The Health, Economic, and Legal Implications of Successful ... · The Health, Economic, and Legal...
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The Health, Economic, and Legal Implications of Successful Worksite Wellness Programs
Presented by:Don R. Powell, Ph.D.President and CEO
American Institute for Preventive Medicine
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Total Employee/Employer Health Care Costs: 2002 - 2007
Source: Towers Perrin 2007 Health Care Cost Survey
2002 Total Cost = $5,386 2007 Total Cost = $8,748
$1,896
$6,852
Employee
Employer
$1,044
$4,342
Employee
Employer
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Health Insurance Premiums vs Other Indicators
Source: Kaiser Family Foundation, 2005
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If Food Were Health Care
If food prices had risen at medical inflation rates since the 1930’s:1 dozen eggs $ 80.201 pound apples $ 12.231 pound sugar $ 13.701 roll toilet tissue $ 24.201 dozen oranges $107.901 pound butter $102.071 pound bananas $ 16.041 pound bacon $122.481 pound beef shoulder $ 43.571 pound of coffee $ 64.17
10 item total $586.56
Source: American Institute for Preventive Medicine, 2007
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How Companies Are Responding to Increased Health Care Costs
% of companies
Increased participant cost
Participant pay more for prescription drugs
Switched providers
Source: Society for Human Resource Management, 2006
Increased copays
Increased deductibles
Offer wellness program
66%59% 56% 55%
31%
62%
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Issues Most Affecting Employee/Member Productivity
Stress Personal/ Family
Chronic medical conditions
Unscheduled absences
Presenteeism Lifestyle medical conditions
Source: Watson Wyatt, 2005
57%58%59%
72%
49% 49%
0
10
20
30
40
50
60
70
80
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10 Most Purchased Products in Grocery Stores
1. Marlboro cigarettes2. Coke Classic3. Pepsi4. Kraft cheese5. Diet Coke
6. Tide7. Campbell’s soup8. Folger’s coffee9. Winston cigarettes
10. Tropicana
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The Cost of Unhealthy Behavior
Steelcase1 Dupont2 Chrysler3
Smoking $285 $960 $342
Weight $222 $401 $410
Exercise $488 N.A. $ 96
Alcohol $597 $389 NA
Seatbelts $196 $272 $226
Hypertension $327 $343 $ 94
Cholesterol $189 $370 $118
Sources: 1. American Journal of Health Promotion, 19912. American Journal of Health Promotion, 19933. Milliman & Robertson, 1995
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High Risk Employees Cost More
70.2%
46.3%
34.8%
21.4% 19.7%14.5% 11.7% 10.4%
-50%
-25%
0%
25%
50%
75%
100%
Dep
ress
ion
Stre
ss
Glu
cose
Wei
ght
Toba
cco-
Past
Toba
cco
Blo
odPr
essu
re
Exer
cise
Perc
ent
Source: Journal of Occupational and Environmental Medicine, Oct. 1998
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Association of Risk Levels with Several Corporate Cost Measures
Outcome Measure Low Risk (N-671)
Medium Risk (N=504)
High Risk (N=396)
Short term disability $120 $216 $333
Worker’s compensation
$228 $244 $496
Absence $245 $341 $527
Medical & pharmacy $1,158 $1,487 $3,696
Total $1,751 $2,288 $5,052
Source: Wright, Beard, Edington, JOEM 44(12): 1126-1134, 2002
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Health Risks & Health Care Costs
$2,516
$3,253
$4,043
$0
$1,500
$3,000
$4,500
Low Risk Moderate Risk High Risk
Ave
rage
Med
ical
Cos
ts -
2003
(0-2 Risks) (3-5 Risks) (6+ Risks)
N = 1,706
Source: Fairview Alive Program Evaluation (StayWell, 2004)
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Savings Per Employee (2001 – 2003)
$41
$282
$54$101$36
$107
$17
$75
$45
$0
$100
$200
$300
$400
$500
2001 2002 2003
Medical Absenteeism Workers' Comp
Source: Fairview Alive Program Evaluation (StayWell, 2004)
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Review of Published Studies on Worksite Wellness (ROI)
$0
$1
$2
$3
$4
$5
$6
28 Studies1 42 Studies3 56 Studies418 Studies2
Medical Costs
Medical Costs, Absenteeism, & Workers Comp
Medical Costs & Absenteeism
1. Source: Aldana, SG, Financial impact of health promotion programs: a comprehensive review of the literature, American Journal of Health Promotion, 2001, volume 15:5: pages 296-320.
2. Source: Aldana, SG, Financial impact of health promotion programs: a comprehensive review of the literature, American Journal of Health Promotion, 2001, volume 15:5: pages 296-320.
3. Source: Chapman, LS, Meta-evaluation of worksite health promotion economic return studies, Art of Health Promotion, 2003, 6:6, pages 1-16.
4. Source: Chapman, LS, Meta-evaluation of worksite health promotion economic return studies: 2005 Update Art of Health Promotion, 2005, p. 1-16.
Absenteeism
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Prevalence of Worksite Wellness Programs
Source: SHRM 2006 Benefits Survey Reports
Resources & Information
Health Screening Program
Smoking Cessation
Health Newsletter
Fitness Center Subsidy
Weight Loss
Onsite Fitness Center
Stress Management
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Risk Factors for Every 100 Employees/Members
25 have cardiovascular disease12 are asthmatic6 are diabetic26 have high blood pressure30 have high cholesterol38 are overweight21 smoke31 use alcohol excessively20 don’t wear seatbelts24 don’t exercise44 suffer from stress
Source: Department of Health and Human Services
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Wellness Wizard®
Determine your employee’s health risks, costs, and savings
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1. Make the Program Multi-Component
Assessment activitiesCommunication materialsSelf-help materials/programsHealth CoachingGroup programs
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2. Teach Demand Management
Medical self-careWise consumerism
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Physician Office Visits Annually
Total - to non federally employed, office based physicians
964 million Approximately 3.3 visits/person
Source: National Ambulatory Medical Care Survey-2007
Unnecessary Visits25% or 241 million
Source: Dunnell, K. and Cartwright, C. Medicine Takers, Prescribers and Hoarders
Average cost - $121/visitSource: American Medical Association, 2001
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Emergency Room Visits Annually
Total 115 million37.8 visits/100 persons
Source: National Ambulatory Medical Care Survey - 2005
Unnecessary Visits55% or 63 million
Source: National Ambulatory Medical Care Survey - 2005
Average cost - $586/visitSource: New England Journal of Medicine, 1996
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HealthyLife® Self-Care Studies
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“Health at Home® was the reason I went to see my doctor and it saved my life.”
Jeff BilbreySales Specialist, Lowe’sBloomfield Hills, Michigan
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“Health at Home®
was a real lifesaver. It helped me to know my husband, Jay, was having a heart attack.”
Marijo Parsons Pharmacy SupervisorAurora Medical CenterMilwaukee, WI
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Self-Care Program ROI Analysis
Cost of self-care guidesComparison to annual health expendituresUtilization & cost assumptionsProjected cost savings
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3. Present Psychosocial Issues
Self-esteemAnger managementDepression managementLaughter workshops
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4. Address High Risk Employees
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Address Low Risk Employees
Keep healthy people healthyLow risk employees won’t remain low risk10 – 20% will move to high risk in 1 year
Source: University of Michigan Health Management Research Center
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5. Manage the Health Care Continuum
Prevent Low Risk from Becoming High Risk
Help High Risk Become Lower Risk
55%
WellnessManagement
HealthyNo Disease
25%
RiskManagement
HypertensionObesity
DemandManagement
Doctor VisitsER Visits
15%
DiseaseManagement
DiabetesAsthma
5%
CatastrophicIllness
ManagementCancer
Head Injuries
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No / Low Cost Wellness Programs
Weight controlPhysical fitnessSmoking cessationStress managementNutritionTotal Health
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6. Use High Tech as an Adjunct to High Touch
No data to support cost savingsOnly 50% of U.S. population has internet accessOnly 25% goes online for health informationSome intranets can only be accessed at workMay not reach dependentsTime consumingMany people still prefer printEmployees thank you for books
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7. Maximize Employee Participation
Multi-component methodsSaturation effect Incentives
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8. Involve Employee’s Family
70% of health care costsWomen make 80% of health care decisions
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9. Know Legal Restrictions
Americans with Disabilities Act (ADA)Health Insurance Portability and Accountability Act (HIPAA)
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10. Evaluate Your Program
Risk Factors
Absenteeism
Productivity/ Presenteeism
Employee Satisfaction
Financial
Wellness Program
Participation
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Thank you for your attention.
Questions?Phone: 800-345-2476, extension 221
Fax: 248-539-1808
E-mail: [email protected]
Web Site: www.HealthyLife.com