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Chronic Obstructive Pulmonary Disease (COPD): The New Workplace "Epidemic"

Nature, Prevalence, Cost Impact & Management of COPD- Chan-Chou Chuang, MD -  HealthCare Partners Medical Group

Economic Burden of COPD on Employers - William Bunn, MD, JD, MPH - Navistar International

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Jennifer Bruno - Worldwide Dir., Wellness & Health Promotion

IHPM News Archives

April 14, 2003

Inaugural Leadership Forum Sets the Stage for an Annual Event for Purchasers, Plans and Providers

More than a hundred individuals from all corners of health care gathered in Atlanta, GA on April 4-5, 2003, for the launch of a new kind of meeting -- the "3Ps" Leadership Forum to establish an ongoing collaboration among purchasers / employers, health plans and providers of care on employee providers of care on employee health and productivity. More than a hundred individuals from all corners of health care gathered in Atlanta, GA on April 4-5, 2003, for the launch of a new kind of meeting -- the "3Ps" Leadership Forum to establish an ongoing collaboration among purchasers/employers, health plans and providers of care on employee health and productivity.

The 3Ps Forum was presented jointly by the Institute for Health and Productivity Management (IHPM) and the National Association of Managed Care Physicians (NAMCP) with organizational help from Aetna Inc. and the American Medical Group Association and welcome financial support from AstraZeneca, Pfizer, Pharmacia, and TAP Pharmaceuticals. It was structured to maximize interaction and engage all participants in a new joint endeavor to create collaborative efforts to produce health and productivity outcomes.

The morning of day one featured perspectives from leaders involved in IHPM's original four Centers of Inquiry. Joe Leutzinger, former wellness director at award-winning Union Pacific and now a consultant to Wellness Councils of America, covered the links between Health Promotion/Disease Prevention and employee performance. Dr. Tom Morrow reported as the former director of the Center for Care Management and medical director of One Health Plan of Georgia (and now of Matria). Dr. Bill Bunn, vice president for Health, Safety, and Productivity at International Truck and Engine, made it clear why the traditional domain of corporate occupational medicine is becoming a dynamic new source of cost
savings and productivity gains. And Cindy Keaveney, senior vice president and national practice leader at Aon Workforce Strategies, spoke to the significance of corporate culture to the health and performance of employees and organizations. A panel discussion with attendees then addressed the need to integrate data and actions across these "silos” to improve health and productivity.

After lunch, presentations by leaders from the 3Ps led to another discussion of the need for collaboration by corporate human resource (HR) and health executives, health plans, and medical leadership to restructure incentives and establish measurement to produce health and productivity outcomes. Tom Dameron, now in the health plan world but formerly HR director at US West, laid out a compelling blueprint for strategic and tactical health and productivity management (HPM). Mark Bertolini, senior vice president of Aetna, spoke to the growing role of health plans in meeting the demands of corporate customers for workplace outcomes. And Dr. Richard Tucker, an associate medical director of quality and education for Wenatchee Valley Medical Center, provided a role model for physician leadership to improve health and well being rather than just contain disease.

The morning of day two started with a case study of collaboration by the 3Ps in Kansas City to improve prevention, diagnosis, and treatment of depression -- the leading cause of productivity loss for many employers. The Kansas City effort and progress to date were described by Bill Bruning, president of the Mid-America Coalition on Health Care, John Heryer, MD, vice president and medical director of Blue Cross Blue Shield of Kansas City and Harold Marshall, the director of employment benefits for the Yellow Corporation. The Forum then concluded with a panel discussion involving HPM consultants who work across the Ps and the silos: Jack Bastable, health management consultant for CBIZ, Spencer Borden, MD, principal with Integrity Consulting, Chuck Reynolds, principal and managing consultant, The Benfield Group and Susan Willette, a senior consultant for Mercer Human Resource Consulting. Their discussion with attendees -- looking back over the earlier sessions -- produced a clear set of next action steps:

(1) make this an annual event!
(2) expand it to "4Ps" (to include the patient)
(3) keep it small enough to maintain its interactive nature
(4) try to advance the HPM movement through collaborative initiatives and report back on progress next year!

IHPM and NAMCP are already acting on these recommendations:

(1) the next "4Ps" forum will convene next April in Orlando
(2) a survey of patients will be used to bring the 4th P to the table
(3) collaborative actions are under discussion in two locations -- to produce case studies for next year.

About the Institute for Health and Productivity Management
The IHPM is a non-profit research and development organization dedicated to establishing the value of employee heath as a business asset and investment in corporate success. The Institute works with all the major stakeholders in health care for this purpose – employers, providers, health plans, insurers and employees – to assemble and analyze databases; develop and refine key metrics and measurement tools; organize pilot projects to build the business case for health and productivity; and carry the message and the evidence to all stakeholders. The IHPM operates from offices in Scottsdale, AZ and Richmond, VA. For additional information on the IHPM, visit www.www.ihpm.org.

About the National Association of Managed Care Physicians
The National Association of Managed Care Physicians (NAMCP) is an organization of dedicated edical directors, physicians, medical students, residents, and other health care professionals involved in various healthcare delivery systems, including health plans, group practices, IPAs, PHOs, PSOs, MSOs, and IDS’ whose mission is providing education and developing tools in managed health care. The NAMCP operates from offices in Richmond, VA. For additional information on NAMCP, visit www.namcp.org or call 804-527-1905.

IHPM Press Releases
November 7, 2002

Arthritis, Low Back Pain & Repetitive Motion Strain Among Major Reasons For Lost Worker Productivity

Few Employers Have Programs to Deal With Leading Causes of Diminished Performance

Scottsdale, AZ – A new survey by the Institute for Health & Productivity Management (IHPM) shows that musculoskeletal and mental health conditions have the greatest reported negative impact on worker productivity. The survey asked about absence from work (absenteeism), as well as the health and disease issues that diminish performance while at work (presenteeism) – both major reasons for lost productivity.

The so-called indirect cost of illness in general – including lost productivity -- is estimated to be at least three times the direct medical cost of treating that illness.

The IHPM survey found that musculoskeletal conditions, including arthritis, low back pain, and repetitive motion strain, were the leading cause of absenteeism. Mental health conditions – largely depression -- and pregnancy were the second and third leading causes of absences from work.

Musculoskeletal problems were second to mental health conditions in causing productivity loss due to presenteeism – followed by respiratory and gastrointestinal problems.

Although musculoskeletal and mental health conditions have the largest reported negative impact on productivity, disease management programs for these conditions were not common among the employers surveyed. Health and productivity initiatives currently underway with employers in Dallas and Louisiana will look at how better management of musculoskeletal conditions can increase productivity.

“If more employers established disease management programs to deal with these health issues, they would be able to reduce their overall health-related costs, while also increasing productivity,” said Sean Sullivan, President & CEO of IHPM.

The IHPM surveyed 34 employers with a combined total of 1.2 million employees. The average age of these workers was 43 and 61% were men.

IHPM Press Releases
March 21, 2003

Employee Health and Productivity Could Suffer From Recent Changes

That Reduce Access to Non-Sedating Antihistamines

Scottsdale, AZ – The Institute for Health and Productivity Management (IHPM) cautioned today that recent coverage changes to non-sedating antihistamines (NSAs) could diminish the quality of medical care for employees with allergies, and have significant cost and productivity implications for employers. Approximately 36 million Americans suffer from seasonal allergic rhinitis, which is responsible for more than eight million visits to office-based physicians each year and 3.4 million lost workdays.

Employers need to recognize the long-term implications of insurance plans dictating patient treatment,” said Sean Sullivan, President and CEO of IHPM. There’s a lot of confusion about NSA prescription coverage in the marketplace right now and employers need to understand how changes affect their employees.”

According to a nationwide survey of more than 1,000 allergy sufferers, one out of two (52 percent) believe their quality of life would decrease if NSAs are removed from their managed care drug formularies, and about half of allergy-induced asthma sufferers (49 percent) believe their health would actually be in jeopardy.

In addition, eight out of ten allergy sufferers (82 percent) think it would be unfair for insurance companies to stop paying for all NSAs because one NSA brand goes over-the-counter (OTC), and most sufferers (93 percent) would be unhappy if the cost of a non-prescription NSA is much more than their current co-pay ($16 avg.).

Formulary restrictions and higher out-of-pocket costs could force employees with allergies to self-medicate and opt for the less expensive OTC products that have side effects, such as sedation,” said Sullivan. llergies, in and of themselves, impact the ability to sleep restfully and be productive at work -- to perform a broad range of functions needed to do jobs safely and effectively. IHPM has worked with employers and medical providers to measure and reduce the impact of allergies on employee productivity.”

Allergy sufferers responding to the survey claimed they would have to endure uncomfortable, and often times debilitating, allergy symptoms, risk additional ailments such as asthma and ear infections, and ultimately have a decreased quality of life, if access to prescription NSAs was restricted.

The end result from these changes is simple,” explained Sullivan. mployees suffer the discomfort of allergies and a lower quality of life, and employers suffer the cost of lost productivity.”

A 1999 study published in The American Journal of Managed Care estimated that $150 million of wages are lost each year due to allergy symptoms. Additionally, allergies were found to be the most prevalent medical condition among 4.1 million insured employees surveyed for a 2000 study conducted by the MEDSTAT Group for IHPM.

About the Survey

A total of 1,015 interviews were completed via an online survey among a national sample representative of allergy sufferers. Respondents were recent prescription NSA users with prescription coverage. The survey was sponsored by Aventis and conducted by Synovate Inc., a leading U.S.-based full service global marketing research consulting and information company.

IHPM Press Releases
October 29, 2002

The Institute for Health and Productivity Management Announces 2002 Health and Productivity Management Award Winners

Scottsdale, AZ- At its recent annual conference in Scottsdale, the Institute for Health and Productivity Management (IHPM) recognized the 2002 winners of its Corporate Health and Productivity Management (HPM) Award. They were Pitney Bowes Inc. (NYSE: PBI), Lockheed Martin, and Delnor Community Hospital. IHPM President & CEO Sean Sullivan views the awards as “recognizing leadership in managing the most critical asset of all in the human-capital-based economy of the new century – the total health and functionality of working people.”

Pitney Bowes demonstrated excellence in all areas of HPM – including solid corporate commitment to employee health and productivity, program innovation and leadership, well-defined health and productivity measures, and integration of HPM – related functions within the organization. In addition, Pitney Bowes is developing the vital links between the health of its employees and its own corporate culture. The company was cited for having a well-conceived and executed approach to understanding, measuring and managing the corporate investment in human capital.

In accepting the award for Pitney Bowes, Jan Murnane, manager of wellness programs, stated that the company has a long-standing history of investing in programs that enhance employee health and productivity.

Dr. Jack Mahoney, Pitney Bowes’ corporate medical director and director of health care management, added that HPM initiatives have had a significant impact on helping the company manage its health care, disability and workers’ compensation costs. “It’s been an evolutionary process that has involved many internal functional areas working together to manage costs in a tough economic environment,” he said. “We’re particularly excited about several new initiatives that help us investigate the link between corporate culture and employee engagement with issues related to “presenteeism” and lost productive time. We appreciate the recognition and look forward to working with IHPM to share our results in the future.”

Lockheed Martin was given the HPM Award for Innovation & Leadership, which was accepted by Dr. Pamella Thomas, the Director of Wellness and Health. Lockheed Martin was recognized for its experimentation with new measures of health and productivity and for its willingness to share strategies and results with others to help move the HPM field forward. One of the ways Lockheed Martin has been able to advance its initiatives is through partnerships with pharmaceutical companies, managed care plans, and non-profit organizations including the Cancer Society and the Lung and Heart Associations.

In accepting the Award, Dr. Thomas said, “More and more enlightened employers are realizing that health and productivity management should be a part of their strategic business policy. Lockheed Martin Aeronautics Company has done this and is beginning to see some impact. This award and recognition from IHPM is an added bonus and incentive that will help us not only to move forward with our strategy in our corporation, but also as we attempt to educate other companies to the need to start addressing HPM as a business necessity. We truly appreciate the honor and recognition this award brings us and will continue to make our contributions.”

Delnor Community Hospital was given the HPM Award for mid-sized employers. It was accepted by Cynthia Schafer and Judy Smith, representing the Community Education and Leadership Institute of the Hospital. Delnor was recognized for its efforts to build a corporate culture that links good employee health to on-the-job performance and, ultimately, to high levels of employee and customer satisfaction that translate into organizational productivity. Delnor’s reductions in employee turnover represent a significant gain in productivity that is visible and valued at all levels of the organization.

Sponsored by Schering-Plough, this is the third year of the HPM Awards program. Previous winners were Bank One, Dow Chemical, Federal Express, GlaxoSmithKline, International Truck and Engine, and Union Pacific Railroad. Awards were presented by John Riedel, president of Riedel & Associates, who chairs the Institute’s Awards Committee. The other judges are George Anstadt, medical director of Lucid, Inc., Pamela Hymel, vice president for human resources at Hughes, and Joe Leutzinger, director of health promotion at Union Pacific Railroad.

IHPM Press Releases
The Institute for Health and Productivity Management Questions Health Plan Proposals to Reduce Access to Allergy Medications

Scottsdale, AZ – The Institute for Health and Productivity Management (IHPM), announced today its opposition to efforts by managed care organizations to make second generation non-sedating antihistamines (NSAs) less accessible to consumers.
Several large health insurers, including UnitedHealth Group and Humana, are considering whether to end prescription drug coverage for all second-generation, non-sedating antihistamines (NSAs), or raise the patient co-payment to the most expensive tier, if one or more of them are sold over the counter.

“This is simply a new way to shift costs from insurers to consumers without telling them,” said Sean Sullivan, President and Chief Executive Officer of the IHPM. “It is not inspired by concerns over safety or effectiveness, indeed, research indicates that reducing access to NSAs would increase safety hazards in the workplace and cause productivity losses on the job because of drowsiness.”

Approximately 40 million Americans (22 percent of the population) suffer from seasonal allergic rhinitis. In terms of lost productivity in the workplace, a 1999 study published in The American Journal of Managed Care estimates that 3.4 million workdays already are lost yearly due to allergy and estimates of lost wages are more than $150 million per year.

“Reducing insurance benefits in this way would leave allergy sufferers with several choices detrimental to their health or their pocketbook,” Mr. Sullivan said. “Some will foot the bill for a prescription drug previously covered by their health plan, effectively increasing their insurance costs. Others will switch to a sedating antihistamine, adding the risk of drowsiness in the workplace. Yet others may stop taking their allergy medications entirely and suffer the discomfort and potentially harmful health effects from untreated allergy symptoms. And, their employers would suffer the additional costs of their lost productivity.”

“This proposed move has nothing to do with science and everything to do with economics,” Mr. Sullivan added. “Consumers would pay more ‘out-of-pocket’ while health plans would keep more of their employers’ premiums in their ‘pockets’.”

In an earlier release, May 10, 2001, the IHPM stated its opposition to an effort by WellPoint Health Networks to get the U. S. Food and Drug Administration to switch all NSAs to over-the-counter availability because it would harm the patient-physician relationship and quality of medical care. The IHPM has conduced two studies of its own showing the large total impact of allergies on health-related costs and productivity. The IHPM has conducted similar studies on migraine, musculoskeletal conditions, and gastrointestinal disease – also major causes of work loss.
IHPM Press Releases
June 10, 2003

Institute for Health & Productivity Management Establishes Center for Study of Pain in the Workplace with Support from Purdue Pharma

The Institute for Health and Productivity Management (IHPM) today announced the establishment of a new Center for the Study of Pain in the Workplace, with initial funding support from Purdue Pharma L.P., a member of IHPM's Advisory Council. The first study to be conducted by the Center will examine the prevalence of pain in an employee population and its impact on workers’ performance. Initial study findings could be reported as early as IHPM's 3rd Annual Conference in October, with the full results to be published later.

Disease management programs typically focus on specific medically diagnosed conditions, rather than generalized symptoms such as pain. The new Center will focus more broadly on the prevalence of pain in the workplace and its impact on productivity. The findings from these initial analyses then will guide the next phase of the Center's work, which will involve intervention programs to manage various kinds of pain and follow-up measurement to show the success of these programs in reducing both the incidence of pain and its impact on employee job performance.

"Pain itself has not been addressed directly as a workplace health issue," says Sean Sullivan, IHPM's President and CEO. "It's part of many medically diagnosed conditions, but as a widespread symptom of many health problems its overall impact on workers' health and functionality -- and, consequently, their productivity -- has not been studied. Thanks to the generous support of Purdue Pharma, IHPM is establishing the Center to start doing just this -- with enormous ramifications for employers."

"There is a clear need to fully examine the impact of pain from a public health standpoint," says Raafat Seifeldin, Purdue's Executive Director of Health Economics & Outcomes Research. "It is important to document the impact of pain on work productivity and to determine how appropriate pain management intervention programs can reduce presenteeism while enhancing satisfaction, functionality, and productivity."

Purdue Pharma L.P. is a privately held pharmaceutical company known for pioneering research on persistent pain. Headquartered in Stamford, CT, Purdue is engaged in the research, development, production, and distribution of both prescription and over-the-counter medicines and hospital products. Additional information about Purdue can be found at www.purduepharma.com.

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