Measuring the Impact of a Health Risk Management (HRM) Program on Employees’ Health Risks
and Workers’ Compensation
Lee S. Newman1, MD, MA, Kaylan Stinson1, MSPH, Hai Fang1, PhD, Adam Atherly, 1 PhD, PhD Claire Brockbank2, MS, Jim McMillen3, MSPH, CIH, Margo Trotter4, RN, MHSc, Kim Jinnett5, PhD, Liliana Tenney1, MPH, Ron Goetzel6, PhD
1- Colorado School of Public Health, University of Colorado, Aurora, CO;
2- Segue Consulting, Denver, CO; 3- Pinnacol Assurance, Denver, CO; 4-Trotter Wellness, Sheboygan, Wisconsin; 5-Integrated Benefits Institute, San Francisco, CA; 6- Truven Health Analytics, Washington D.C.
Significant factors associated with filing workers’ compensation claims
Table: Predictor Variables and Reference (ref) Groups
(Models 1 & 2)
Background
Demographic
Health
Behavioral
• Americans spend one-third of their time at work.*
Age
• Worksite health promotion programs can improve health risk factors and reduce
costs (direct and indirect).
BMI
(ref: 18.5-24.9)
Cancers
(ref: no cancer)
Smoking status
(ref: non-smoking status)
Gender
(ref: Male)
Diabetes
(ref: normal glucose values)
Lung:
(ref: no lung disease)
Alcohol use (ref: < excessive
consumption)
Race
(ref: Caucasian)
Blood Pressure
(ref: normal bp values)
Back Pain
(ref: no back pain)
Sleep hours
(ref: >=7 hours/day)
Income
(ref: >$24/hour)
Cholesterol
(ref: normal cholesterol values)
Chronic Fatigue
(ref: no chronic fatigue)
Safety habits (ref: lower riskseatbelts, helmet use, drinking &
drinking, etc.)
Education (ref: college
education or higher)
Allergies
(ref: no allergies)
Depression
(ref: no depression)
Exercise habits
(ref: lower risk- regular exercise
program)
Martial Status
(ref: married)
Arthritis
(ref: no arthritis)
Stress (ref: low risk- low stress Nutrition
at work, home, finances)
(ref: lower risk- >= 3
fruit/vegetable servings/day)
Heart:
• Some published evidence exists showing associations between health
risks/behaviors and workers’ compensation outcomes.
• It is not known if wellness programs that address health risks and comorbid
conditions reduce the number and cost of work-related injuries.
• Studies that have methodically studied health promotion in small businesses are
lacking, despite the fact that 56% of US workers are employed by small
businesses.**
Asthma
(ref: no asthma)
(ref: no heart disease)
A worksite wellness program, provided free of charge to companies and their
employees insured by Pinnacol Assurance, a workers’ compensation carrier in
the state of Colorado.
Results
Employees
Frequency (%)
<10
51 (19.9)
10-49
82 (32.0)
50-250
88 (34.4)
250-500
21 (8.2)
500+
14(5.5)
61.4
Female
Mean Age
42.8
>=55
Married
76.8
< High School
High School/Some College
White
83.5
Hispanic/Latino
10.2
<=$16/hour
$16.01-24/hour
<18.5 (underweight)
Education
Information presented in this poster will:
Less than High School
5.1 %
Permanent Partial
Disability
$25K-39.9 K
25.7
$40k-74.9K
35.4
$75K-99.9K
7.2
100K+
7.5
93.5 %
Blood Pressure values unknown
Depression
24.2
Medical Only
Cholesterol unknown
46.6
<$25K
Type of Payment:
High Cholesterol
50.7
4- year college degree or
higher
Yearly Salary
1.4 %
35.0-39.9 (class II obesity)
2.7
High school some college
(N=958)
Methods
Frequency (%)
Race/Ethnicity
Workers’ Compensation Claims
 Describe the baseline health status of participants enrolled in the HRM
program.
 Identify associations between risk factors and prospective workers’
compensation data.
Significant factors associated with medical costs related to workers’
compensation claims
Individual Baseline
Characteristics (N=11,007)
Male
Company Size (N=256)
The overall objective of this study is to assess the effect of the Health Risk
Management program on the frequency and severity of workers’ compensation
claims and to determine if the HRM provides measurable benefits to policyholders
by improving employee health and productivity.
High Alcohol Consumption
Summary & Future Directions
Temporary Total
Disability
Data Collection & Analysis
1.Health Risk Assessment Data (HRA): Baseline HRA data was collected using
a web-based, self-administered questionnaire provided by Trotter Wellness and
certified by the National Committee for Quality Assurance.
2.Workers’ Compensation Data: prospective workers’ compensation claims data
(closed medical claims only) were collected for individuals in the HRM program
from the Pinnacol Assurance workers’ compensation database.
What are the top self-reported health risks among the population at
baseline?
Overweight
58.2%
Stress (high)
45.7%
Chronic Back Pain
Statistical Models
Type
Outcome variable
Model 1
Poisson multivariate regression
Number of claims filed (Injuries)
Exposure time
Logistic regression with multiple
dichotomous predictor variables
Binary: medical costs
(costs vs. no costs)*
See table
Predictor variables
Results
Model 2
Incidence Rate Ratios
One year
Chronic Fatigue
20.7%
High Blood Cholesterol
21.5%
Notes:
*medical costs= no lost work time paid out (<3 missed work shifts)
All statistical anlayses performed using STATA 12 (StataCorp. 2011. Stata Statistical Software: Release 12. College Station,
TX: StataCorp LP.)
Research reviewed and granted exempt status by the Colorado Multiple Institutional Review Board (COMIRB)
• By pooling data from many small employers into a uniform database, we have
created a unique opportunity for a prospective, multi-year intervention study in
small businesses.
• First year analysis identified important modifiable health risks in the small
business workforce
• Workers’ compensation injuries and medical costs are associated with important
demographic, health and behavioral risk factors.
• Future analyses will test whether the intervention results in improved health and
reduced costs and claims.
25.1%
High Blood Pressure
18.2%
The long term evaluation objectives of this project are to prospectively:
 Measure changes in workers’ compensation claim rates/costs over time
Migraine Headaches
18.4%
 Identify changes in employee health profiles over time
Odds Ratios
One year
25.0-29.9 (overweight)
30.0-34.9 (class I obesity)
35.0-39.9 (class II obesity)
>=40.0 (class III obesity)
High Cholesterol
Cholesterol unknown
Glucose values unknown
Depression
Back Pain
Arthritis
High Alcohol Consumption
Cigarette Smoking
Migraines (ref: no migraines)
Intervention: Health Risk Management Program
Objective
Female
34-54
< High School
High School/Some College
African American
Hispanic/Latino
<=$16/hour
$16.01-24/hour
Depression
17.4%
Arthritis
17.5%
Smoking
 Study the effects of the Health Risk Management program on labor market and
performance
 Study the effects of the Health Risk Management program on preventive health
behaviors
13.0%
Asthma
11.2%
Alcohol (excessive consumption)
8.2%
Diabetes
4.2%
0
1000
2000
3000
4000
5000
6000
7000
References:
* Bureau of Labor Statistics, American Time Use Survey 2010
** Bureau of Labor Statistics, Business Employment Dynamics Survey 2011
For more information about this poster, please contact: Lee.Newman@ucdenver.edu