INDIVIDUAL HEALTHCARE MANAGEMENT: How to Help Employees Own Their Health

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1 INDIVIDUAL HEALTHCARE MANAGEMENT: How to Help Employees Own Their Health Michelle A. Gourdine, M.D. CEO and Principal Consultant Michelle Gourdine & Associates LLC A Healthcare Consulting Firm

2 OBJECTIVES Understand how employee health affects productivity and costs. Describe effective ways to support employee health decisions. Name the two key components of workplace wellness programs. Identify three key ways employers can increase employee ownership of their health.

3 Impact of Poor Health in the US Total healthcare spending in US - $2.2T 75% healthcare costs spent on chronic disease Diabetes>$170B High blood pressure>$66b Heart disease >$250B Cancer>&190B Obesity >$117B Stroke>$65B (Source: US DHHS Centers for Disease Control and Prevention)

4 The Real Cost of Unhealthy Employees Unhealthy workers cost businesses $153B in lost productivity. Only 1 in 7 employees is of normal weight with no chronic conditions 30% are overweight or obese with 1 to 2 chronic conditions. 1 sick day a month $32B in losses. Those with 3 or more chronic conditions 42 sick days a year $81B in losses (Source: 2011 Gallup Poll)

5 The Real Cost of Unhealthy Employees Costs include: Medical care costs Disability benefits Cost of hiring and training new employees Added stress on remaining employees

6 The Real Cost of Unhealthy Employees Most common chronic diseases of employees High blood pressure Diabetes Heart attack Back pain Asthma Depression Arthritis

7 The Promise of Workplace Wellness Programs Improved employee health Lower healthcare costs Improved employee productivity Reduced absenteeism

8 2 Key Components of Workplace Wellness Programs Lifestyle management Reduces health risks Improves well-being Prevents health problems Disease management Helps employees who already have a chronic condition take better care of themselves Educates employees about disease self-care and treatment options Medication reminders

9 Are Workplace Wellness Programs the Answer? To be effective, programs must show: High levels of employee participation employees must own it! Meaningful results Reduced disease risk Return on investment, i.e. healthcare cost savings

10 EMPLOYEE OWNERSHIP

11 If You Build It, Will They Come? For programs to be beneficial, employee participation is essential. Participation = Ownership Keys to participation Practical decision support that helps employees make informed decisions User-friendly Demographically-appropriate Culturally and linguistically-appropriate Incentives

12 Practical Decision Support Aids that help consumers make informed decisions about their health and healthcare Provide and manage information Present trade-offs involved in various possible choices For aids to be effective, they must be: Disseminated Promoted Adopted (Source: RAND corporation;

13 Practical Decision Support Brochures Education sessions Help lines Websites Apps Books

14 Practical Decision Support What Employees Want to Know Which health plan should I choose? Which provider is best? Which treatment should I receive? Which screenings do I need and when? How do I start living a healthier lifestyle?

15

16

17 User-Friendly Assess learning styles by looking at demographics of covered population Children? Teens? Elderly? Young professionals may prefer internet-based information Others may not have access to home computer or may not be computer savvy. For them, printed materials. Newsletters Check stuffers Bulletin boards Ask departments that use these methods which have worked best

18 User-Friendly Assess demographics of covered population to tailor resources based on: Language Cultural beliefs and practices Health literacy level Most common conditions Most frequently prescribed meds

19 User-Friendly Education PUSH information rather than require users to pull data Makes mobile technology addictive Users check their phones up to 150 times a day in search of new information or connections As more new and interesting information is automatically sent ( pushed ) to patients, their adherence and health outcomes improve. Engagement drops when user is expected to go in search of information (Source: Center for Connected Health)

20 User-Friendly Education Giving patients access to information through a portal is not the same as actively engaging them. Consumer adoption of patient portals is low (around 10%). Portals and many other health apps require patients to pull information.

21 User-Friendly Education Appointment reminders Medication reminders Alerts regarding availability of test results Educational information for better disease management and self care (Source: Center for Connected Health)

22 Incentives Credits Premium Discounts 100% coverage of preventive services

23 Incentives Health risk assessment Healthy living education Diabetes prevention Healthy heart Healthy diet Living smoke free Weight loss Stress management Physical activity Disease management education Taking control of your chronic disease through healthy living, adherence to meds, etc.

24 Incentives Routine preventive care Well baby Well woman Prenatal care Mammogram Immunizations (adult and child) Eye exams

25 Incentives 100% coverage for preventive services Benefits may include preventive services, Recent surveys show that at best 1 in 5 employees actually use them Which preventive services are most effective? United States Preventive Services Task Force, rated A or B The Community Guide

26 USPSTF App for Recommended Preventive Services AHRQ epss

27

28 MEANINGFUL RESULTS

29 2 Key Components of Workplace Wellness Programs Lifestyle management Reduces health risks Improves well-being Prevents health problems Disease management Helps employees who already have a chronic condition take better care of themselves Educates employees about disease self-care and treatment options Medication reminders

30 Meaningful Results Reduced Disease Risk LIFESTYLE MANAGEMENT Weight loss Smoking cessation Increased physical activity Reduced absenteeism DISEASE MANAGEMENT Better self-care 29% drop in hospital admissions (Source: Health Aff January 2014, Vol 33 (1); )

31 Meaningful Results Reduced Costs LIFESTYLE MANAGEMENT Saved $6 per member per month DISEASE MANAGEMENT Saved $3.78 for every $1 invested Saved $136 per member per month, $1632 annually (Source: Health Aff January 2014, Vol 33 (1); )

32 Meaningful Results Benefits of Integration Disease management PLUS lifestyle management saved $260 per member per month with a 66% drop in hospital admissions (Source: Health Aff January 2014, Vol 33 (1); )

33 Meaningful Results Benefits of disease management programs are realized in the shorterterm. Avoiding heart attack in employees with heart disease. Avoiding amputation in employees with diabetes. Benefits of lifestyle management are realized in the longer-term. Improved eating habits may prevent diabetes. Smoking prevention/cessation may prevent cancer. (Source: Health Aff January 2014, Vol 33 (1); )

34 SUMMARY - How to Help Employees Own Their Health Practical education and decision support Print vs. web-based Culturally and linguistically appropriate Literacy level Focused on the most common conditions Interactive Push information to maximize engagement

35 SUMMARY - How to Help Employees Own Their Health Provide incentives for adopting healthy lifestyles Target disease management to employees with chronic disease Integrate disease management and lifestyle management for maximal financial return

36 Resources The Community Guide, The United States Preventive Services Task Force, Health Affairs January 2014, Vol 33 (1); /RB9744/RAND_RB9744.pdf What Motivates Wellness Program Participation?

37 RESOURCES

38 Creating a healthcare system in which ALL people benefit equally. Michelle Gourdine and Associates LLC

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