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Tammy Bradly: With an Aging Workforce, Old Interventions Won’t Do

November 11, 2013 - WorkCompWire

By Tammy Bradly, VP Clinical Product Development, Coventry Workers’ Comp Services

Tammy BradlyIt used to be simple: Work. Retire at 65. Enjoy your retirement spending time with the grandkids, traveling, or playing golf. Today, not so much. Economic realities and cultural trends are keeping workers on the job longer than ever—and that presents employers with both benefits and challenges.

The first Baby Boomers—the population wave born from 1946 to 1964—started to hit traditional retirement age, 65, in 2011, but they are not retiring in droves. Instead, they are continuing to play a major role in the workforce. The U.S. Bureau of Labor Statistics estimates that by 2020, one in four American workers will be 55 or older. According to U.S. Census predictions, by 2050 more than 19 million workers will be 65 or older and will make up approximately one-fifth of the U.S. workforce.

Individuals are remaining in the workforce for a number of reasons. A series of market corrections and the 2008 recession eroded retirement savings, and Social Security payments may not be sufficient to sustain pre-retirement lifestyles. In addition, even with Medicare, the cost of health benefits in retirement can be high. However, not all the reasons are economic. Many older adults wish to stay productive—and employers need their skills, experience and expertise.

Employers need to prepare for this shift in employee demographics. The first step is to understand the demographics, including age distribution, of their employees and the type of tasks they need to perform. With a clear picture of the risk factors associated with an aging workforce, the employer can implement a program that addresses prevention as well as the more complex management of injuries in older workers in order to retain the skills and knowledge of these experienced employees.

Risk factors rise in an aging workforce
Aging workers are more vulnerable to injury, and their injuries can be more difficult to manage due to the higher likelihood of one or more comorbidities. Wear and tear on aging joints makes these workers more susceptible to musculoskeletal injury due to repetitive motion and other factors. Other risks include falls due to declining balance or reduction in depth perception, and injuries due to losses in body strength, vision and hearing.

Whether we like it or not, as we age, pretty much everything declines except body fat. According to the Centers for Disease Control, more than one-third of all adults do not meet the recommendations for aerobic physical exercise. Nearly one of every two adults has at least one chronic condition, such as arthritis, high blood pressure, obesity, cardiovascular disease or diabetes. Bear in mind that, although chronic illnesses are more common among older adults, they do affect people of all ages. In fact, they are a leading health concern—and can pose challenges to recovery and return-to-work in any demographic. An October 2012 NCCI Research Brief reported that the share of workers’ compensation claims with a comorbidity nearly tripled between 2000 and 2009, from 2.4 percent to 6.6 percent. Furthermore, claims with a comorbidity diagnosis have about twice the medical costs of otherwise comparable claims. The brief noted that claimants with comorbidity diagnoses are typically older than other claimants. It also suggested that comorbidities in workers’ compensation are underreported, because most comorbidities are diagnosed outside the workers’ compensation system.

An ounce of prevention pays off
Employers can take a wide range of injury prevention and wellness measures that stand to benefit older and younger workers alike. Injury prevention measures include ergonomic and physical considerations. Typical features of wellness programs include health risk assessments (HRAs), health screenings, behavior modification programs, education and incentives to encourage healthier behaviors. Incentives can range from small gifts to discounted gym memberships to reduced deductibles for health insurance.

Keeping employees healthy, regardless of age, is key to keeping healthcare costs down. A healthy employee population results in reduced productivity losses, fewer work-related injuries and faster return-to-work when an injury or illness does occur. Studies have shown that wellness programs can be a smart investment. A widely cited article in the December 2010 Harvard Business Review notes that companies with wellness programs realized returns on investment (ROIs) of 6 to 1 in reduced healthcare costs.

Given health care reform, the media are reporting that companies are considering dropping employee healthcare coverage. Which begs the question: “Will they also discontinue wellness programs?” If so, that may be shortsighted. Return-on-investment in wellness goes far beyond savings on healthcare dollars. It has a direct impact on productivity and presenteeism, as well as recovery and return-to-work following an injury. In fact, worksite health promotion programs have shown that companies that implemented an effective wellness program realized significant cost reductions and financial gains, including an average of 28 percent reduction in sick days and 30 percent reduction in workers’ compensation and disability management claims.

Older employees and a wiser approach
Incorporating age-specific prevention measures and wellness initiatives into risk management programs makes good business sense. Keeping employees of any age healthy can reduce the incidence of work-related injuries as well as the recovery and treatment durations that are necessary in the presence of comorbidities. When an injury does occur, it is important to understand how the injured workers’ comorbidities can complicate recovery.

Managed care programs must establish best practices that take a holistic view of the individual, evaluating all physical, psychosocial and emotional factors that may impact recovery. This may involve coaching the individual to be a better healthcare consumer and to take personal responsibility for his or her own overall health and recovery. It’s never too late to change behaviors. Incorporating tools such as an online coaching center into the case management process is an inexpensive way to improve an employee’s overall health and to help prevent prolonged treatment and recovery following injury.

In addition, the complexity of managing injuries for older workers makes ergonomic and physical considerations even more important. In order to achieve optimal outcomes, your managed care partner should consider RTW planning an integral part of the case management process using job analysis and transitional duty to match the injured worker’s physical capabilities to return-to-work opportunities. Professionals trained in job analysis and ergonomic assessment can assist employers in identifying low or no cost ergonomic adjustments to the injured workers’ work station that not only allow the injured worker to return-to-work but may prevent future injuries from occurring. Indemnity costs are typically higher for older employees due to higher salaries and longer recovery following an injury. Returning an injured worker to work in a transitional duty capacity during their recovery allows the employer to have access to the skills and expertise of the aging worker, makes the worker feel valued and eases them back into the workforce in a safe and timely manner.

The aging workforce is the new norm. Taking steps to address injury prevention and the overall health and wellness of the workforce will benefit all employees. When injuries do occur, understanding the nuances of an aging injured worker, applying coaching techniques to assist them in overcoming the barriers to their recovery and incorporating RTW planning into the case management process will help reduce medical and indemnity costs.

About Tammy Bradly
Tammy Bradly is vice president of clinical product development for Coventry Workers’ Comp Services. Bradly is a certified case manager with more than 25 years of comprehensive industry experience through service delivery, operations management and product development. She holds several national certifications, including certified case manager (CCM), certified rehabilitation counselor (CRC) and certified program disability manager (CPDM).

About Coventry WCS
Coventry Workers Comp ServicesCoventry Workers’ Comp Services, a division of Aetna, is the leading provider of cost and care management solutions for property and casualty insurance carriers, (workers’ compensation and auto insurers), third-party administrators and self-insured employers. We design best-in-class products and services to help our partners restore the health and productivity of injured workers and insureds as quickly and as cost effectively as possible. We accomplish this by developing and maintaining consultative, trusting partnerships with our clients and stakeholders, built on a foundation of innovative and customized solutions that support the claims management process.

 
Disclosure:
Coventry WCS is a WorkCompWire Advertising Partner.
This is not a paid placement.

Filed Under: Leaders Speak

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