever get reports on occurrence –8% get reports on financial impact Source: The Business Value of Health: Linking CFOs to Health and Productivity, IBI, 2006

18. Quantifying Financial Lost Productivity * Lost productivity – “the financial impact on a company when employees are not at work and fully functioning” Two components: absence and decrements in job performance (“presenteeism”) The Financial Impact of Absence –Wage replacement payments –“Opportunity costs” of ER’s response The Financial Impact of Presenteeism –Wage and benefit “overpayments” –Opportunity costs of resulting lost time *Source: Sean Nicholson, Mark Pauly, et al., "Measuring the Effects of Work Loss on Productivity with Team Production," Health Economics 15: 111-123 (2006).

19. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007

20. RA Study Population 5,483 employees with RA Ave. age: 51 years (14% under 40 and 14% over 60) 41% Male; 59% female

21. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007 Impact of Out-of-Pocket Cost -- on medication adherence --

22. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007 Impact of Out-of-Pocket Cost -- on medication adherence --

23. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007 Impact of Out-of-Pocket Cost -- on medication adherence --

24. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007 Impact of Out-of-Pocket Cost -- on medication adherence --

25. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007 Impact of Out-of-Pocket Cost -- on medication adherence --

26. Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007 Impact of Out-of-Pocket Cost -- on medication adherence -- Adherence reduced 38% by $20 copay increase

27. Savings in Lost Productivity Costs -- For No-Script Group -- -26% Source: A Broader Reach for Pharmacy Plan Design, Integrated Benefits Institute, 2007

28. New Report: Linking VBBD and Productivity

30. Health Risks & Job Performance

31. Co-Morbidity and Absence

33. Prevalence across broad condition clusters among those with at least one chronic condition

34. Annual Absence Days Single vs. Co-Morbid Condition Clusters

35. Annual Presenteeism Days Single vs. Co-Morbid Condition Clusters

36. Annual Lost Days Absence and Presenteeism

37. Transitioning from ROI to Value of Investment

38. Key Health Dimensions Financial Program participation Biometric screening Health risks Utilization Preventive care Chronic conditions Lost worktime Lost productivity Employee engagement

39. The Temporal Dimension Leading indicators –Health risks –Preventive care –Biometric screening –Chronic conditions –EE engagement Treatment indicators –Utilization –Program participation Lagging indicators –Financial –Lost worktime –Lost productivity

40. Dimensions & Dashboard Metrics DimensionSummary Metric Financial Program cost/EE Program participation EEs participating/All EEs Biometric screening EEs reaching target/All EEs Health risks # of health risks/EE Utilization # EEs getting care/All EEs Preventive care # EEs getting screened/All EEs Chronic conditions # EEs w/ chronic conditions/All EEs Lost worktime # of lost workdays/EE Lost productivity Lost productivity $/EE Employee engagement Engagement score/EE

41. Thinking about Metrics as Hierarchies Dashboard metrics Component metrics Contributing metrics

42. Contact IBI Thomas Parry, Ph.D., President tparry@ibiweb.org www.ibiweb.org