Download to read offline
Uploaded byDenise Dumont-Bernier
Kennebec Valley Chamber Womens network meeting 2011
This document discusses the business case for workplace wellness programs. It notes that chronic conditions are increasing as the workforce ages and obesity rises. Poor health leads to higher medical costs and lost productivity. Data from MaineGeneral Health shows that their wellness program reduced health risks and medical claims costs for participating employees. The personal case for wellness is also made, with five rules to live by: quantify your health status, eat well and watch portions, get regular physical activity, get good sleep, and quit smoking. The document advocates being a smart healthcare consumer by getting the right care, at the right time, and in the right place.
More Related Content
Similar to Kennebec Valley Chamber Womens network meeting 2011
Kennebec Valley Chamber Womens network meeting 2011
- 1. Denise Dumont- Bernier,PT Administrative Director Workplace Health & MGMC Express Care Wellness and the Bottom Line
- 2. Objectives Why Wellness? (thebottom line trends) The business case for wellness (the bottom line for business) The personal case for wellness ● 5 Rules to Live By (the bottom line for you) ● Be a better consumer of health care
- 3. Why Wellness? (thebottom line) Prevalence of chronic conditions is growing Inactivity and obesity contributes to chronic diseases Our workforce is aging Poor health costs more Employers / We can make a difference
- 4. Prevalence Of Chronic ConditionsIs Growing 118 125 133 141 149 157 164 171 100 120 140 160 180 1995 2000 2005 2010 2015 2020 2025 2030 Year NumberofPeople(millions) Wu, Shin-Yi and Green, Anthony. Projection of Chronic Illness Prevalence and Cost Inflation. RAND Corporation, October 2000
- 5. Inactivity And Obesity ContributesTo Chronic Diseases
- 6. Obesity Trends* AmongU.S. Adults (*BMI ≥30, or about 30 lbs. overweight for 5’4” person) 2008 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Maine 26.8%
- 7. Diabetes Trends Among Adults:U.S. Age-Adjusted Estimates of the Percentage of Adults with Diagnosed Diabetes 2004 2006 2008
- 8. A New DiabetesDiagnosis Doubles The Risk Of Stroke Within 5 Years Stroke: June 2007
- 9. The Business Casefor Wellness
- 10. Our Workforce IsAging
- 11. % of Populationwith Chronic Conditions by Age Group 25% 40% 67% 87% 5% 67% 40% 15% 0% 25% 50% 75% 100% Age 0-19 Age 20-44 Age 45-64 Age 65+ One or more chronic condition Two or more chronic conditions Source: Medical Expenditure Panel Survey, 2001, Johns Hopkins University, Partnership for Solutions
- 12.
- 13. Costs Follow HealthRisks Study of 13,000 employees investigated the association between health risks and medical claims As the number of risk factors increases, the cost of claims increases exponentially: Number of Risks Increase in Claims 0 1.0 1 1.9 2-3 2.9 4-5 3.8 6+ 8.2 Edington, Am J Health Promo, Sept/Oct 1991
- 14. The Real Problem: TheFull Cost of Employee Poor Health Personal care costs Medical Care Pharmacy 25% Productivity costs 75% STD LTD Overtime Turnover Temporary staffing Administrative costs Replacement training Off-site travel for care Customer dissatisfaction Variable product quality Absenteeism Presenteeism Medical & Pharmacy Costs $3,376 PEPY Health-related Productivity Costs $10,128 PEPY Total: $13, 504 PEPY Sources: Edington DW, Burton WN. Health and Productivity. In McCunney RJ, Editor. A Practical Approach to Occupational and Environmental Medicine. 3rd edition. Philadelphia, PA. Lippincott, Williams and Wilkens; 2003: 40-152. Loeppke, et.al., JOEM, 2003; 45:349-359 and Brady, et.al., JOEM, 1997; 39:224-231
- 15. Ballooning Costs ofPoor Health Dealing only with the financial transactions of healthcare doesdoes notnot lowerlower totaltotal costscosts—it tends to only shift them Health Enhancement (Wellness) programs can reduce the Burden of Illness and Burden of Health Risks leading to healthier population and measurable total cost DECREASES © R Loeppke, MD – Reprinted with Permission
- 16.
- 17. 0 500 1000 1500 2000 2500 3000 # Participants 9001724 2002 2319 2530 2007 2008 2009 2010 Curre nt Results: Wellness Participation
- 18. $0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 2005 2006 20072008 2009 2010 Estimated Cost PEPY Actual Cost PEPY Linear (Estimated Cost PEPY) Results: MGH Bends the Cost Curve 2005 2006 2007 2008 2009 2010 Actual Cost PEPY $6,703 $7,901 $8,471 $8,431 $8,369 $8,315 Estimated Cost PEPY $6,703 $7,306 $7,964 $8,680 $9,462 $10,059
- 19. Employees CAN changeBehaviors 2007-2010 0 200 400 600 800 1000 1200 Low Medium High 788 672 303 1,102 504 157 Risk Level #ofParticipants % Count % % 9% -146 -48.2% Total 1763 1763 High 303 17% 157 39.8% Medium 672 38% 504 29% -168 -25.0% Count Count Low 788 45% 1102 63% 314 Begin Date End Date Change
- 20. Actual Claims CostsPer Risk Category $0 $2,000 $4,000 $6,000 $8,000 $10,000 2008 2010 2008 $4,025 $6,600 $9,750 2010 $2,948 $5,067 $8,219 Low Risk Medium Risk High Risk
- 21. MaineGeneral Results CY2010 Net Change among risk categories (1763 participants) Count Per Person Risk Variance in Costs Total Variance 314 moved into low risk category 788 stayed in low risk -168 moved out of medium risk category $ 2,120 $ (356,160) -146 moved out of high risk category $ 3,151 $ (460,046) TOTAL POTENTIAL SAVINGS $ (816,206)
- 22. MaineGeneral Results 2008 NetChange among risk categories (1493 participants) Count Per Person Risk Variance in Costs Total Variance 325 moved into low risk category 843 stayed in low risk -191 moved out of medium risk category $ 2,575 $ (491,825) -134 moved out of high risk category $ 3,150 $ (422,100) TOTAL POTENTIAL SAVINGS $ (913,925)
- 23. MaineGeneral Health’s Wellness Programhas saved Millions of Dollars in claims For Our Organization And For Our Employees!!
- 24. As an employee TotalHealth Benefit Cost per Employee in 2009 by employer size All U.S. employers: $8,945 Source: Mercer's National Survey of Employer-Sponsored Health Plans. Increases are averaging about 10.6% per year Year Cost with 10.6% increase Cumulative savings 2008 $8,945 2009 $9,893 -$948 2010 $10,942 -$1,997 2011 $12,102 -$3,157 2012 $13,385 -$4,440 Total -$10,542
- 25. By helping employeesto adopt healthy lifestyles as we age We Can Make A Difference
- 26. Ounce of Prevention= Pound of Cure
- 27. Just the Facts More than 95% of the average health benefit is expended on preventable existing illness. More than 70% of medical claims attributed to lifestyle factors are within an employee’s/our direct control. Each year, over $33 million in medical costs and $9 billion in lost productivity are spent due to heart disease, cancer, stroke and diabetes caused by poor diet alone *WELCOA
- 28. Personalized Approach One sizedoes not fit all One size fits one
- 29. Rule #1: Quantifyyour Health Status See your PCP Take a health risk appraisal/personal health assessment ● Be honest with yourself ● Know your risks Engage in preventative screening tests ● Know you numbers Today’s 4 leading cause of death are preventable! Persons with healthier lifestyles live 6 to 9 years longer
- 30. Rule #2: PayAttention To What You Eat And Portion Sizes Good Nutrition ● Lowers risk of heart disease, stroke, cancer, diabetes and osteoporosis ● Helps you lose and maintain a healthy weight ● Gives you healthier stronger bones ● Look and feel better about yourself Tips ● Control Portion size ● Take the fat out of fast food ● Increase fruit and veggie intake ● Count Calories ● Learn how to shop at the supermarket
- 31. Rule #3: MoveMore Inactivity damages your heart and other major organs- reducing life span Leads to diabetes Regular Activity will ● Reduce many health risks ● Boosts immunity & endorphins ● Fosters a sense of well-being Tips ● Take the stairs ● Park further away ● Schedule it in your day/week ● Find a partner
- 32. Rule #4: GetA Good Night’s Sleep 1/3 of the population is sleeping less than 6 hours per night Affects health and drains ambition, can lead to dangerous/deadly consequences Develop Good Habits ● Keep regular bed/wake times ● Develop and use regular pre-sleep routine ● Avoid working/TV in bedroom ● Turn your clock away ● Use relaxation techniques
- 33. Rule #5: QuitSmoking 46 million smokers in the US Dramatically increases many health risks including a number of different cancers Smoking cuts your life short Smoking is costly Tips: ● Set a quit date ● Quit with a friend ● Avoid situations that tempt you to light up
- 34. The Right Care Nocare, self-care, emergency care, primary care, specialty care, occupational health care, complementary care, community health program, palliative care The Right Time now, today, few days, few weeks, as scheduled, whenever, never The Right Place ●home, work, emergency department, hospital, medical office Be a better consumer: The Right Care, Right Time, Right Place
- 35. What is MedicalSelf Care? Knowing: ●When to seek emergency care ●When and how to treat yourself at home ●Your primary care provider ●When to see your provider or contact provider’s office ●What preventive care services are recommended
- 36. Know When ToSeek Emergency Care Difficulty breathing Sudden or severe pain Chest pain Sudden weakness or trouble talking Sudden confusion or change in mental status Uncontrolled bleeding Large open wounds Sudden change in vision Severe head injury Suicidal and more
- 37. 55.4% of ERvisits are for non- urgent conditions ●Headaches, sore throats, stubbed toes (CDC & Prevention, 2006) The average ER visit costs 5-6 times more than a visit at the physician's office It is estimated that 25% of physician office visits (228 million) are unnecessary ●At $60/visit, a great deal of money is spent unnecessarily (National Hospital and Ambulatory Care Surveys, US. DHHS, 2006) The Economic Case
- 38. Illnesses ● Colds, Flu,Cough ● Backache ● Constipation ● Allergies ● Headache ● Fever ● Heartburn ● Nosebleeds Injuries ● Sprains & Strains ● Cuts and bruises ● Insect bites ● Animal bites ● Burns Online: ● Mayoclinic.com more information ● Familydoctor.org >healthy living > first aid or search by topic very basic ● Uptodate.com/patients lots of detail Various printed self-care guides When and how to treat self at home
- 39. Persons who receivemore “ideal” primary care services: ●Are hospitalized less frequently ●Are readmitted to hospital less ●Use the Emergency Room less ●Have lower healthcare costs ●Have lower morbidity and mortality ●Are more satisfied with their healthcare Learn about your primary care team/office ●Other staff, services, hours, on-call coverage, etc Know your PCP!
- 40.
- 41. USPSTF: United StatesPreventive Services Task Force; http://healthfinder.gov/< myhealthfinder American College of Physicians CDC: Centers for Disease Control (especially immunizations and infectious disease) American College of Cardiology American Cancer Society Your insurance company Your PCP What preventative services are recommended?
- 42. QUESTIONS? Thank You Feel freeto contact me: [email protected] W: 207-621-7550 C: 207.242.3924
Editor's Notes
- #6 Obesity-related Illness and Disease Type II Diabetes Stroke Cardiovascular Disease High Blood Pressure High Cholesterol Pulmonary Disease Sleep Apnea Respiratory Problems Cancers Acid Reflux Disease Psychological/Social Effects Gallbladder Disease Bladder Control Problems Uric Acid Kidney Stones Gout and osteoarthritis Reproductive Issues Women – pregnancy complications, irregular menstrual cycles Men - infertility Musculoskeletal problems In past 15 yrs… Walking trips declined 40% Children walking to school dropped 60% Workers have more sedentary jobs Leisure includes more screen time
- #9 Overweight&gt;&gt;&gt; Diabetes&gt;&gt; Stroke Waterville based company- had a 42 YO employee have a stroke on the job, very visible, well liked, passed away a few days later…. Unfortunate tragedy jump-started their wellness program last year
- #16 Now let’s discuss the third element of an HPM program: optimizing. After measurement and evaluation we optimize in order to determine the most cost-effective ways to improve health -- and ultimately, productivity -- through action steps in the workplace. When faced with rising medical and pharmacy costs, some workplaces may opt for traditional solutions, such as increasing deductibles and co-pays. But these solutions do not lower total costs. They tend to simply shift expenses from one aspect of health-related costs to another. To be successful in decreasing health-related costs, we must promote a healthier workforce through health-enhancement programs. This is the heart and soul of the HPM concept – which moves from a focus on reducing health expenditures to a strategy of investing in health outcomes. Decreasing the overall health risks of the employee population through health enhancement programs leads to a healthier, more productive workforce and measurable total cost decreases.
- #18 DENISE TAKES OVER
- #22 Actual budget variance running $1.4 million.
- #23 Actual budget variance running $1.4 million.