Aphorisms by

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Aphorisms by
Paul B. Handel M.D. Vice President, Chief Medical
Officer
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Prevalence of Behavioral Risk Factors in the US
Workforce
Source NHIS 2005 (alcohol, smoking)
NHANES 1999-2002 (exercise)
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Causes of Death, United States 2000
Source Mokdad A, Marks JS, Stroup DE, Gerberding
JL. Actual causes of death in the United States.
JAMA 2004 291(10)1238-1245. Correction
published JAMA 2005 293(3) 293-294.
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Underlying Causes of Death, U.S. 2000
Source Mokdad A, Marks JS, Stroup DE, Gerberding
JL. Actual causes of death in the United States.
JAMA 2004 291(10)1238-1245. Correction
published JAMA 2005 293(3) 293-294.
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General Health Statistics
Economic Health and Burden of Chronic Disease
a2000, b2002, c2003. Categories may
overlap. Direct Costs Costs that can be traced
to or identified with a specific product or
procedure. Indirect Costs Costs that cannot
specifically be traced to an individual service
or procedure. Source Centers for Disease
Control and Prevention, 2004d
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The Rising Spiral of Health-Care Costs

• Healthcare premiums are growing more than 3 times
  faster than workers wages and 2.5 times faster
  than the inflation rate
• State of Texas employee health care costs up 53
  since 2000
• Healthcare cost increases (national)
• 2005 9.2
• 2004 11.2
• 2003 13.9

Source Kaiser Foundation Survey and Employee
Retirement System/LBB
2005 Kaiser Foundation Survey
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Whats Driving Higher Health-Care Costs?

• The number of obese adults has doubled since the
  1970s
• Research shows poor diet lack of exercise are
  major drivers of health-care cost increases
• At least 50 of your organizations health-care
  costs are driven by your employees
  lifestyle-related behaviors
• Mental health (or, rather, a lack thereof)
  accounts for almost 50 of ER visits

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50 of All Cancer DeathsCould Be Avoided By

• Stopping smoking
• Eating healthy

American Cancer Society WSJ April 6,2006
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• 1 decrease in death due to cancer equals
• 500 billion in value

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Nicotine addiction from smoking is a chronic,
relapsing medical condition not just a bad
habit. FACT Tobacco use is the leading cause
of preventable death in the United States.
FACT About 8.6 million Americans will suffer
from at least one illness caused by tobacco this
year.FACT Excess medical expenses due to
smoking and smoking-related illness cost
employers 1,850 per smoking employee in 1999
(adjusted for 2002 dollars).
The Bad Habit Myth
Source National Business Group on Health, New
Insights for Employers on the Value of Smoking
Cessation and Practical Guidance for Action,
2007, www.nbgh.org
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Healthy Minds, Healthy Bodies

• Employees with untreated mental illness have a 50
  percent increase in time lost from work and 5.6
  hours per week in lost productivity.
• Total economic cost of mental illness in Texas
  was 16.6 billion in 2003 more than two-thirds
  of that cost stemming from lost productivity and
  absenteeism.
• Employees who suffer with undiagnosed depression
  alone will incur incremental medical costs from
  2,000 to 3,000 per year more than other
  employees.

Source Mental Health America of Texas, Mentally
Healthy Employees Benefit the Workforce,
www.mhatexas.org
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Number of Obese Adults in Texas by Age Group,
2000 to 2040
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Costs of Obesity to US Business

• 8 Billion Healthcare costs
• 2.4 Billion Paid sick leave
• 1.8 Billion Life Insurance
• 1 Billion Disability

Department of HHS, 2003
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Hidden Costs of Obesity toUS Business

• 30 Million lost work days
• 239 Million restricted activity days
• 90 Million bed days
• 63 Million physician visits

Obesity Research, 1998
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An ounce of health is worth a pound
(actually,1.75 pounds) of healthcare!
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Questions Every Employer Must Answer

• How much are you spending on health insurance
  today?
• How much have your costs increased over the past
  5 years?
• What are the projected increases over the next 5
  years?
• What are you going to do to reverse the trend
  line of ever-increasing costs?

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The Healthcare Equation is Out of Balance

• Supply
• Improving Quality of Care
• Improving Technology
• Improving Meds
• Increasing Workforce -
• Increasing Access -

• Demand
• Older
• Heavier
• More Sedentary
• Un Underinsured
• Health Illiterate

Demand Reduction Is Imperative
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Balancing the Healthcare Equation

• Supply
• Improving Quality of Care
• Improving Technology
• Improving Meds
• Increasing Workforce
• Increasing Access

• Health Promotion
• More health literacy
• Healthier lifestyle
• Access to care

Demand Reduction Is Imperative
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Why Invest in Worksite Wellness?

• Most employers currently spend less than 5 of
  health-care costs on prevention screening
• The average cost-benefit ratio has increased
  from 13 for earlier programs to 16 today
• The average reduction in health-care costs, sick
  leave, disability costs and workers compensation
  is more than 25 for well-designed programs

Chapman, Meta-Evaluation of Worksite Health
Promotion Economic Return Studies, 2005 update,
American Journal of Health Promotion, July?August
2005
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Published Research Supports Quantifiable ROI
Rates
Return on Investment (Per dollar ROI for
lifestyle programs)

• Some employers and brokersunfamiliar with ROI
  researchexpressed that one of the impediments to
  adding affinity/discount programs was a reported
  lack of ROI capability or the ability to see an
  immediate benefit
• Without a method for calculating ROI, employers
  report that affinity/discount programs just add
  another operating cost
• In fact, the preponderance of relevant literature
  speaks to positive ROI for health promotion
  programs
• Most experts estimate that it takes 3 years for
  ROI to begin, with nearly unanimous reports of
  positive ROI
• The T.E. Brennan Companys ROI assessment serves
  as an example of the published research which
  quantifies the impact of wellness programs

Source Healthcare Costs Worry Employees, Oct.
31, 2005, Messenger-Inquirer Employee Health
Promotion Programs What is the Return on
Investment?, Wisconsin Public Health Health
Policy Institute, Sept. 2005 HR Magazine.
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Our resources would be better directed towards
improving efforts to prevent illness and manage
chronic ailments like diabetes and heart disease.

• David Goodman, MD
• Health Affairs, March/April, 2006

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Readiness to Change

• Habit is habit, and notto be flung out of
  thewindow, but coaxed downstairsa step at a
  time.
• Mark Twain