Relieving Pain, Restoring Productivity at IUOE Local 4

"I've learned that I'm not alone in facing this issue, and that there are exercises that can help alleviate my problems and improve my quality of life. I've also come to understand the importance of self-care and prioritizing time to exercise and take care of myself."

IUOE Local 4 employee and Hinge Health participant

About IUOE Local 4

MSK injuries are a significant challenge for heavy equipment operators, with the potential to cause chronic pain, reduce productivity, and increase healthcare costs. For the International Union of Operating Engineers (IUOE) Local 4, a trade union representing over 5,500 heavy equipment operators across Massachusetts, New Hampshire, and Maine, addressing these issues is crucial. For over 125 years, the union has been committed to delivering top-tier results, ensuring that every job is completed correctly, on time, and within budget.

Local 4 is dedicated to its mission of creating safe workplaces, advocating for workers' rights, and actively promoting diversity, equity, and inclusion in the trades.

Greg Geiman, an attorney by trade, became the administrator of the Local 4 Funds in 2020. He oversees the Health and Welfare, Pension, and Annuity Funds for the union's approximately 5,500 active and retired heavy equipment operators.

By working closely with partners, the Local 4 Funds ensure that their participants enjoy industry-leading benefits. These benefits provide their members with access to high-quality healthcare and a secure pension.

The Unique Needs of Heavy Equipment Operators

Local 4 employs heavy equipment operators, mechanics, surveyors, equipment house employees, and wastewater technicians. These men and women operate everything from backhoes and pavers all the way to the tower cranes you see on top of 70-story buildings in Boston. Having such physically demanding jobs, Local 4 looks to provide great health and retirement benefits that combat medical inflation with an eye toward the future, but that also provides low costs for all members. 

“We find that not only are we dealing with MSK related issues, we are also dealing with cardiovascular issues and diabetes as well. Which makes sense because our members are using their bodies quite a lot on the job. But, unlike laborers or electricians, they’re more sedentary because they’re sitting in machinery for much of the day. So we therefore have sort of unique challenges," added Greg. 

MSK claims landed in the top 3 of healthcare spending at Local 4. Greg mentioned that a lot of their members do go in for different surgeries due to the nature of what they do. 

With the extraordinarily dispersed population with work sites all across the three states, Greg and his team find it difficult to centrally communicate with these members. He mentioned that there’s a union meeting once every month, but because of the geography dispersed group, typically only 10% of the total membership is able to attend any given meeting. 

Putting Solutions into Actions: Results and Insights

Understanding the unique challenges faced by its participants, the Local 4 Health and Welfare Fund recognized the need for an effective MSK solution.  They found Hinge Health and began its partnership in early 2019. The implementation of Hinge Health was a strategic move to address the specific health needs of Local 4's members.

To help communicate Hinge Health with Local 4’s unique population, the team partners with Hinge Health to send out mailers and emails. Greg also noted that his team is consistently reminding members of their benefits and takes advantage of their two wellness events each year. “We host a good old fashioned benefits fair and a 5k race. Hinge Health has been a partner at both of those and has co-sponsored  the 5K for the last four years. Since we congregate our members and their families at these events, we use that time to remind them of all of their benefits.” 

Since Local 4 tries to lean into technology, they began using email communication within the last few years. It has become extremely helpful due to the newer apprentices that have joined and are very-versed in the world of technology.

Having been a partner for several years now, Local 4 has seen different variations of Hinge Health. Greg mentioned, “I think there’s an appreciation that the technology is constantly evolving and so are the solutions.” 

Greg shared, “We’re trying to do the best we can do for our members and their families. We’re also trying to be innovative. We had tried working with digital solutions before and we didn’t see the engagement we liked, but we found that Hinge Health has actually been a bit of an anomaly for us. I think it’s just the services Hinge Health provides and the way everything is done.” 

The partnership between IUOE Local 4 and Hinge Health has yielded remarkable results, significantly improving the wellbeing of Local 4's members while reducing healthcare costs. As Greg highlighted, the convenience and accessibility of Hinge Health's program have been crucial in addressing the unique challenges faced by heavy equipment operators. 'If you give members an easy-to-use and convenient alternative to physical therapy appointments, they're going to use it,' Greg observed.

• Positive Member Feedback: Members have really appreciated the ease of use and since launch, there is a member satisfaction score of 8.9/10. 

• Mental Health Improvements: Members have self-reported a 88% reduction in depression and 82% reduction in anxiety since launch. 

• Pain Reduction: Members have reported a 54% average pain reduction in the first 90 days. 

• Surgery Indent Reduction: Members are less likely to pursue surgery after starting Hinge Health, self-reporting an overall reduction in surgery likelihood of 52%.

• Reduced Claims: Local 4 has a projected all time program savings of $1,377,354, which is equivalent to a projected ROI of 3.8x.*

  • *Net Savings and ROI based on 3 validated medical claims analysis on total MSK spend reduction, Hinge Health saves $71.09 per 1% pain reduction. The average percent pain reduction based on participant self report data and 1 year costs savings is used to calculate these values. 

• Clinical Outcomes: 84% of members achieved MCID (minimal clinically important difference) compared to 59% in traditional physical therapy.*

  • *Olsen, MF et al. Journal of clinical epidemiology (2018). Eleswarapu, AS et al. Spine (2016).

Greg noted the high usage of the Women’s Pelvic Health program by female participants and dependents . He also explained, “Mental Health is also an area of high spending for us and we’ve been pleased to see that Hinge Health has even helped folks with anxiety or depression.” 

As Local 4 looks to the future, the Union remains committed to refining its wellness programs to further address the diverse health needs of its members. “At the end of the day, Local 4 members and contractors are the backbone of this great Union. So, we’re trying to do the best we can for them and their families. We want to help folks to feel better so we gave them the best solution and clearly they’re using it and appreciating it.”