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How to Align Evidence-Based Benefit Design With the Employer Bottom-Line: A Case Study

Bunn, William B. III MD, JD, MPH; Allen, Harris PhD; Stave, Gregg M. MD, JD, MPH; Naim, Ahmad B. MD


In the article by Bunn, Allen, Stave, and Naim ( J Occup Environ Med. 2010;52:956–963), the caption for Figure 3 on page 959 appeared incorrectly. The caption should have read “Health Care Cost Trend per Employee/Retiree: 1999–2009,” not “Hospital Cost Trend per Employee/Retiree.” The inadvertent change in name before the colon occurred during the final stage of the publication process. The dates after the colon we are adding now to underscore the length of the time period covered by the graph. We apologize to readers for not issuing this erratum earlier.

Journal of Occupational and Environmental Medicine. 56(11):e142, November 2014.

Journal of Occupational and Environmental Medicine: October 2010 - Volume 52 - Issue 10 - p 956-963
doi: 10.1097/JOM.0b013e3181f72ae5
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Objective: To illustrate how to use evidence-based benefit design (EBD) by presenting the case study of a major manufacturer.

Method: Key components of the company's measurement and management approach to EBD are introduced. Descriptive results on the direct and indirect cost and utilization trends of the company's US active workforce during 2002 to 2008 are presented.

Results: From 1999 to 2002 aggregated to 2008, health care costs dropped sharply, with 2006, 2008, and projected 2009 reporting decreases even as annualized increases in national expenditures approximated 10%. Annualized rates for hospitalizations, office visits, and prescriptions showed corresponding decreases from 2004 to 2008. From 2002 to 2008, workers' compensation/disability and absenteeism costs decreased 38% and 46%, respectively.

Conclusions: These results support the company's direction in health benefit design although further confirmation is needed. Ongoing quality improvement processes are discussed, as are implications for implementing EBD.

From the Health, Safety, Security and Productivity (Dr Bunn), Navistar, Inc, Warrenville, Ill; Northwestern University School of Medicine (Dr Bunn), Chicago, Ill; Harris Allen Group, LLC (Dr Allen), Brookline, Mass; Division of Community and Family Medicine (Dr Stave), Duke University Medical Center, Durham, NC; and Health Economics and Outcomes Research (Dr Naim), Centocor Ortho Biotech Services, LLC, Horsham, Pa.

Address correspondence to: Ahmad B. Naim, MD, Health Economics and Outcomes Research, Centocor Ortho Biotech Services, LLC, 800 Ridgeview Drive, Horsham, PA 19044; E-mail:

©2010The American College of Occupational and Environmental Medicine