Guinness is good for you – That’s the news from Tinker Ready, who is hosting the Health Wonk Review: Wearing the Green for the St. Patrick’s Day Edition at her blog Boston Health News. We think it’s pretty fitting to have a Boston blog hosting this particular edition!
From the bizarre file – Thomas A. Robinson ofRisk Management Magazine offers a list of the 10 most bizarre workers compensation cases during 2011. Robinson rightly notes that, “Despite their unusual nature, however, one must always be respectful of the fact that while a case might be bizarre in an academic sense, it was intensely real, affecting real lives and real families.” So true. We hope he’ll follow with a collection of the 10 most bizarre employer acts – we’ve seen a few in our day.
OSHA whistleblowers – Just a reminder: Don’t fire someone for reporting safety hazard. A Florida charter school is learning this lesson the hard way. OSHA is suing Manatee School for the Arts in Palmetto, Fla seeking reinstatement of the former employee with full benefits; payment of back wages, punitive damages, and compensatory damages, among other things.
New York’s Reg. 194 – There’s a big brouhaha in New York over N.Y. Reg. 194, with risk manager groups and agent groups coming down on opposite sides of the fence. N.Y. Reg, 194 is a broker-disclosure rule that requires agents to advise clients that they receive commissions from insurers. The ruling was proposed by the Division of Insurance in the aftermath of the Spitzer investigations against several large brokerage firms. Last week, a NY Appellate Court upheld the rule.
Exploding pig farms – We posted a link to this issue before – but the mysterious hog farm explosions continue to stump scientists. A strange, potentially explosive foam is surfacing near manure pits in about 1 ou tof every 4 hog farms, and has caused six explosions since 2009. According to the article: “This has all started in the last four or five years here. We don’t have any idea where it came from or how it got started,” said agricultural engineer Charles Clanton of the University of Minnesota. “Whatever has happened is new.” The National Hog Farmer has more background: Foaming swine manure poses explosive risks.
Wellness focus – Of cancers affecting both men and women, colorectal cancer (cancer of the colon and rectum) is the second leading cancer killer in the United States, and the number one cancer killer in non-smokers. Why not issue a reminder to your employees: Colorectal cancer screening saves lives.
Market conditions – Roberto Ceniceros notes that captives are thriving as the work comp market hardens. Rising prices for traditional insurance vehicles always means that alternative insurance programs see growth.
Posts Tagged ‘wellness’
Health Wonk Review, Irish style, and other noteworthy news briefs
Thursday, March 15th, 2012Risk roundup and other news of note
Wednesday, November 16th, 2011Insurance Writer Nancy Germond hosts this week’s edition of Cavalcade of Risk and she has a seasonal theme: The Turkey Edition. Check it out.
Reminder – Tomorrow is Great American Smokeout day. More than 46 million Americans still smoke and if some of them are your employees, it is likely that smoking is taking a financial toll on your organization. It’s not too late to remind your employees: here are some printable tools, or you can just email a reminder about 1-800-QUIT-NOW, a free smoker’s quit line.
Wellness – Speaking of smoking or any other so-called lifestyle issue that is related to employee health, Roberto Ceniceros recently tackled the topic of wellness programs being adapted for workers comp in an article in Business Insurance, as well as at his blog. He notes a trend toward integrating wellness benefits into workers comp programs, which “…requires employers to transcend traditional corporate silos that typically separate risk management and workers compensation departments from those administering health benefits and nonoccupational disability plans.”
Sandy Blunt update – Joe Paduda recently featured a post on progress in clearing Sandy Blunt’s name. North Dakota Supreme Court’s disciplinary board has recommended that Cynthia M. Feland, the prosecutor in the Blunt case and now a judge, should have her attorney’s license suspended for 60-days and be required to pay court costs related to her failure to “… disclose to Michael Hoffman, defense attorney for Charles Blunt, the Wahl memo, and other documents which were evidence or information known to the prosecutor that tended to negate the guilt of the accused…” Next step, new trial? (For more background, see A Good Man Wronged). We had a chance to catch up with Sandy at the Las Vegas Work Comp Expo at the Medata reception. Sandy is serving as Vice President of Insurance Services with Cy King and crew. (Side note: if you are ever invited to a Medata reception, say yes. Three words: “nice people” and “yum.”)
Other notes from last week’s Las Vegas Workers’ Comp Expo – Kudos to Peter Rousmaniere, who collaborated with Sedgwick to produce a great video on the history of workers comp – we’ll bring it to you as soon as it’s available online.
Our fellow blogger Joe Paduda kicked off the show with an informative opening general session, part of which was a Point/Counterpoint style sparring between Joe and David North of Sedgwick and Davidson Pattiz of Zenith about pricing and billing transparency. You can see Joe’s reports from Vegas here and here.
Evan Falchuk was part of a panel on expert physicians. Falchuk is President and Chief Strategy Officer of Best Doctors, an organization that has been making quite a splash on the healthcare side. (Check out Falchuk’s blog, See First). While not as widely known as their general healthcare services, Best Doctors also offers services in the workers comp arena, which include help for legacy claims, complex care claims, and cases involving chronic pain, among other services.
Chris Brigham of Impairment Resources made an impassioned presentation on how we can and should be making a commitment to prevent the needless disabling of injured workers. He and his team were also exhibiting, side by side with their partner firm and our neighbor, Insurance Recovery Group, who were touting their subrogation services.
Other sightings: Colleague Jim Paugh was representing his new predictive analytics endeavor, WorkersComp Analytics; Mark Walls was the man of the hour, moderating sessions and hosting a reception for members of his popular linkedIn Work Comp Analysis Group; We also spotted Bob Wilson, another online pioneer, and were fortunate to spend time with Helen Knight of King Knight Communications, arguably the best PR person in workers comp; and a shoutout to Frank Pennachio (erstwhile guest poster) and Susan Toussaint of Work Comp Advisory Group, who we finally met in person. Finally, congrats to Nancy Grover, program chair, along with all the advisors and staff of LRP and Risk & Insurance for putting on a good conference.
Obesity and Smoking: Pay to Play?
Thursday, November 3rd, 2011We all know that people who smoke and/or are obese tend to have more medical problems, of greater duration, compared to people with healthier lifestyles. The higher medical costs associated with smoking and obesity translate into higher cost for insurance. As a result, it is no surprise that there is a strong trend among employers to charge more for the insurance premiums of workers who smoke or who are obese.
The Insurance Journal writes that the use of premium penalties is expected to climb in 2012 to almost 40 percent of large and mid-sized companies, up from 19 percent this year and only 8 percent in 2009. An Aon Hewitt survey released in June found that almost half of employers expect by 2016 to have programs that penalize workers “for not achieving specific health outcomes” such as lowering their weight, up from 10 percent in 2011. The premium surcharges usually come hand-in-hand with incentives to quit smoking and lose weight. Unfortunately, the carrot of incentives, by themselves, have not succeeded in lowering health costs. Hence the big stick.
Taxing the Poor?
As is often the case, lower paid workers bear the brunt of the higher costs. Obesity and smoking often – but not always – accompany lower income lifestyles. Low income workers already pay a larger proportion of their income for health insurance; now they will pay more for the consequences of their smoking (a formidably taxed bad habit) and obesity (the result of poor dietary habits). The working poor often live in neighborhoods with limited fresh foods and nothing much in the way of health clubs – which they can’t afford anyway.
There is evidence that the carrot and stick approach actually works. We have written about the Cleveland Clinic, which refuses to hire smokers or obese individuals and which fosters healthy lifestyles among its 40,000 employees. The clinic has seen medical costs grow by only 2 percent this year, far below the national average of 5 to 8 percent.
The Big “But…”
The move to force people into healthy lifestyles does raise a few interesting issues.
1. In cases where obesity or other unhealthy conditions are beyond the control of the individual (genetics, specific diseases, etc.), the higher premiums might be considered discriminatory, although there has been little such litigation to date.
2. Healthy lifestyles (including regular exercise) may well result in higher medical costs for maintaining well-tuned bodies: the ever-growing incidence of knee, hip and shoulder replacements among active people.
2. The goal is to reduce medical expenses, but the leverage exists only with the principal policy holder: there is no way to force other family members to abide by the lifestyle guidelines.
3. The imposition of wellness standards can lead to legitimate privacy issues: for example, holding employees accountable for behavior away from the job (smoking, drinking, eating).
If all goes as planned, medical costs will indeed come down and people will live longer and longer lives. As people with healthy lifestyles live longer, we will have succeeded in transferring costs from private insurers (who cover working people and their families) to social security (which covers retirees). That will require a hike in social security taxes, which the working poor, among others, can ill afford. It seems that every solution carries the seeds of new problems, just as every problem gives rise to new solutions. It is a privilege, of course, just to watch the entire process as it unfolds before us.
Superhero Health Wonk Review and other news of note
Friday, October 28th, 2011Joe Paduda hosts The Superhero Edition of Health Wonk Review, in which he attributes superpowers to our regular health wonk contributors and cites them for doing battle with tough issues. My question is when are we going to get the costumes, Joe?
By the way, while you are at Joe’s blog, don’t overlook his smoking gun post Physican dispensing – boy do we have a deal for you!
Good news – DOL reports that private industry workplace injuries and illnesses declined in 2010. They fell to a rate of 3.5 cases per 100 equivalent full-time workers, down from 3.6 cases in 2009. But the more serious cases are holding constant: More than one-half of the 3.1 million private industry injury and illness cases reported nationally in 2010 were of a more serious nature that involved days away from work, job transfer, or restriction–commonly referred to as DART cases.
Wellness – Ezra Klein covers Cleveland Clinic’s wellness program in Health Care’s Brave New World of Compulsory Wellness. The program is not without some controversy, but it appears to be working: “Not only has the clinic cut its health-care costs, but its employees are also getting healthier in measurable ways. Workers have lost a collective 250,000 pounds since 2005. Their blood pressure is lower than it was three years ago. Smoking has declined from 15.4 percent of employees to 6.8 percent.”
See you there? – we’re getting close to two important industry events, and we’ll be at both. From November 9 to 10, we’ll be at the National Workers Compensation & Disability Conference in Las Vegas. If you are attending, why not meet up at Mark Walls’ Link UP reception at 5 pm on Wednesday? We’ll also be at the WCRI’s 28th Annual Issues & Research Conference in Boston on November 16 and 17. We’re looking forward to both. Drop us a line if you will be attending too.
Sneak peek – Business Insurance has had a redesign and is offering an “open house” through the 31st of the month. Here’s the workers’ comp section – if you read Workers Comp Insider regularly, you know we are a Roberto Ceniceros fan. The whole publication is worth a glance, BI has an excellent staff of reporters many of whom have been with the publication for years.
Get your fright on – In honor of Halloween weekend, we thought this feature on 8 Terrifying Robots Now Stalking Your Local Hospital was appropriate – but be warned, the feature appears on an irreverent site and if you are at work, it might trigger your company’s net nanny filter. Also on a scary theme, we noted this recent study on Psychopathic bosses.
News Briefs
Risk roundup & other news briefs
Thursday, October 20th, 2011Van R. Mayhall of Insurance Regulatory Law makes his debut as host of Cavalcade of Risk with his “Meet the Experts” edition. Mayhall is an expert himself – an attorney who practices in the areas of Business & Corporate Law and Insurance Regulatory Law. We welcome his participation!
Workers Comp Conference – Nancy Grover offers a sneak peek at highlights of the National Workers’ Compensation and Disability Conference & Expo which is on the docket for November 9 and 10 in Las Vegas. You can follow more about upcoming conference events on LinkedIn’s National Workers’ Compensation and Disability Conference & Expo Group.
Maximizing wellness program ROI – According to a post by Preston Diamond in Risk Management Monitor, “On average, employers can see a 30% reduction in Workers’ Compensation and disability claim costs, according to a review of 42 published studies involving the economic returns of wellness programs. Moreover, wellness programs will reduce the costs of absences that, according to the 2010 Kronos/Mercer Survey on the Total Financial Impact of Employee Absences, add up to 8.7% of payroll costs, more than half the cost of health care.” But experts caution that all wellness programs are not equal so employers need to implement with care. See 5 Steps Companies Should Take Before Launching a Wellness Program.
Performance Standards & Disabilities – Employment law attorney Daniel Schwartz posts an FAQ on Applying Performance Standards to Employees with Disabilities. He notes that although the ADA affirms an employer’s right to define jobs and to evaluate employees according to consistently applied standards governing performance and conduct, it’s a case where the devil is in the details. But he links to some lesser-known EEOC guidance on the matter that helps to address some common questions.
High costs of excessive alcohol consumption – According to a new study on the costs of excessive drinking by the Centers for Disease Control and Prevention, the cost of excessive alcohol consumption in the United States in 2006 reached $223.5 billion, which translates into about $1.90 per drink or $746 per person. Researchers also pointed out that 72% or the total costs could be attributed to losses in workplace productivity.
Is Ohio drinking the tea? – Looking at some ballot issues in Ohio, Roberto Ceniceros asks if a tea party initiative could end workers’ comp. He cites a Toledo Blade editorial which argues that although the intent of the measure is to thwart the health-care reform law, it may open the door to some unintended consequences.
A picture is worth a thousand words – The Geography of a Recession is an animated view of U.S. unemployment from 2007 to 2011. Hat tip to Workplace Prof Blog for the pointer.
Lift Gates – Tony Jones of the MEMIC Safety Blog offers a good overview on safety considerations related to lift gates, including equipment considerations, pre-operations, operations, and special considerations.
News briefs
- World Series Throws Risk Managers a Curve
- The Employer’s Bill of Rights
- Simple Solutions for Office Hazards
- Oct. 16-22 Is National Teen Driver Safety Week
- OSHA gathering info on hearing loss prevention
- A Year Out of the Dark in Chile, but Still Trapped – followup on Chilean miners
- 10 Tips for Encouraging PPE Compliance
Cavalcade of Risk #111 and items that hit our radar this week
Wednesday, August 11th, 2010Nancy Germond hosts this week’s Cavalcade of Risk #111. Make sure you click her “just for fun” video for a display of unusual talent! Of course, her links to more serious risk-related posts are fun too, although in a slightly more nerdy way ;-)
Here are a few other links to news items that hit our radar:
- Kleen Energy explosion: OSHA issues third-largest fine ever
- Employee wellness the L.L. Bean way
- The Book of Odds: the odds of everyday life
- Misuse and abuse of prescription drugs in the workplace
- Insurers’ top underwriting priorities
- Top 20 ADA cases: Large jury verdicts and perhaps some litigaphobia
- Workers’ comp meets the ADA: A rock and a hard place
- Disaster planning for small businesses
- The Ultimate Glossary: 101 social media marketing terms explained
- It’s official: WHO says swine flu pandemic is over
- Top 40 red flags which might indicate fraud
- Safety-driven software aims to block texting while driving
A Question of Language?
Monday, July 19th, 2010The following guest post was submitted by Gary Anderberg, Phd, the Practice Leader For Outcomes and Analytics at Broadspire.
I was participating in a recent meeting of health, wellness, workers’ compensation and disability professionals. One of the issues on the table was information that the regs defining “Cadillac” plans may loop the cost of wellness programs, disease management and other health related productivity benefits into the total cost of the employer’s health plan for purposes of assessing penalties. If this intelligence is correct and if such provisions become effective, most large employer plans, so defined, will be subject to potentially expensive penalties, thus strongly incenting employers to relegate employee health care to the soon to be created exchanges.
This question stirred up a wide ranging discussion of how to frame the value of health and productivity programs for employers. For the last several years, most of the players in this space have been using the “investment” and “ROI” model, telling employers that they will reap rewards for astute investments in employee health and productivity. As a practical matter, returns on investment have been problematic to quantify. There is broad, intuitive agreement that a healthier workforce is a good thing, but what does it drive to the bottom line?
I suggested a different model — risk management. If trained, knowledgeable, productive employees are indeed a corporate asset — like trucks, buildings, airplanes, equipment, and so forth — then the health and well being of those employees presents a major risk exposure for the corporation in very immediate terms. We know that as the overall well being of a workforce declines, not only do absences of all types go up, but so do opportunity costs and the costs of poor performance and decision making. As absence rates and disability claims climb, more positions are filled by new employees with less experience and training than the absent workers. Mistakes get made, customers do not get the service they expect, and product quality suffers.
I suggested that, properly viewed, health plans, chronic disease programs and all types of effective wellness programs are really risk management tools in much the same way that fleet maintenance is a risk management tool. We assume that companies will maintain their eighteen wheelers and provide safety courses for their drivers, but the health and well being of the person behind the wheel is equally critical to the company’s risk exposure when a truck is on the road.
Every time a company hires a new employee, it takes on a new risk. For every employee on the payroll, from the CEO on down, there is a definite risk cost of employment which is based in large part on that person’s health and well being. So, are health, wellness and productivity programs investments with uncertain returns or are they critical risk management tools which allow the employer an important measure of control over the performance of a key asset — employees? It seems to me that these tools are vital to controlling employment costs and critical parameters of product and service delivery, especially in a world of very lean staffing and just in time management.
To my mind this is not just a question of which metaphor to use. Managing risk is real and the consequences of poor risk management are often dramatic and even tragic. I wonder how many companies would consider handing over the maintenance of their critical manufacturing and distribution equipment to a government program just to save a few bucks. But how many employers may be tempted to do the same thing if the soon to be created healthcare exchanges offer a short term dollar saving?
The words we use to frame decisions can carry massive consequences. If you think about the health and well being of your employees as a risk exposure to be effectively managed to minimize replacement costs and the expense of suboptimal performance and errors, what might you do differently? Think about it.
Fire the Smokers! Tax the Fat?
Monday, August 17th, 2009Back in December of 2006 we blogged the story of Scott Rodrigues, a new hire of the Scotts lawn care company, who was fired after failing a drug test. No news here, perhaps, except that the drug in his system, nicotine is perfectly legal. Scott’s is self-insured for health benefits, so they have a vested interest in making sure that employees follow basic wellness practices.
On his way to a pre-placement drug test, Mr. Rodrigues chewed on Nicorette gum. He was trying to kick the habit. Ironically, the Nicorette may have triggered the positive finding for nicotine. Rodrigues was hired provisionally and then abruptly terminated once the test results were released.
Rodrigues brought suit in federal court for violation of privacy and civil rights. Judge George O’Toole has ruled in favor of the company. The judge found no violation of privacy laws, as Rodrigues smoked while walking down the street and in a restaurant parking lot. His supervisor spotted a pack of cigarettes on the dashboard of his truck. Would the judge have ruled for Rodrigues if the employer had peeked through a window to see him smoking at home?
O’Toole also rejected the notion that the firing violated a 1974 federal law that protects employee rights to benefits. O’Toole ruled that Rodrigues was not yet a bona fide employee and was working on the condition that he pass the urinalysis.
Jim King, a spokesman for Scotts, said the smoking ban has never been used to fire an “existing” employee. It is used solely to screen out applicants. Since the ban went into effect in 2005, the percentage of smokers among the company’s 7,000 employees has fallen to 7 percent from 28 percent.
[The Insider notes in passing that even as a “provisional” employee, Rodrigues was covered by workers comp from the moment he began working – indeed, while he was on his way to the drug testing lab.]
Whether employees can smoke or not depends upon the state they work in. A few states (e.g., Kentucky, Louisiana) explicitly protect smoker rights. Other states do not. It’s interesting that Rodrigues pursued his case in federal court, probably because Massachusetts laws offered no protection to smokers.
Is Obesity Next?
We all know that smoking increases the risk of illness and the cost of medical coverage. The same goes for obesity. So the next front in the battle to control the business side of medical costs may well be the bathroom scale. The New York Times magazine profiles the Cleveland Clinic, which has been upheld as a model for medical cost control. Two years ago, they stopped hiring smokers. Delos M. Cosgrove, the heart surgeon who is the clinic’s chief executive, would like to expand the hiring ban to include applicants who are obese.
“Why is it unfair? Has anyone ever shown the law of conservation of matter doesn’t apply?” Cosgrove states that people’s weight is a reflection of how much they eat and how active they are. The country has grown fat because it’s consuming more calories and burning fewer. Our national weight problem brings huge costs, both medical and economic. Yet our anti-obesity efforts have none of the urgency of our antismoking efforts. “We should declare obesity a disease and say we’re going to help you get over it.”
Should the Cleveland Clinic – or any other employer- decline to hire obese people, it will be interesting to track the results. Where obesity can be traced back to genetic or chemical issues – where it qualifies as a disability under the Americans with Disabilities Act- employers would be guilty of discrimination. If no such causes can be specified, employers may be on solid ground. (The unaddressed issue in these hiring practices, of course, is the loss of a vast pool of talented and often essential workers.)
A recent article in Health Affairs estimated the annual cost of obesity to be $147 billion and growing. That translates into $1,250 per household, mostly in taxes and insurance premiums.
The Fat Tax
Cosgrove is interested in an idea that some economists favor: charging higher health-insurance premiums to anyone with a certain body-mass index. Call it the Fat Tax. Another alternative might be taxing the calorie-rich foods that lead to obesity: just imagine paying a little surcharge for your large order of fries, your jumbo soda and your two-for-one pizza. That would be interesting, indeed! Just as smokers pay a tax-driven premium for their cigarettes, eaters would be taxed for their food addictions.
This is simply not going to happen. To be sure, fundamental wellness is the cornerstone of any plan to contain health care costs. But when the public good collides with the rights of freedom and privacy, individual rights will win out. Policy wonks may not like it, but citizens can eat whatever they damn well please. Lighting up after that supersized meal? Well, that’s one area where the public good pretty much trumps the private right.
Injuries at the gym: compensability, incentives, and wellness
Thursday, July 16th, 2009Roberto Ceniceros blogs about the New York appeals court ruling in Frank P. Torre v. Logic Technology, which awarded workers comp benefits to an employee for an injury sustained in the gym. Usually, injuries sustained in extracurricular activities aren’t covered by workers comp, but there are exceptions, such as when injuries occur during “mandatory attendance” events or while an employee is on business travel (see our past posts: Mandatory fun: when recreational activities are compensable and When play becomes work, or the case of the traveling employee).
On first glance, a case like this might seem open and shut. The employee was on his own time at the gym – the injury did not appear to arise out of and in the course of employment. But on closer examination, the court apparently determined that gym participation was furthering the employer’s interest for the networking potential. (Is gym the new golf?) When it is determined that an employer has derived significant business benefit from an activity – such as interacting with clients and prospects – then an activity may be compensable.
The courts also noted that the employer encouraged and sponsored this activity. In this case, the sponsorship entailed reimbursement for membership fees. One has to wonder what kind of chilling effect a ruling like this could have on wellness programs. Employers frequently incent employees by paying for or supplementing gym membership, exercise programs, and weight loss or smoking cessation programs. Some companies offer financial incentives for participating in wellness programs or disincentives such as increased cost for insurance for not participating.
This type of endorsement and sponsorship can be tricky when it comes to workers comp. In days gone by, sponsorship generally referred to softball or bowling teams and employers could take some steps top mitigate risks. But as employers become more aggressive about wellness programs in an effort to control health care costs and these wellness programs become more ingrained in the corporate culture, does the compensability exposure increase? Some of the variables that have come into play in determining compensability are the location and time of the activity – is the gym on the employer’s premises? Does the activity take place during work hours? Another factor is how strongly the company encourages participation and whether participation is purely voluntary. If a corporate culture is such that it so strongly endorses an activity, the issue of whether participation is truly voluntary could be up for debate.
Comorbidities like obesity and diabetes have been shown to have an impact on claim frequency and severity so it would appear that wellness programs would have a positive net effect on workers comp costs. But good intentions can often have bad outcomes. Take the concept of programs that heighten worker awareness about safety and incent workers for best practices – that may sound great on the surface, but The New York Times recently reported on safety incentive programs that ran headlong into the law of unintended consequences.