A Retrospective Cohort Analysis of the Impact of Osteoarthritis on Disability Leave, Workers' Compensation Claims, and Healthcare Payments.

OBJECTIVES: Examine short-term disability (STD) and workers' compensation (WC) associated leave and wage replacements, and overall direct healthcare payments, among employees with osteoarthritis (OA) versus other chronically painful conditions; quantifying the impact of opioid use. METHODS: Analysis of employees with more than or equal to two STD or WC claims for OA or pre-specified chronically painful conditions (control) in the IBM MarketScan Research Databases (2014 to 2017). RESULTS: The OA cohort (n = 144,355) had an estimated +1.2 STD days, +$152 STD payments, and +$1410 healthcare payments relative to the control cohort (n = 392,639; P < 0.001). WC days/payments were similar. Differences were partially driven by an association between opioid use, increased STD days/payments, and healthcare payments observed in pooled cohorts (P < 0.001). CONCLUSIONS: OA is associated with high STD days/payments and healthcare payments. Opioid use significantly contributes to these and this should be considered when choosing treatment.

Using Predictive Analytics for Early Identification of Short-Term Disability Claimants Who Exhaust Their Benefits.

Purpose Early interventions can help short-term disability insurance (STDI) claimants return to work following onset of an off-the-job medical condition. Accurately targeting such interventions involves identifying claimants who would, without intervention, exhaust STDI benefits and transition to longer-term support. We identify factors that predict STDI exhaustion and transfer to long-term disability insurance (LTDI). We also explore whether waiting for some claims to resolve without intervention improves targeting efficiency. Methods We use a large database of STDI claims from private employer-sponsored disability insurance programs in the United States to predict which claims will exhaust STDI or transition to LTDI. We use a split sample approach, conducting logistic regressions on half of our data and generating predictions for the other half. We assess predictive accuracy using ROC curve analysis, repeating on successive subsamples, omitting claims that resolve within 2, 4, and 6 weeks. Results Age, primary diagnosis, and employer industry were associated with the two outcomes. Rapid attrition of short-duration claims from the sample means that waiting can substantially increase the efficiency of targeting efforts. Overall accuracy of classification increases from 63.2% at week 0 to 82.9% at week 6 for exhausting STDI benefits, and from 63.7 to 83.0% for LTDI transfer. Conclusions Waiting even a few weeks can substantially increase the accuracy of early intervention targeting by allowing claims that will resolve without further intervention to do so. Predictive modeling further narrows the target population based on claim characteristics, reducing intervention costs. Before adopting a waiting strategy, however, it is important to consider potential trade-offs involved in delaying the start of any intervention.

On-the-Job Productivity Losses Among Employees With Health Problems: The Role of Work Accommodations.

OBJECTIVES: Debates about the productivity impact of work accommodations typically focus on employment and labor force participation outcomes. This study considers whether accommodations mediate on-the-job productivity losses among employees who report health problems. METHODS: The study uses ordered logistic regression to predict employees' self-reported productivity losses as a function of health problems and experiences with needed work accommodations. RESULTS: On average, the odds that an employee who did not get a needed accommodation reported higher levels of lost productivity are 5.11 times the odds for an employee who got a needed accommodation. CONCLUSIONS: Although health problems make it difficult for many employees to perform well on the job, accommodations could reduce productivity losses in some cases. Nonetheless, more research on the impact of specific kinds of accommodations for different chronic conditions is warranted.

Temporarily Disabled Workers Account For A Disproportionate Share Of Health Care Payments.

About one in four employees in a cohort of 408,000 US workers took a temporary leave of absence from work because of illness or injury in the period 2008-12. They accounted for nearly 60 percent (about $6.5 billion) of total worker health care and disability payments. This finding underscores the importance of workplace care management, lifestyle management, and health and safety efforts to prevent disability leaves.

Unhealthy Body Weight, Illness Absence, Presenteeism, Medical Payments, and Disability Leave: A Longitudinal View.

The objective of this study is to examine how much of the relationships between unhealthy body weight, and health and productivity outcomes are attributable to health status, and how much can be ameliorated by weight loss or improvements in health. Cross-sectional and first-difference regressions were conducted of employees' body mass index (BMI) category, illness absences, presenteeism, medical spending, and disability leaves. Employees in the obese BMI category have significantly worse outcomes than employees in the healthy and overweight BMI categories. Controlling for physical and emotional health status mediates much of the observed relationships. Improved health, stress, and psychological distress are associated with reduced illness absence and presenteeism among overweight and obese employees. Obese employees who lost weight experienced reduced presenteeism. The findings suggest that overweight and obese employees can realize improved productivity without weight loss.

Hidden costs associated with venous thromboembolism: impact of lost productivity on employers and employees.

OBJECTIVE: To determine productivity loss and indirect costs with deep vein thrombosis (DVT) and pulmonary embolism (PE). METHODS: Medical and pharmacy claims with short-term disability (STD) and long-term disability (LTD) claims from 2007 to 2010 were analyzed from the Integrated Benefits Institute's Health and Productivity Benchmarking (IBI-HPB) database (STD and LTD claims) and IMS LifeLink™ data (medical and pharmacy claims), which were indirectly linked using a weighting approach matching from IBI-HPB patients' demographic distribution. RESULTS: A total of 5442 DVT and 6199 PE claims were identified. Employees with DVT lost 57 STD and 440 LTD days per disability incident. The average per claim productivity loss from STD and LTD was $7414 and $58181, respectively. Employees with PE lost 56 STD and 364 LTD days per disability incident. The average per claim productivity loss from STD and LTD was $7605 and $48,751, respectively. CONCLUSIONS: Deep vein thrombosis and PE impose substantial economic burdens.

Employees' work responses to episodes of illness: evidence from the American time use survey.

OBJECTIVE: To better understand presenteeism and absenteeism on the basis of the choices employees make about working when they experience episodes of illness. METHODS: We examine nationally representative data to describe employees' work responses to episodes of illness and how different leave policies contribute to their decisions. RESULTS: Illness episodes typically result in absence from work rather than working a normal or adjusted routine. Employees adjust their routine when ill primarily to save leave or because they have too much work. Paid sick leave and scheduling flexibility influence the likelihood of absence in different ways. CONCLUSIONS: Although flexibility to adjust work routines can reduce absences, it is not known to what extent productivity suffers when this occurs. Measures of both short- and long-term presenteeism are necessary to understand the full productivity costs of illness in the workforce.

The economic burden of acute coronary syndromes for employees and their dependents: medical and productivity costs.

OBJECTIVE: To determine the total burden of illness, including direct and indirect costs for employees and their dependents with acute coronary syndrome (ACS). METHODS: Medical and pharmacy claims along with short-term disability (STD) and long-term disability (LTD) claims from 2007 to 2010 were analyzed using two data sets: Integrated Benefits Institute's Health and Productivity Benchmarking Database (STD and LTD claims) and IMS LifeLink™ Health Plan Data (medical and pharmacy claims). RESULTS: Employees with ACS lost 60.2 ± 0.29 STD and 397.9 ± 8.09 LTD days per disability incident. For employers, the estimated average per claim productivity loss from STD and LTD was $7943 ± 39.7 and $52,473 ± 1114, respectively. Total annual ACS health care costs per employee were $8170 ± 106, with $7545 ± 104 for annual medical costs. Hospitalizations accounted for 75% of total annual ACS health care costs. CONCLUSIONS: ACS imposes a substantial economic burden on employees, employers, and society.

Modifiable health risks and illness absence from work: evidence from the panel study of income dynamics.

OBJECTIVE: Modifiable health risks such as smoking, exercise, and body weight have been linked to illness absence from work. This suggests that employers could improve their productivity if their workers adopted healthier lifestyles, but methodological concerns regarding selection bias and omitted variables remain. METHODS: We use a first-difference model of changes in health behaviors and illness- and family-related absence from work among a nationally representative, longitudinal panel of employed individuals. RESULTS: Workers who lost weight or increased their frequency of light exercise also saw their illness absences decrease over a 2-year period. Some, but not all, of the relationship is mediated by the change in health status. No such decrease was observed for family-related absences. CONCLUSION: The findings are consistent with the proposition that both employers and employees could benefit from efforts to support better health habits.