Appendix 2
Texas Health Care Cost Survey

Below is a copy of the survey instrument.

Employer Survey

The Texas economy depends on a thriving business environment. To strengthen the Texas economy, Susan Combs, Texas Comptroller of Public Accounts, is researching your major challenges and costs associated with the health of your workforce. Participants will not be identified in any report.

Optional Information

Company name
Contact name
Contact Phone Number
Contact Email

1. Approximately how many employees does your firm employ?

2. What type of industry?

	Agriculture/Mining/Construction		Manufacturing
	Transportation/Communications/Utilities		Wholesale
	Retail		Finance
	Service		Healthcare
	Education		Other

3. Does your firm offer health benefits to your employees?

	Yes
	No (If "No", please skip to question 7)

4. Do covered workers pay a portion of their insurance premium?

	Yes		Full-time %	Part-time%
	No

5. Has your firm seen an increase in the cost per employee associated with healthcare from 2002 to 2006?

	Yes	What percent of increase? %
	No

6. What is your firm's average annual healthcare cost per employee?

Dollar Amount	Year
$

7. What are the three most prevalent medical conditions at your firm?

	Coronary artery disease		Gastrointestinal disorders
	Hypertension		Osteoarthritis
	Type I Diabetes		Type II Diabetes
	Obesity		Stroke
	Cancer		Injury
	Mental Health		Lung and respiratory diseases
	Other

8. Which three medical conditions are the most costly to your firm?

	Coronary artery disease		Gastrointestinal disorders
	Hypertension		Osteoarthritis
	Type I Diabetes		Type II Diabetes
	Obesity		Stroke
	Cancer		Injury
	Mental Health		Lung and respiratory diseases
	Other

9. Which three medical conditions are the top causes of absenteeism in your firm?

	Coronary artery disease		Gastrointestinal disorders
	Hypertension		Osteoarthritis
	Type I Diabetes		Type II Diabetes
	Obesity		Stroke
	Cancer		Injury
	Mental Health		Lung and respiratory diseases
	Other

10. What are your greatest health concerns for your workforce? (identify all that apply)

	Loss of productivity
	Healthcare costs
	Absenteeism
	Workers at work, but due to health related problems, have decreased productivity
	Other

11. What percent of your workforce would you consider to be overweight or obese?

%

Is this an estimate or measurement?
	Estimate
	Measurement

12. What effect does obesity have on your firm? (identify all that apply)

	Increased healthcare costs
	Increased absenteeism
	Loss of productivity
	Expenses incurred from building or furniture modifications
	None
	Other

13. Does your firm measure the costs of lost productivity or absenteeism due to medical conditions?

	Yes
	No

14. If "Yes" to Q13, what is the annual amount?

Dollar Amount	Year
$

How did you make that determination?

15. Do you offer any wellness programs to your employees?

	Yes
	No

16. If "Yes" to Q15, what benefit (savings or cost avoidance) to your firm do these programs provide.

	Dollar Amount	Year
Lower healthcare costs?
Better productivity or less absenteeism?

Other return-on-investment measures? Please describe:

What is your workforce participation rate?	%

17. Does your firm offer any disease management programs to your employees?

	Yes
	No

18. If "Yes" to Q17, what benefit (savings or cost avoidance) to your firm do these programs provide.

	Dollar Amount	Year
Lower healthcare costs?
Better productivity or less absenteeism?

Other return-on-investment measures? Please describe:

Please estimate the percentage of your employees who participate in at least one disease management program.	%

19. If "Yes" to Q15 or Q17, does an outside company provide wellness and/or disease management services to your firm?

	Yes
	No

20. If "Yes" to Q15 or Q17, what incentives do you offer your employees to participate in these programs? Please check all that apply.

	Cash
	Paid time off
	Awards and recognition
	Reduced employee costs for health premiums or copays
	Discounts for health clubs
	Other
	None

21. If "No" to Q15 or Q17, would such programs be helpful to your firm?

	Yes
	No

22. Would the health of a region's population and workforce factor into your decision to expand in Texas or move to a new region in Texas?

Please explain.
	Yes
	No

23. Would the cost of healthcare weigh as heavily as labor costs and the education and skill of the workforce in your decision to expand in Texas or move to a new region in Texas?

Please explain.
	Yes
	No

Appendix 2 Texas Health Care Cost Survey