Women's Heart Smarts: Top Ten List for a Heart Healthy Life
Corporate Wellness
1. Wellness Initiatives-
Employers are also in the “Health Business”
September 11, 2009
8:15 AM
Arvid R. “Dick” Tillmar – Health Advocate
2. Session Agenda
Why we’re here:
- Wellness Initiatives
– Employers are in the “Health Business”
- Describe the latest changes in health care reform related to wellness
- Explain how the employer can make changes that influence their bottom
line and have a positive ROI.
2
3. The biggest threats facing the American
workforce today are obesity, tobacco use, and
stress. Together, these lifestyle factors
contribute to lost productivity and absenteeism,
among other problems, but a wellness program
can work to combat all three
3
4. Benefits of Worksite Wellness Programs
Companies receive many benefits after implementing a worksite wellness program in addition to reducing costs.
They include increases in employee morale, improved employee health, reduction in workers compensation claims,
reductions in absenteeism, and increases in productivity.
Source: National Business Group on Health, 2005
6. Milestones in Contemporary America
Hostess introduces
Twinkies, 1953
Ray Kroc franchises the
McDonald Brothers, 1955
And then introduces
“supersizing,” 1993
6
25. Constraining Medical Costs
Behavior & Lifestyle: Weight Gain ’86-’06
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985 No Country
Can Fund All
the
Consequences:
Hypertension
Type 2 Diabetes
Osteoarthritis
Stroke
Coronary Heart
Gallbladder
Sleep Apnea
Respiratory
Issues
Some Cancers
Obesity Trends Among U.S. Adults (BMI>30%)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Centers for Disease Control & Prevention, 2006 Behavioral Risk Factors Surveillance System
25
26. Diabetes Trends Among Adults in the U.S.,
BRFSS 1990
No Data <4% 4%-6% 6%-8% 8%-10% >10%
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27. Diabetes Trends Among Adults in the U.S.,
BRFSS 1991-92
No Data <4% 4%-6% 6%-8% 8%-10% >10%
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28. Diabetes Trends Among Adults in the U.S.,
BRFSS 1993-94
No Data <4% 4%-6% 6%-8% 8%-10% >10%
28
29. Diabetes Trends Among Adults in the U.S.,
BRFSS 1995 - 96
No Data <4% 4%-6% 6%-8% 8%-10% >10%
29
30. Diabetes Trends Among Adults in the U.S.,
BRFSS 1997
No Data <4% 4%-6% 6%-8% 8%-10% >10%
30
31. Diabetes Trends Among Adults in the U.S.,
BRFSS 1998
No Data <4% 4%-6% 6%-8% 8%-10% >10%
31
32. Diabetes Trends Among Adults in the U.S.,
BRFSS 1999
No Data <4% 4%-6% 6%-8% 8%-10% >10%
32
33. Diabetes Trends Among Adults in the U.S.,
BRFSS 2000
No Data <4% 4%-6% 6%-8% 8%-10% >10%
33
34. Diabetes Trends Among Adults in the U.S.,
BRFSS 2001
No Data <4% 4%-6% 6%-8% 8%-10% >10%
34
35. A Weighty Toll on Employers
Obesity costs U.S.
companies $13 billion
annually3
These workers have 36%
higher medical costs than fit
employees4
35
36. The High Cost of Smoking
A smoker costs the employer $3856/yr in added
healthcare costs and lost productivity43
The overall prevalence of tobacco use is about 25% of
the population, which can be generalized to any
workplace population
Calculating the cost of smoking:
– Assume a workplace with 100 employees
– Assume 25 employees use tobacco
• Result = $96,400/yr in business borne costs
associated with smoking
– Because of this high cost, it is estimated more than
6,000 companies now refuse to hire smokers
• Alaska Airlines requires a nicotine test before
hiring people
• Kalamazoo Valley Community College
stopped hiring smokers for full-time positions
• Union Pacific won’t hire smokers
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37. The Cost of Poor Health
Lost productivity related to
absence & presenteeism
compared to Medical Costs
medical & pharmacy costs Presenteeism
25%
Lost Productivity
34%
STD/LTD/WC
5%
Absenteeism
Lost Productivity
36%
IBI Research Insights, May 2007 - Single employer example
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38. The Top 10 Most Costly Health
Conditions
Chronic disease has $1 TRILLION impact on U.S.
lost productivity each year.
Goetzl, R; JOEM 45(1) 5-14 2003 38
40. The Preventable Causes of Death
in Wisconsin
Tobacco: 8,100 +/- deaths per year in Wisconsin
Poor diet: Physical inactivity: 6,900 +/- deaths per year in Wisconsin
Microbial agents: 1,700 +/- deaths per year in Wisconsin
Alcohol: 1,600 +/- deaths per year in Wisconsin
Toxic agents: 1,000 +/- deaths per year in Wisconsin
Medical errors: 1,300 +/- deaths per year in Wisconsin
Motor Vehicles: 800 +/- deaths per year in Wisconsin
Firearms: 400 +/- deaths per year in Wisconsin
Sexual behavior: 400 +/- deaths per year in Wisconsin
Uninsurance: 300 +/- deaths per year in Wisconsin
Illicit drug use: 300 +/- deaths per year in Wisconsin
– TOTAL: 22,800
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41. Six Unhealthy Truths Tell the Story of
the Rise of Chronic Disease and It’s
Impact on Health and Health Care
Truth #1: Chronic Diseases are the #1 cause of death and disability in
the U.S.
Truth #2: Chronic diseases account for 75% of the nation’s health care
spending.
Truth #3: About two-thirds of the rise in health care spending is due to
the rise in the prevalence of treated chronic disease.
Truth #4: The doubling of obesity between 1987 and today accounts for
nearly 30% of the rise in health care spending.
Truth #5: The vast majority of cases of chronic disease could be better
prevented or managed.
Truth #6: Many Americans (five in six) are unaware of the extent to
which chronic disease harms their health – and their wallets.
www.fightchronicdisease.org
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42. Impact of Health Risk Factors on
Productivity
30%
Risk Factors
considered in 25.9%
study include:
tobacco use, 25%
BMI <18.5 or Presenteeism
>24.9; poor
diet, physical Absenteeism
M e a n L o st P r o d u c t iv it y
inactivity, lack 20%
of emotional
fulfillment, high
stress, high 15%
blood
pressure, high
cholesterol,
alcohol use, 10%
overdue
preventive 6.3%
visits, and
diabetes 5%
0.0%
0%
0 risks 1 risk 2 risks 3 risks 4 risks 5 risks 6 risks 7 risks 8 risks
Boles M, Pelletier B, Lynch W. The Relationship Between Health Risks and Work Productivity. JOEM, 2004; 46(7):737-745
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43. Imagine If Your Customers Could Shave
25% Off Rising Health Care Costs
25% savings off of Rising Health Care Costs
$10,000
h e a lth c a r e c o s t p e r
A n n u a l e m p lo y e r
$7,379 $7,832
$8,000 $6,348 $6,918
e m p lo y e e
$5,758 $1,958
$6,000 $4,604
$5,162 $1,587 $1,730 $1,845
$4,320 $1,440
$4,000 $1,080 $1,151 $1,291
$2,000
$0
1999 2000 2001 2002 2003 2004 2005 2006
Year
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44. Wellness Programs:
Definition, Legal
Implications & Essential
Elements
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45. Corporate Wellness Programs Defined
Assess the health risks of an
employee population
Include customized and
individualized programs and
interventions to address the
health and wellness needs of
workers
Track the participation, use
and effectiveness of the
program to provide
quantitative feedback to
employers
Use quantitative results to
evaluate the impact of
wellness initiatives
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46. Detailed List of Program
Components
The employer’s commitment to improve worker health and manage
health plans, sick leave, workers’ compensation, disability and
productivity costs
Awareness – An annual Health Assessment is the key in driving
awareness and beginning participation in the program
– Education – Content is packaged in engaging, easy to understand
tools to make learning fun and tailored to adult learning styles
– Action – A variety of activities help members practice and ultimately
adopt healthy behaviors and earn points towards incentives
– Support – Ongoing communication and progress tracking are key
to long-term employee engagement
Telephonic or face-to-face lifestyle coaching for those with risks
Incentives to motivate participation and reward improved outcomes
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47. Detailed List of Program
Components
Range of resources to help individuals change behaviors to
improve health
Structured opportunities to practice new behaviors and habits
Integration of wellness throughout organization
Organizational support for wellness; address environmental and
cultural barriers
Annual evaluation to refine program and improve it’s
effectiveness
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48. Research Says: Assessments
Help Moderate Health Care Costs
Multiple studies link health assessments with cost moderation8,
9, 10
University of Michigan research: As assessment scores
increase, health care costs decrease11
GM wellness program: Assessments linked with reduction of
more than 185,000 specific health risks among GM workers12
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49. Making Sure Your Client’s
Program is Compliant
What rules regulate wellness
programs?
HIPAA Nondiscrimination Rule
HIPAA Privacy and Security
Rules
Americans With Disabilities Act
(ADA)
Age Discrimination in
Employment Act (ADEA)
COBRA
Federal and State tax laws
State lifestyle and
nondiscrimination laws
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50. HIPAA Nondiscrimination Rules
Prohibit an employer from charging different premiums or
contributions based on an employee’s health factors (health
status, medical condition, claims, disability)
Prohibit different coinsurance, deductibles and co-payments
based on an employee’s health factors unless done pursuant to
a wellness program that meets the requirements set forth in the
Rule…
– …However, a wellness program based on participation
rather than satisfaction of a standard, result or outcome,
does not violate HIPAA and is not subject to the
requirements in the Rule
– …For example, a blood screening program that is not
based on outcomes: waiving copays for well-baby visits or
prenatal care
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52. Numerous Studies Document
Strong ROI
A multitude of studies show ROI averages of $3 for every $1
invested14
One recent study had the return as high as 10 to 115
Companies must be patient. “Worksites typically don’t realize
returns until about three years into the program. If an
organization is willing to wait two or three years, it will be
capable of achieving this magnitude (3 to 1) of ROI.”16
A review of 32 studies found claims costs were reduced by
27.8%, physician visits by 16.5%, hospital admissions by
62.5%, disability costs by 34.4% and incidence of injury by
24.7%17
52
53. Wellness Works, According to ROI
Studies
From a review of 73 published studies of worksite wellness
programs18
– Average $3.50-to-$1 savings-to-cost ratio in reduced
absenteeism and health care costs
From a meta-review of 42 published studies of worksite
wellness programs19
– Average 28% reduction in sick leave absenteeism
– Average 26% reduction in health care costs
– Average 30% reduction in workers’ compensation and
disability management claims costs
– Average $5.93-to-$1 savings-to-cost ratio
A comprehensive health management program at Citibank20
– $4.56-$4.73-to-$1 savings-to-cost ration in reduced total
health care costs
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55. Defining Health Risks & Risk Levels
Health Risk Measure High Risk Criteria
Alcohol > 14 drinks per week
Blood Pressure Systolic >139 mmHG/Diastolic >89 mmHG
Body Weight BMI =/>27.5
Cholesterol >239 mg/dl
Existing Medical Problem Heart, Cancer, Diabetes, Stroke
HDL <335 mg/dl
Illness Days >5 days last yr
Life Satisfaction Partly or not satisfied
Perception of Health Fair or Poor
Physical Activity <1 time per week
Safety Belt Usage Using safety belts <100% of time
Smoking Current smoker
Stress High
Overall Risk Levels
Low Risk 0 to 2 high risks
Medium Risk 3 to 4 high risks
High Risk 5 or more high risks
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56. ($)
H
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$0
ig 35
h -4
R 4
isk
45 $4,530
-5
4
55 $5,813
-6
4
Health Risk
$7,123
M
ed
iu
m 35
-4
R 4
isk
$2,667
45
-5
4
55 $3,364
-6
4
$4,718
N
on
- Pa
r tic 35
ip -4
an 4
Age Group
t4 $2,110
5-
54
55 $2,912
-6
4
$3,894
Linking higher Costs With Higher
Lo
w 35
-4
R 4
isk
$1,523
45
-5
4
55 $2,081
-6
4
$2,941
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57. Get Well or Pay Not To
Consumers may be able to improve their health and bottom line by
participating in company sponsored wellness programs.
More employers are offering cash, discounts and even lower health
insurance premiums to entice workers to participate in a variety of
programs.
Starting next year, employees could have further incentives to get healthy
as more companies add penalties to insurance premiums for workers who
don’t partake.
“It’s an opportunity to get cash for doing what’s right for you.
Despite cutbacks amid the recession, 58% of large U.S. companies now
offer lifestyle-improvement programs, up from 43% in 2007, according to a
Watson Wyatt Study. And 56% provide health coaches, compared with
44% in 2007. Health-risk appraisals are offered at 80% of companies, up
from 72% in 2007.
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58. Discounts and Freebies
Employees may be able to get $200 to $300 for participating in health-risk
appraisals, smoking-cessation, weight management and preventive care
classes.
Other offerings include heavily discounted weight loss programs and free or
discounted gym memberships. At some companies, employees who
participate are rewarded with gift cards or lower insurance premiums.
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59. Wellness Education/Communication
Most survey respondents offered at least one type of wellness
education and communication program component.
Program Component Percentage of Respondents
Online Communications 93%
Print Communications 87%
Audio/Visual 27%
Self-Care Guide 27%
Pre-Natal Program 67%
In tomorrows’ Advisor, we’ll cover survey responses on HRAs, disease
management, and smoking cessation, and we’ll take a look at a unique
guide that will help you in setting up and administering your wellness
program.
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