This
WisdomWorkplace
program
Health
& Wellnesswebinar
and employee
is brought
to you by United Benefit Advisors
motivation:
in conjunction with Unum
Making the connection
Health and Productivity Solutions
www.UBAbenefits.com
Kristin Tugman| August 27th 2013
www.unum.com
Health & Wellness and employee
motivation:
Making the connection
Health and Productivity Solutions
Kristin Tugman| August 27th 2013
Agenda
 Workforce Productivity Challenges
 Healthcare challenges
 The Healthcare lost time picture
 The multigenerational workforce
 Motivation
 Productive Aging
 Summary/Conclusion
33
The Productivity Challenge Is Growing
 Research indicates that disability costs employers between 8% and 15% of payroll
(7)
 Disability costs are expected to increase in the United States by 37% over the next
10 years (7)
 This is not only a United States issue but also a global issue. The United Kingdom
reports their disability payments have doubled in the last 30 years (8)
 The sandwich generation has emerged due to the aging population in that workers
are required to not only care for their children but also aging parents and this place
significant stress on the individual that can lead lost time from work (1)
 65% of the 55-65 year old population will participate in the workforce by 2012 (12)
 Physical changes occur in workers over 40 years that lead to an increased opportunity
for disability, ie, a decrease in muscle strength, cardiovascular function and
endurance (4)
 Employees over 40 are out of work on average 8-18 days longer than the younger
worker (10)
 By 2012 the median age for workers is 41.4 years (5)
4
Today’s top trends and benefits challenges
Economic
pressures
Rising costs, tight
budgets, reduced staff
Health care
reform
Legal mandates and
financial implications
Disengaged
workers
Lower morale, increased absence,
increased productivity demands
Regulatory
complexity
FMLA and state leave laws,
managing intermittent leave
Changing
workforce
Delayed retirement, aging workers
(including nurses), the “sandwich”
generation, flex time, unique work
schedules
Employees at
financial risk
High deductible health
plans, no savings
How do they impact your hospital?
5
Absence impact is higher for hospitals
62 full-time employees are absent from work every day
in a hospital with 5,000 workers
Number of absent workers
65
60
55
22
RNs
50
45
40
Affecting the care
of 90 patients
35
30
25
40
all
other
workers
20
15
10
5
0
62 absent workers
Which costs you
$4.5 million
annually
Based on 2010 Unum internal data for hospital clients, 2011.
6
Disability and FMLA incidence higher in hospitals
Incidence as much as 40%
higher for hospitals − significant
impact to staffing-sensitive
operations
Family and Medical Leave1
Short term disability2
Short term disability lost
work days3
Long term disability4
Average employee age5
Incidence per 100 employees
Hospital and
health services
All industries
28.0
20.0
7.4
5.1
323.3
300.9
.62
.49
44
48-nurses
42
1 FML snapshot study, Unum data 2010; 2,3 Short term disability incidence and lost days: Unum internal data, 2009 and 2010; 4 Long term disability
incidence, Unum internal data, 2010; 5 Average Age of Employed and Projected Employment Growth: Bureau of Labor Statistics, 2010.
7
Intermittent FMLA is more significant in hospitals
The nature of hospital work and worker demographics
greatly increases FMLA leave and absence incidence
compared to other industries.
Mean incidence per
100 employees
Health care
8.8
Banking & finance
6.1
Manufacturing
4.6
Transportation – Utility
4.0
Med technology
3.5
Education
3.0
Services
<1.0
Source: 2010 Unum internal data, 2011.
8
Reducing short term disability duration a must
Employees over the age of 50 are out of work on average 10
days longer than an employee under that age of 50.
Unum, 2012
Short term disability durations for select diagnostic conditions
100
Duration in days
79
75
83
80
74
71
73
Hospitals
78
All other industries
71
61
54
59
52
50
40
38
38
42
25
0
Cancer/
Neoplasm
Unum internal data, 2010
Circulatory
Behavioral
Back
Musculoskeletal
l
Pregnancy
Digestive
Respiratory
All
diagnoses
9
Chronic conditions drive many short term leaves
An integrated disability/health management strategy can
effectively help employees deal with chronic conditions and
reduce leave time.
Short term disability durations for chronic/other conditions in hospitals
Duration in days
100
90.3
90.4
75.4
75
72.7
68.5
67.6
55.9
55.5
50
53.9
52.0
42.4
25
0
Cancer
Heart
failure
Low
back
Diabetes
Coronary
artery
disease
Depression
All
Maternity
conditions
COPD
Other
Asthma
Based on Unum book of business – 2009-2010
10
Long term disability claims reflect unique workforce
The physical nature of hospital work and the importance of
patient safety can drive greater disability incidence.
Top diagnostic conditions for long term disability leaves in hospitals:
40%
Percent of claims
35%
Hospital sector
32%
30%
Unum block
26%
25%
20%
17%
13%
15%
8%
10%
9%
11% 11%
8%
6%
6%
7%
5%
0
2%
Musculoskeletal
Tumor
Circulatory
Injury
Nervous/
sensory
Behavioral
3%
Respiratory
Source: Unum database, 2011
11
Health & Productivity Spectrum
Health & Productivity Spectrum
Wellness
• Weight loss
• Prevention
• Health clinics
• Smoking cessation
• Employee assistance
• Health Risk
Assessments
Chronic condition Leave
management
management
• Disease
management
• Treatment Decision
Support
• Employee assistance
• Case Management
• FMLA
• STD
• LTD
• Return to
work/productivity
assistance
This spectrum must be connected in order to promote the health,
wellness and productivity of your workforce
112
The Generations - Changing Incentives
Managing a Multi-generational Workforce
• Reward prevention & restoration
• Establish a flexible work environment
• Fund for longevity & independence
A New Way
of Thinking
13
The multigenerational workforce: what motivates them?
BABY BOOMERS
GENERATION X
GENERATION Y
Born between 1946-1964
Born between 1965-1978(80)
• A different view of authority
• Pessimistic about
entitlements/loyalty
• Demand workplace
flexibility
• Value relaxed/team based
workplace
• Technology
• Work life balance
• Nurses – Marketability,
innovation, credentials, &
Expertise
Born between 1978-1990
• Work to Live
• Competition
• Benchmarking
• Reward for performance
• Work life balance
• Immediate gains
• Suspect of long term
employer relationships
• Concrete measures
• Technology beyond X’ers
• Diversity
• Optimistic
™
• 55+ Fastest growing piece
of the workforce
• Live to Work
• 34% never expect to retire
• Sandwiched
• Effort
• Loyalty
• Reward for loyalty
• Choice
• Information
• Nurses – value loyalty,
professionalism &
independent practice
14
The multigenerational workforce: How do we leverage their
unique motivational drivers?
BABY BOOMERS
™
Born between 1946-1964
• Productive aging
program
• Workplace Flexibility
• Creative benefit plans
• Communication
strategy
• Emphasize skills and
experience
• Deliver choice in
benefit plans
GENERATION X
Born between 1965-1978(80)
• Communication
Strategy
• Demonstrate trust
worthiness
• Workplace flexibility
• Allow for fun in the
workplace
• Technology as a tool
• Offer assistance with
Work life balance
GENERATION Y
Born between 1978-1990
• Offer Competition
• Offer Benchmarking
• Immediate Reward for
performance
• Work life balance
• Immediate gains
• Concrete measures
• Technology as a tool
15
The Traditionalists
Born 1922-1945 (today between 90 & 67)
Motivation
•The silent generation – survived the Great Depression
•Loyalty
•Respect for authority and rules
•Logical
•Disciplined
•Patriots
•Team oriented
•Conflict avoidant
Motivation to Action in the workforce
•Prefer hierarchy within an organization
•Innovative – seek out technological advances
•Consistency and uniformity
•Understand/embrace more with less
•View history as a means of understanding future strategy
The 65 – 74 year old age is increasing and has
already increased 73% between 2000 and 2012
16
16
Driving Health & Wellness
Wellness
• Preserve the health of your employees
• Tailor communication strategies to address each generation’s needs
• Offer competition and benchmarking
• Offer rewards for loyal participation
• Technology
Disease Management
•Ensure Employees with Chronic Conditions receive the care they need
•Offer information and knowledge
•Technology
•Offer immediate concrete incentives for participation
• Offer choice in participation type
•Communicate the strategy to address each generation’s needs
Consumer Driven Health Plans
•Communicate based on needs of each generation
•Offer technology to make choice
•Offer concrete benefits of plan
•Emphasize programs to reduce cost and secure proper care
17
The evolution of workforce by age group
70
60
50
40
30
20
10
0
2010
2020
2020
16-24 yrs
2010
25-55 yrs
55+ yrs
Bureau of Labor Statistics, DOL, 2011 (14)
18
1
Productive Aging – Program Building Blocks
The Building Blocks
Return on
Investment
Corporate
Strategies
People
Strategies
Health
Strategies
Targeted Benefits
for Longevity
Social & Cognitive
Engagement
Controlled
Health Risks
Independence
Flexible Work
Environment
Hopefulness
Access to
Medical Care
Applied Wisdom &
Problem Solving
Appropriate
Nutrition
Strength, Flexibility
& Endurance
The 55-64 and over population increased 51% over the
last 10 years and will continue to grow rapidly (10)
The 65-74 year old population increased by 48% (10)
The most prominent generations in nursing today are
Gen X & the Baby Boomers (13)
19
Employer Message: A Productivity Rx
Manage the productivity
• Expect financial gaps
created by non treatment
costs – fill the gaps.
impact @ diagnosis:
• Avoid premature work or career
decisions.
• Provide appropriate
communication with co-workers.
• Give “permission” to engage
in treatment.
• Understand employee &
caregiver presenteeism.
• Build transitions:
• Explore employer-healthcare
insurer partnerships that
create accessibility to new
therapies.
• Performance Management:
Understand the “good”
employee to “bad” employee
progression.
Transitional Work
Transitional Work
Full work Capacity
Stay
Stayatatwork
Work
)
(preserve
productivity
(preserve
productivity)
Absence
Absence
from
Work
from work
Return
Returnto
towork
Work
)
(restoreproductivity)
productivity
(restore
20
A Solution – Transitional Return to Work
●
Individuals out of work for six months are 50 percent less likely to return to
work, and the likelihood of a return to productivity decreases by another 25
percent as the leave approaches one year. (2)
●
Early intervention return-to-work strategies can mitigate the associated cost of
these long-term absences by 20 to 40 percent. (2)
●
Structured programs are becoming more important due to changes to the
Americans with Disabilities Act (ADA), as well as the ongoing risk surrounding the
Family and Medical Leave Act. (12)
●
A lack of understanding surrounding what is required of a specific position results in
guess work and is not effective return to work planning (6)
●
Early intervention had an impact on long term return to work results associated
with musculoskeletal disorders (8)
●
An extensive literature review found that a case management approach can lead to
a $50,000 savings per short term psychiatric disability cases (3)
•
Effective programs included a case management component and transitional
return to work
•
The early intervention approach also produced fewer transitions to long term
disability
21
Hospital-tailored return-to-work programs
Customized for the unique needs of your workforce
Sample solution from return-to-work tool
Restriction: Reduced Lifting Demands
Transitional Work Option
Transition Description
Reduce Patient Load
Temporarily alter nurse’s patient load to reduce lifting demands.
Gradually increase patient load until nurse is back to full capacity.
Partner with co-worker
Nurse paired with co-worker as a team or partners with co-worker for
lifting assistance. In some units co-workers will increase patient load, and
divide work according to the employee’s restrictions.
Special Roles
Consider nurses with proper qualifications for roles as patient educator or
preceptor.
Project Work
Consult managers to identify temporary project work. Examples include,
but are not limited to:
 quality audits
 medical records review
 education sessions
 utilization review
Alternate Work
Location/Float
Identify other units or departments nurse could temporarily move to, such
as in the same day area or triage, if the Floor cannot accommodate the
restrictions.
22
Summary & Conclusions
•The baby boomers are driving an older population in the workforce
•Generation Y, Generation X, and baby boomers are motivated for
different things
•The workforce is multi-generational in way we have not seen before
•Healthcare is particularly impacted by the aging workforce and
nursing is primarily made up of Generation X and Baby Boomers
•In order to drive employee satisfaction and participation in wellness,
disease management, and return to work efforts, HR professionals
must understand what drives behavior among these generations
23
Questions?
Insurance products are underwritten by the subsidiaries of Unum Group.
unum.com
24
References
1.
Beauregard, T.A., Ozbilgin, M. & Bell, M. P. (2009). Revisiting the social construction of family in the context of work. Journal
of Managerial Psychology, 24(1), 46-65.
2.
Bose, H.A. (2008). Returning injured employees to work. Professional Safety, 53(6), 63-68.
3.
Burton, W.N, Schultz, A.B. Chen, C. & Edington., D.W. (2008). The association of worker productivity and mental health: a
review of the literature", International Journal of Workplace Health Management, 1(2), 78.
4.
Choi, S.D. (2009). Safety and ergonomic considerations for an aging workforce in the US construction industry. Work, 33,
307-315.
5.
Gonyea, J. (2008). America’s aging workforce: A critical business issue. Boston University School of Social work.
6.
Gosner, B. & Archibald, B. (2010). Getting physical with return to work programs. EHS Today, 3(4), 17.
7.
Hawley, C. E., Diaz, S., & Reid, C. (2009). Healthcare employees’ progression through disability benefits. Work, 34, 53-66.
8.
Lydell, M., Grahn, B., Mansson, J., Baigi, A., & Marklund, S. (2009). Predictive factors of sustained return to work for
persons with musculoskeletal disorders who participated in rehabilitation. Work, 33(3), 317.
9.
McVicar, D. (2008). Why have UK disability benefit rolls grown so much? Journal of Economic Surveys, 22(1), 114-139.
10.
Mitchell, K. (2006). Productive Aging: The new life stage. World at Work, 62-72.
11.
12.
13.
Ring, K. (2010). 10 Return to work mistakes. Buildings, 104(4), 42-45.
Sanders, M.J. & McCready, J. (2009). A qualitative study of two older workers’ adaptation to physically demanding work.
Work, 32, 111-122.
Leiter, M.P.,
25
References Continued
13. Leiter, M.P., Jackson, N.J.,Shaughnessy, K., (2009). Contrasting burnout, turnover intention, control, value
congruence, and knowledge sharing between baby boomers and generation X. Journal of Nursing
Management, 17, 100-109.
14. Sommers, D. & Franklin, J.C., (2012). Employment outlook : 2010-2020: Overview of Projections to 2020.
Monthly Labor Review, Bureau of Labor Statistics, 1-20.
15. James, J.B., Swanberg, J.E., & McKenchie, S.P. (2007). Generational differences in perceptions of older
workers’ capabilities. The Center on Aging Work and Workplace Flexibiltity, 12, 1-10.
16. Golden, M. (2013). 7 ways generation X’ers differ from baby boomers. Retreived 2013,
http://top7business.com/?Top-7-Ways-Generation-Xers-Differ-From-Boomers&id=1860
17. Boychuk-Duchscher, J.E., & Cowin, L. (2004). Multigenerational nurses in the workplace. JONA, 34(11), 493501.
26
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Health & Wellness and
This program has been submitted for 1.50 (General)
recertification credit
hours toward PHR, SPHR
and GPHR
employee
motivation:
recertification through the HR Certification Institute.
Making the connection
All attendees will be notified by email of the program ID number
once approval is granted to include on your recertification
application form.
• Health and Productivity
For more information
about certification or recertification, please
Solutions
visit the HR Certification Institute website at www.hrci.org.
• Kristin Tugman| August
27th 2013
27
27
Health & Wellness and
Thank you for your participation
motivation:
in the employee
UBA WisdomWorkplace
presentation.
To view a recording of this presentation, or to register for future
presentations,
contact your
localconnection
UBA Member Firm.
Making
the
• Health and Productivity
Solutions
www.UBAbenefits.com
www.unum.com
• Kristin Tugman| August
27th 2013
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