Texas Coalition for Worksite Wellness CEO Summit November 15, 2006 Worksite Wellness: A Strategy for

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Texas Coalition for Worksite WellnessCEO
SummitNovember 15, 2006Worksite Wellness A
Strategy for Lower Health-Care Costs More
Productive EmployeesEduardo J. Sanchez, MD,
MPHDirector, Institute for Health
PolicyUniversity of Texas School of Public
HealthVisiting ProfessorUT LBJ School of Public
Affairs
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TIME November 6, 2006

• Companies trying to cope with rising medical
  costs are asking their employees to share the
  pain
• Offering more preventive programs to keep workers
  healthy
• Companies are seeing the link between good health
  and productivity

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• The Burden of Chronic Diseases, Rising Health
  Care Costs

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Growth in National Health Expenditures 19802015
from 1,000 to 13,000
7,110 (2006)
Per Capita Costs
Levit et al. Health Affairs 200221172181.

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The Rising Spiral of Health-Care Costs

• State of Texas employee health care costs up 53
  since 2000
• Health care now consumes 30 of total state
  budgets
• Medicaid alone accounts for 20

National Governor's Association Center for Best
Practices
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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
• Percentage of employers providing health benefits
• 2000 69
• 2005 60
• Healthcare cost increases (national)
• 2005 9.2
• 2004 11.2
• 2003 13.9

2005 Kaiser Foundation Survey
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Employer-SponsoredInsurance Coverage

• 61 have insurance through their employer in the
  United States
• In Texas, only 53 have insurance through their
  employer
• 43 of companies with 50 or less employees
  provide insurance nationally
• In Texas, only 31 of companies with 50 or less
  employees provide insurance

Texas Hospital Association, April 2006
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Percent Uninsured in Texas and US3 Year Average
2001-2003
Source Texas Comptroller of Public Accounts,
2005.
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Spiral of Health Cost Increases withHigh Numbers
of Uninsured
Uninsured utilize higher than necessary levels of
care
Higher uncompensated costs
More uninsured
More employers drop coverage because of high
premiums
Increased charges to paying customers
Insurance companies Raise premiums for insured
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These Are The 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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U.S. vs. Other Advanced Nations (2002)
Rank by Percent of GDP
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The Price (1.79 Trillion) is Not Right

• The U.S. Ranks
• Health Care Spending 1st
• Life Expectancy 28th
• In comparison of 6 similar countries the U.S.
  ranked last in
• Patient safety, efficiency, equity, and patient
  centeredness

Australia, Canada, Germany, New Zealand, U.
Kingdom
Source The World Health Report 2003, Total
Population at Birth. Commonwealth Fund studies,
2004, 2005
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Causes of Death in United States 2002
Actual Causes of Death2
Leading Causes of Death1
Tobacco
Heart Disease
Poor diet/lack of exercise3
Cancer
Alcohol
Stroke
Infectious agents
Chronic lower respiratory disease
112,000
Pollutants/toxins
Unintentional Injuries
Firearms
Diabetes
Sexual behavior
Pneumonia/influenza
Motor vehicles
Alzheimers disease
Illicit drug use
Kidney Disease
Percentage (of all deaths)
Percentage (of all deaths)
Sources 1 National Vital Statistics Reports,
Vol. 53, No. 15, February 28, 2005. 2 Adapted
from McGinnis Foege, updated by Mokdad et. al.,
2000. 3 JAMA, April 20, 2005Vol 293, No. 15, pg
1861.
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8 million seniors by 2040?
Key Texas Demographics
3rd youngest population . . . . . . but 5th
highest number of elderly Presently, 1 in 10
over 65 . . . . . . by 2040, 1 in 6
Aging
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Estimated Per Capita Health Expenditures, by Age
and Sex, 1995
Source From Baby boom to elder boom Providing
Health Care for an Aging Population. Washington,
DC Watson Wyatt Worldwide, 1996.
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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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Two Disturbing Trends
Obesity CDC NHANES Expenditures Centers for
Medicare Medicaid Services, Health 2004
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Obesity Trends Among U.S. Adults
1991
1996
2004
No Data lt10 1014
1519 2024 25
BRFSS, 1991, 1996, 2004
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Overweight Youth in TexasCompared to National
Data

Healthy People 2010 Goal
Source Hoelscher et al., 2004 Ogden et al.,
2006 SPAN, 2004-2005
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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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The Healthcare Equation is Out of Balance

• 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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Increased Life Expectancy
Increased years due to public health measures 25
Increased years due to medical care advances 5
Source Centers for Disease Control and
Prevention (CDC).
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• Worksite Wellness A Winning Strategy For
  Employers

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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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Dollars Saved for Every 1 Invested
6.15
6.00
5.78
5.52
3.90
3.40
3.15
3.00
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Should Health Insurance Work Like Car Insurance?

• Good drivers pay less because they represent
  lesser risk
• Should employers pay less when their employees
  are more healthy?
• And should individual employees who take steps to
  reduce their health risk factors pay lower
  premiums deductibles?

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The First Rule of Success for Worksite Wellness
Programs

• Executive Level Support Success starts at the
  top.
• Only leaders can create a culture of health
  within their organization.
• They must lead by example.

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The 2nd Rule of Success for Worksite Wellness
Programs

• Frontline level ownership
• While success starts at the top, employees must
  feel a sense of ownership of the worksite
  wellness program.
• A plan imposed from on high will not take hold.

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Steps to Start a Worksite Wellness Program
Start now Keep it interesting Build wellness into
your culture
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DSHS Worksite Wellness ProgramKickoff October
17, 2005

• Health knowledge (assessments), healthy eating,
  physical activity and stress reduction are
  programs 4 components
• 3450 Health Assessments to date
• 30 participation

Austin-based pilot project
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Building Healthy TexansA Worksite Wellness Guide

• Why Worksite Wellness makes sense
• Essential steps to start your own program
• Success Stories

http//www.dshs.state.tx.us/wellness/wwt.shtm
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Success Stories

• City of Ft. Worth
• American State Bank
• Bell Helicopter
• Midland ISD

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WellnessEmployer Expectations
Why Employers Offer Wellness Programs
Control health care costs
Improve productivity
Decrease absenteeism
Happier healthier employees
Reduce workers Comp expenses
Enhance morale
Increase Employee retention
Happier healthier families
Supports recruitment efforts
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Worksite Wellness Its About Healthy ChoicesIt
is PUBLIC HEALTH in the workplace

• Unhealthy choices and unhealthy environments are
  driving the rates of chronic disease
• Unhealthy choices and unhealthy environments are
  making health care less affordable for all
• Workplaces can reinforce healthy choices by
  creating healthier environments

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Worksite Wellness The Verdict is InIt Works

• Every new worksite wellness program needs a
  champion
• Are you the champion?