Case Studies

The unique blend of market-based innovation, experience, and methodological/ technical rigor that we have brought to these and related projects has distinguished us as a pioneer and leader in the emerging field of health and productivity and related areas of health services research. 

Current and past projects include the following.  A number of these projects have produced publications in peer and non-peer reviewed venues.   We can be contacted at harris@harrisallengroup.com if you would like copies of these reprints and/or further information on any of these engagements.

Developing, Analyzing & Reporting on the Leading Integrated Database of a Major Self-insured Employer

In collaboration with three major sponsors -- Centocor Ortho-Biotech, Novartis Pharmaceuticals, and The Conference Board -- we are currently finalizing the "refresh" of a health and productivity database at Navistar, Inc.

The previous iteration of this database encompassed two employee surveys of the company's US workforce in 2001 and its workers compensation/disability, medical/pharmaceutical and absenteeism activity spanning 2001-2002. It served as the data source for 12 peer-reviewed and non peer-reviewed publications whose topics ranged from the burden and management of allergies to validation studies of measures of presenteeism.

The "refresh" is adding behavioral health claims and expand the coverage for all administrative sources from 2001 through 2009. These claims data will cover the activity of active employees as well as retirees and dependents in the continental U.S. The "refresh" is also incorporating data from another company-wide US employee survey conducted in the fall of 2009.

Once completed, this updated database will be serving as the data source for a wide variety of longitudinal studies, ranging from the total cost burden of immune mediated diseases, hypertension, respiratory diseases and osteoporosis to employee engagement.

Measuring and Managing Workplace Depression

In colloboration with the developer of a leading health risk appraisal and a major client, we examined workplace depression as both a predictor of health and productivity and as an outcome of a variety of job, demographic, and other health) characteristics. The analyses featured structural equaltion models involving 41 measures. They were conducted on a broad-based international sample (n=44,000) completing the version of the HRA that included validated measures of depression and job performance.

Key findings:

• 15.7% exhibited mild depression, whereas 6.9% recorded moderate to severe symptoms
• Depression severity exerted large effects on general health and productivity loss, with the mild group posting the largest aggregate impact
• Adverse personal life impact and financial concerns more significantly predicted moderate to severe depression. In contrast, factors more amenable to employer health management efforts (e.g., health risk behaviors) better predicted mild depression.

These results reaffirm depression's key role in employee health and productivity, and call for public-private collaboration, parity in mental and physical health benefits, and resource allocation that is proportionate acrss the depression spectrum and faciliiated by symptom severity screening.

This work has just been published in the Journal of Occupational and Environmental Medicine (4/10) and will be the subject of several upcoming presentations.

Pain and Employee Health & Productivity

Working with the field’s leading trade organization and a Fortune 100 Company, we evaluated the burden of pain on employee health, presenteeism and absenteeism.

Key findings:

• nearly 30% of employees were affected by pain
• pain was associated with reductions in physical and mental health of 45% and 23%, respectively
• pain was linked to a five-fold increase in health-induced limitations in work performance
• pain was responsible for the loss of 3 and 2/3 days in presenteeism and absenteeism over a 20-day period (a productivity loss of 18%)
• although employees with pain reported using a wide variety of treatment options, they also reported considerable room for improvement in pain control.

This work was published in the Journal of Occupational and Environmental Medicine (7/05) and Health and Productivity Management (10/05)..  It also has been the subject of notable press attention (see News). 

Long Work Hours
and Health & Productivity

Working with a major employer, the United Auto Workers, and the National Institute for Occupational Safety and Health, we have conducted a series of studies examining relationships between long work hours, employee health and productrivity.

Our results:

• Confirmed prior research linking hourly employees with extended hours to a greater likelihood of at least one workers comp episode over the next year.
• Limited this effect to workplace injuries, just one aspect of the broader health and productivity space. Workers with long hours were no more likely to incur adverse physical or mental health outcomes, or to report presenteeism outcomes, or to post a disability episode over the next year.
• Determined that antecedent factors (e.g., age, gender, prior diseases and health risks) had much more impact on adverse health and productivity outcomes than how many hours were worked.

This work led to several recommendations proposed to the employer (e.g., introducing new curbs for working 60+ hours). It has produced several papers in collaboration that are being prepared for publication. And, a symposium on this work was held -- with all major parties participating -- at the International Work, Stress and Health Conference in March 2006 in Miami, FL.

Allergy Burden and Drug Effectiveness

With a major heavy manufacturer and drug maker, we conducted a three-year research program comprised of validation, observation and intervention studies.  The focus was the burden of allergies on the health and productivity of employees at a heavy manufacturer. This program used a pre-post/experimental-control design, featuring an integrated database that included employee surveys, absenteeism and group health/pharmaceutical/disability/workers compensation claims.

Key findings:

• Nearly one in four employees were affected by allergies
• Employee health, productivity, absenteeism, workplace injury and workers comp episodes consistently worsened as allergy severity increased.
• Drug regimens including non-sedative antihistamines showed better capacity to reduce allergy burden than regimens including sedative antihistamines.
• An 8-modality educational program served to improve the knowledge of employees about allergies but did not succeed in promoting behavior change.
• Self reports of productivity loss performed well in a series of concurrent and predictive validitiy tests
• Self-reports helped to differentiate known groups, even when administrative data on adverse events were used.

Four peer-reviewed articles on this workt appeared in the September, 2003 Journal of Occupational & Environmental Medicine.  Another four articles have appeared in sequential issues of Health and Productivity Management. 

Community Health & Work Environment

Sponsored by an employer coalition and pharmaceutical companies, this community initiative ranked the burden of specific medical conditions on employee health and productivity.  Known as the Healthy People/Productive Community Survey,  this engagement implemented a first-of-its-kind two-wave, two-year survey process (a general population survey and 17 condition-specific surveys) on 20,000 employees from 9 major corporations in the Tampa Bay, Florida area..

Key findings:

• The top ranking diseases in terms of prevalence were ranked as follows:  allergies (26%), hypertension (17%), neck/shoulder problems (15%), arthritis (14%), lower back problems (13%), and depression (10%).
• For these diseases, the average loss in presenteeism & absenteeism ranged from 3.1 for allergies to 4.9 days for depression over a 20 workday period.
• The exception was hypertension:  its relatively modest per person impact caused it drop for this top list
• Overall, the 17 disease conditions were linked to a productivity loss of over $7.25 million per 100 employees per year.
• The presence of obesity worsened the productivity loss impact across all 17 conditions.

A copy of the article summarizing this work can be obtained by contacting us harris@harrisallengroup.com.

Health Plan Performance over Time

With three major Fortune 500 employers, we conducted a national two-year, two-wave survey on employee/enrollee satisfaction with health plans. The data from nearly 12,000 employees was used to rank 23 major plans located in five major markets across the U.S.

The three employer clients used the results to assess corporate health care strategy and to initiate and monitor continuous qualitiy improvement with each of these plans.  The National Committee for Quality Assurance used the survey as a model for the Consumer Survey included in iits HEDIS system for measuring health plan performance.

Reprints of the several articles appearing on this work in Health Affairs, the International Journal for Health Care Quality, Managed Care Quarterly and other peer-reviewed venues are available on request..

Enrollee Satisfaction
with Adult and Pediatric Care
and Plan Performance

With a major Midwest health plan, we conducted annual, statewide, enrollee surveys to compare 80+ primary care clinics over a three-year period.  Each year’s survey was used by senior management to gauge plan-wide performance relative to corporate goals developed from the previous year’s survey.

Longitudinal Evaluation
of a Corporate Health Care Delivery System

We conducted five annual surveys over a seven-year period to monitor the impact of a family health center (FHC) for a corporation in a southeastern city. We found that the FHC’s value to employees solidified during the study period, despite a period of continued and divergent change among the four health plans with which it interfaced.

Assessment of effectiveness
of new medical device

Working with seven hospitals and a health plan, we conducted complex data collection on 800 coronary stent patients. This process involved development and administration of two patient surveys as well as abstraction of medical records. Results were used to promote new areas for plan/hospital collaboration.

Health Plan Benefit
and Strategy Consulting

As part of a multidisciplinary team of actuaries and clinicians, we reviewed health benefits provided to state employees and retirees for a state agency in the northeast. This review used focus groups and a large survey to employees and retirees to help formulate and test recommendations made to the agency. The results helped to finalize the recommendations.