Ageonomics™ · tolerance, diversity, confidence “Weisure” Enter the workforce with ... Lost/ EE Sum Total Med/Rx Paid Average Med/Rx Paid/ EE Depressive Disorder (36+

Ageonomics™ Understanding and managing the risks of our ageing workforce

1

Aon | AGRC Ageonomics™ Practice

Proprietary & Confidential

How are American’s Aging?

• 70% - country is “a little or not at

all prepared”

• 10%- feel seniors are “very

prepared” to age well

• 59%- country is heading in the

wrong direction

Intro



Top Worries About Aging

• 72% - Losing their memory

• 71% - Being in poor health

• 71% - Not having financial

security

Intro



How Have We Aged Over Time?

• 25 pounds heavier

• One inch taller

• 12% increase in BMI

Intro

4

Male: 166 lb 1960 Female:

140 lb

Today Female: 164 lb

Male: 191 lb

The Changing Workforce

Risk Managers Must Grapple With the Changes in Our Population Health

Workforce

Observations

from Aon’s

Database

5



Broad

Traits

Managing Life

Chronic

Disease

Changing Workforce by 2020

*2020 forecast data based on Future Workplace Survey; CDC BRFSS 2012

Tobacco

Use

Obesity

Level

Traditionalists (Born 1925-1945)

Loyalty, respect for

authority, discipline,

sacrifice

Work and Life

Aging population

within workforce

develop chronic

conditions

1%

Baby Boomers (1946-1964)

Competitive,

sandwiched

generation, hard work,

long hours

Work/Life Balance

Aging population

within workforce

develop chronic

conditions

22%

Gen X (1965-1980)

Self-reliance,

eclecticism, free

agents,

independence

Work/Life Balance

Enter the

workforce with

chronic conditions

20%

Millennials (1981-2000)

Immediacy,

community service,

cyber literacy,

tolerance, diversity,

confidence

“Weisure”

Enter the

workforce with

chronic conditions

50%

Centennials (2000 or after)

Hyperconnectedness,

mobility, media savvy, life

online since preschool,

e-readers

“Weisure”

Enter the

workforce with

chronic conditions

7%

8.3% 18.4% 22.1% 26.5% 21.2%

26.3% 33.3% 32.8% 30.9% 14.7%



2X 13.4% 14.5% 15.0%

23.2%

31.3%

35.7%

1950-60 1970 1980 1990 2000 2010+

Obesity Rates Are Rising



How Do Employers View Aging & Wellbeing?

Source: 2014 Consumer Health Mindset Survey: Aon Hewitt, 2015 Financial Mindset Study: Aon Hewitt, the National Business Group on Health,

and The Futures Company; 2015 Hot Topics in Retirement; 2014 Aon Health Care Survey

will communicate the link

between financial stress and

health and well-being

67% are very or moderately likely to

create or expand financial

wellness programs in a way that

extends beyond retirement

decisions

93% 86%

of consumers believe workplace

wellbeing programs are a good

business investment for the

employer

87% INCREASING employees’

awareness of and decision-

making related to wellbeing

issues

90% believe the most influential

impact they have on employee

wellbeing is through the work

environment and culture



How do these trends affect workplace absence?

…and is expected

to be 55 by 2030

Average incurred

WC claim cost

for workers age

45+ is 73% higher

than workers <45

Employees with

higher wellbeing are

36% more likely to

report a full

recovery after

an injury

The mean age of

today’s U.S.

Worker has

increased to

41 years old …

Workers >age 45

litigate WC

cases 40%

more often

Claimants > age

45 lose 13 more

days from work on

TTD Claims

80% of

Americans over

age 50 suffer from

1+ chronic

condition

Obese workers

file 2X as many

WC claims and

claims cost are

7X higher

STD claim

duration is

3 days longer

for the obese

Diabetic

employees

are out of

work 12 days

longer



What data is showing?

10



Ideas to Manage this Risk

How to Manage

This Risk

11



Leadership Interviews Program Inventory Review &

Assessment

Three Ways To Begin

Actionable Data

• Blended data sets

• Aligned metrics

PPP

• Vendor Alignment

• PPP Alignment

Gap Analysis

• Current state

• Future state

• Silo elimination

http://www.healingcem.com/archives/419

http://community.bingads.microsoft.com/blogs/advertiser/archive/2011/07/09/adcenter-editorial-policy-handling-upfront-blocks-adcenter-campaign.aspx



How to Identify Age Related Risks

Age Stratification of Workforce

Injuries by age

Symptom surveys

Analyze

Age related exposures

Age specific hazards

Evaluate

Age specific hazard elimination

Training on age specific hazards

Control



Improve Your Vantage Point with Actionable Data

Individual stakeholder sees

need

• Limited locus of control

• Limited data access

• No budget

Several stakeholders see

need

• Broader data access

• Some room in budget

• Moderate locus of

control

• Some vendor control

Key stakeholder sees need

• Maximum access to

data

• Budget secured

• Vendor alignment

possible

• Resource allocation

• Part of mission

statement



Avg. Days Lost 5.1 5.5 24.3 23.6 160 151.1

RISKS

Employees with musculoskeletal issues are more likely

to have higher risk especially for weight

COST AND PREVALENCE

PAIN MEDICATION

Drug Name Therapeutic

Class

Benefits

Paid

% of

Cost

# of

Scripts

% of

Scripts

Humira #1 Antiarthritics $579,604 3.8% 138 0.2%

Enbrel#2 Antiarthritics $484,034 3.2% 121 0.1%

Subsys #6 Narcotic

Analgesics $374,738 2.2% 22 0.0%

Oxycodone Narcotic

Analgesics $15,523 0.1% 1,409 1.6%

Total $1,453,899 9.3% $1,690 1.9%

What Actionable Data Looks Like

ABSENCE

63%

2% 8%

28%

77%

2% 5%

16%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

No Absence NormalAbsence

ModerateAbsence

High Absence

Musculoskeletal Total Population

% P

opula

tio

n

Medic

al/D

rug P

EP

Y

$6,859 $7,523

$14,394

$21,731

$3,556

$7,988

$10,322

$20,256

$-

$5,000

$10,000

$15,000

$20,000

$25,000

No Absence NormalAbsence

ModerateAbsence

High Absence

Musculoskeletal Claimants Total Population

1%

15%

39% 36%

7%

0%

17%

38% 36%

5%

0%

10%

20%

30%

40%

50%

Underweight Normal Overweight Obese MorbidlyObese

Musculoskeletal Claimants Total Population

$10.0

$8.6

$11.7 $9.6

$0

$2

$4

$6

$8

$10

$12

$14

Medical/Rx Paid Medical/Rx Paid w/o HCC

2015 (N=901) 2016 (N=1,004)

To

tal M

usculo

skele

tal C

ost

% P

opula

tio

n A

t R

isk

% P

opula

tio

n A

t R

isk

17% 82%

71%

50% 44% 35%

30% 30% 30%

79% 72%

54% 44%

33% 34% 34%

22%

0%

20%

40%

60%

80%

100%

All data represents Employees continuously enrolled 36+ months, unless otherwise noted

US Population at-risk for weight: 69%

15



COST AND PREVALENCE

PHARMACY

Depression medication compliance is low at 55% for

employees and 58% for spouses (target 72%)

Anxiety medication is the most utilized mental health

related drug

RISKS AND KEY CLAIMANTS

PERFORMANCE

Low performers have a higher risk for depression and

have a much higher cost when at risk for stress

.

% P

op

ula

tio

n a

t R

isk

40%

27%

35% 36% 41%

33% 28%

32% 35%

38%

20% 21% 21% 23% 26%

22% 24% 25% 30%

21%

0%

10%

20%

30%

40%

50%

Total Population 1+ Safety Instances 1+Chronic Conditions Musculoskeletal HCC

2015 Depression 2016 Depression 2015 Stress 2016 Stress

Medic

al/D

rug P

EP

Y

% a

t R

isk

>$5K

26%

34% 38%

22% 21% 19%

0%

10%

20%

30%

40%

50%

High Performance ModeratePerformance

Low Performance

Depression Stress

Linear (Depression) Linear (Stress)

$-

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

High Performance ModeratePerformance

Low Performance

Depression Stress Total Population

Drugs (Rank) Year Cost # of

Scripts

% of Total

Scripts

Employee Top Utilization

Alprazolam (#6) 2016 $4,230 1,391 1.6%

Spouse Top Utilization

Alprazolam (#2) 2016 $5,076 1,506 2.4%

Escitalopram Oxalate (#7) 2016 $3,750 853 1.3%

Sertraline HCL (#14) 2016 $1,918 699 1.1%

$212,668

$293,354

$79,964 $96,770

207 231

162 198

0

50

100

150

200

250

$-

$50,000

$100,000

$150,000

$200,000

$250,000

$300,000

$350,000

2015 2016

Employee Cost Spouse Cost

Employee Claimant Spouse Claimant

# o

f Cla

imants

Annual M

edic

al S

pend

ICD Category Year # of EEs Total Lost

Work

Days

Avg. Days

Lost/ EE

Sum Total

Med/Rx

Paid

Average

Med/Rx

Paid/ EE

Depressive

Disorder (36+

months)

2015 121 15,669 129.5 $869,323 $7,185

2016 121 13,720 113.4 $1,353,937 $11,190

Depressive

Disorder (All)

2015 156 19,288 123.6 $1,219,480 $8,068

2016 127 14,415 113.5 $1,385,945 $10,956

Anxiety Disorder

(36+ months)

2015 78 9,435 120.9 $469,205 $6,016

2016 78 7,655 98.1 $440,488 $5,648

Anxiety Disorder

(All)

2015 91 10,752 115.7 $531,648 $5,831

2016 84 8,326 99.1 $516,013 $6,143

All data represents Employees continuously enrolled 36+ months, unless otherwise noted

US Population at-risk for weight: 69%

ABSENCE

16

What Actionable Data Looks Like



What Actionable Data Looks Like: WC Only

17

TOILETINGASSISTANCE

RESIDENTTRANSFER OR

REPOSITIO

AMBULATIONASSISTANCE

BATHINGASSISTANCE

CALMINGCOMBATIVERESIDENT

Count of Claim Total Incurred 795 2538 370 484 343

Average of Claim Total Incurred2 $6,001 $4,627 $4,239 $3,279 $2,165

0

1000

2000

3000

4000

5000

6000

7000

2014 to 2/28/2018 valued as of 3/6/2018 Combined Data

Count of Claim Total Incurred

Average of Claim Total Incurred2



Discovery Made Easy with Understanding The Current State

Category

Average

Score Discussion Notes

Organizational Leadership and Commitment Integration of worker health into mission and amount of

allocated resources and support

2 Currently focused heavily on metrics over behaviors

Need adequate resources; employees currently fund wellbeing dollars

Coordination Between Health Protection and Health

Promotion Coordination and decision making across departments on

policies, programs, practices, processes and operations

impacting worksite wellbeing and safety

1

Currently little integration between wellbeing and occupational health and

safety but a strong structure to build from

Desire a champion to lead the coordination and work across departments

Need appropriate messaging to support worker health through

environment, education and programs

Supportive Organizational Policies and Practices Support and training provided to program and operational

managers on policies and practices to promote total worker

health

Inclusion of job descriptions requiring interdepartmental

collaboration, performance metrics and professional

development strategies to support wellbeing and safety

2

Safety is supported with organizational policies and practices

Need to develop job descriptions for staff and performance metrics for

those responsible for worksite wellbeing and safety

Include professional development strategies that include training and

setting goals

(1) Absent (3) Partially Adopted (5) Fully Achieved



Current State Team Integration - Obstacles and Considerations

Internal reporting structures often operate in silos:

– Risk Management

– Insurance

– Claims

– Safety

– Human Resources

– Health and Benefits

– Operations

– Finance

– Legal

• Leadership support is required to support an integrated culture and improve outcomes.

19



Managing the Risk: Integrate Worksite Wellness, Absence, and Safety

Work-site wellness and occupational health and safety programs have been shown to

improve employee health, productivity, and absence

1) National Business Group on Health, Integrating Wellness, Occupational Health and Safety 2013.

Impact on Costs

• Eighty-five percent of workers’

compensation costs can be

attributed to employees with

self-reported health risks

• Self-reported high health-risk

employees are three times

more likely to file a workers’

compensation claim

Impact on Employee Safety

• Good physical and mental

health combined with the

absence of chronic health

risk factors have been

associated with low

occupational injury rates

• Non-smokers are less

likely to get injured at work

than smokers

Impact on Employee Wellness

• Employees are less likely to

participate in wellness

programs when there are

unaddressed safety issues

• Shift workers who are

obese, have diabetes

or cardiovascular disease

experience improvements

in their health when they

participate in safety

programs that focus on

improving sleep quality



Focus on Work Conditions: Age Related Hazards in the Workplace

Ageonomics

101

21

•Balance

•Visual acuity Falls

•Strength declines

•Cardiovascular drop MMH

•Response time declines

•Spatial recognition MVA



Controlling Age Related Hazards

ESH Training

Design Guidelines

Engineers On Board

5S Program

Work Design

Work-rest cycles

Break times and length

Control



Age Appropriate Work Design

Poor vision

Focus

%50-100% more lighting

Contrast increase

Larger font and displays

Larger signage

Clear aisles

Clutter free walkways

Escorts



Age Appropriate Work Design

Greater frequency of

disorders of the knees

Eliminate obstructions on the floor

Zero floor level storage

Clear aisles and walkways

Catwalks maintained

Stairs maintained and non-slip

material

Slip-resistant soles

Look at need for squatting and

kneeling and reduce



Managing the Risk: Aon’s Ageonomics™ Model for Aging Workers

Census Trigger

• Clients with 30% of total population over 40 years of age

40+ Issues & Needs

• Retirement

• Disability

• Aging

• Wellbeing

Ageonomics™

Retirement Planning

Absence InSight

Population Wellbeing Diagnostics

Clients with a 30% or greater

workforce over the age of 40

need sophisticated solutions to

reduce TCOR and improve

health, productivity, and longevity

of this vital population

Aon’s Ageonomics™ Model



AgeonomicsTM Solutions

Pre-Hire:

Pre-Employment Screening

Physical Demands documentation

Functional capacity testing

At Work:

Prescriptive Wellness

Absence Mgmt

Workplace Design

Predictive Modeling

Worksite evaluations

Physical Demands Assessments

After Injury/Illness

Absence Mgmt

Return to Work

Early Claim Identification flags

Accident investigations

Rehabilitative ergonomic assessments

Modify workstations

Aggressive claims mgmt

Pre-Hire

• Pre-Employment

Screening

• Physical Demands

documentation

• Functional capacity

testing

At Work

• Prescriptive Wellness

• Absence Management

• Workplace Design

• Predictive Modeling

• Worksite evaluations

• Physical Demands

Assessments

After Injury/Illness

• Absence Management

• Return to Work

• Early Claim

Identification flags

• Accident investigations

• Rehabilitative

ergonomic assessments

• Modify workstations

• Aggressive claims

management



Case Study: Energy Company

Business imperative to reduce

morbidly obese truck drivers

(>40BMI) due to DOT regulation

• 4% of total population considered

morbidly obese

• 71% overweight or obese and 60%

elevated blood pressure

• Circulatory related short-term disability

claim were at higher risk for weight,

blood pressure and tobacco

• Have a safety instance and/or workers’

compensation claim are more likely to

be at risk for weight and significantly

more likely to be at risk for back pain,

stress and physical activity

Implement a specialized weight

management approach

focused on obese and

morbidly obese through

Retrofit

• Partnership between the

Occupational Health and Safety

Department and Wellbeing

programs

• Identify employees through annual

physical and medical exam

• 40% have enrolled

• 5 major program design elements

Measurable impact on

weight loss; better

alignment with DOT

regulations

• 811 total lbs. lost to date

• 13% have moved from obese

to overweight

• Participants reported high level

of satisfaction with the program

Situation Solution Results



US demographic changes should alter our

view of risk and costs going forward

Understanding data sources for leverage

will result in focused and sustainable

management of Total Cost of Risk

Critical to identify key financial metrics

Partnership and communication with other

functions

Data is more actionable and costs are

more manageable than we may believe

In Closing

30

Documents

Ageonomics™ · tolerance, diversity, confidence “Weisure” Enter the workforce with ... Lost/ EE Sum Total Med/Rx Paid Average Med/Rx Paid/ EE Depressive Disorder (36+