Program integration yields savings at UNUMProvident
Program integration yields savings at UNUMProvident
By Susan J. Olson, MSPH
In 1996, UNUM (now UNUMProvident) began to rethink its traditional, solo approach to the provision of health promotion (health education, fitness facilities, prevention, and employee assistance program), as well as occupational health and safety, workers’ compensation and disability management programs. We recognized that prevention programs help employees productively stay at work and prevent disabilities, and return-to-work efforts (disability management) are a vital part of this continuum of care.
By integrating these programs, we have been able to achieve economies of scale through eliminating redundant processes such as program registration, work-related injury reporting, and short-term disability administration, and partner with employees to prevent disability, lost time, and injury. With the merger of UNUM and Provident in June 1999, the company is well-positioned to continue to provide these programs and still achieve savings of over 30% in costs.
An evaluation of our integrated health, safety, and disability management (IHSDM) programs has demonstrated savings of $2.72 for every dollar invested. Studies have compared participants and nonparticipants in our health promotion program — Wellpower — and medical costs and absenteeism rates. Occupational health and safety studies have compared UNUMProvident results to national norms. Disability management studies have looked at the impact of UNUMProvident’s stay-at-work initiatives.
Program strategies
To broaden the impact of UNUMProvident’s health, safety, and disability management programs, the company provides these components:
• A toll-free hotline for all U.S.-based employees to get health, safety, or disability management information.
The hotline provides employees with one place to go:
— To report work-related injury or discomfort;
— To acquire short-term disability claim kits and leave-of-absence information;
— For the employee assistance program (EAP);
— To report safety issues or concerns;
— For the nurseline and eldercare;
— For the Wellpower program;
— For reasonable job accommodations;
— For return-to-work programs.
• A disability plan design that encourages reasonable accommodation, prevention, and return to work.
UNUMProvident’s Occupational Health Program focuses on early intervention and aggressive treatment. Our lost workday claims rate is 0.3 per 100 employees, or 62.5% lower than expected. (Using OSHA standards, the claims rate is based on a three-year estimate.) By combining resources in health promotion, ergonomics education, and workstation evaluation with occupational health case management, we have achieved savings of $2.00 for every dollar invested in occupational health and safety programs.
UNUMProvident’s disability management approach includes an emphasis on early intervention to help an employee remain at work through reasonable accommodation and several return-to-work initiatives, including transitional work, EAP referral, and the use of innovative technology to prevent and accommodate repetitive use injuries. In 1998, our disability management program resulted in 91% of employees working with IHSDM Disability Managers successfully remaining at work instead of going on disability leave.
• An analysis of the UNUMProvident Wellpower fitness facility usage and the impact on medical costs and absenteeism found that fitness facility members have fewer medical claims, fewer repeat claims, fewer claimants, and are in better health than nonmembers.
After controlling for demographics, fitness facility members have nearly $60/member/month less group health costs than nonmembers and fitness facility members have $720 per year in lower medical claims costs than nonmembers do. This is equal to savings of $1,017,360 a year, or $2.86 saved for every dollar invested.
To determine if medical usage changed after joining the facility, data on members before and after joining the facility were analyzed. UNUMProvident found that those new fitness facility members file almost 50% fewer claims after joining the fitness facility, and that medical insurance usage is approximately $750,000 per year lower than before joining the facility. This is equal to $348/year/member in lower medical claims costs and $1.38 saved for every dollar invested.
Productivity savings
In addition, employees use fewer sick days per month after joining the fitness facility, reducing the overall number of sick days taken by more than 12% — a savings of four days per member per year in lost productivity. Or, productivity savings of $768,642 or $2.16 for every dollar invested.
Integrating health, safety, and disability management programs with a focus on prevention of lost time and a quick return to work is an essential part of achieving significant economies of scale and a focus on often disparate programs. It is clear that preventing disability through a more comprehensive definition of health promotion that includes ergonomics, fitness, safety, employee assistance, and occupational health leads to positive results for an employer and less lost time and productivity savings.
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