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THE PRESENTATION

THE PRESENTATION. Preventive Medicine – The Best DM Strategy Frederic S. Goldstein President. THE AGENDA. The Situation What is Preventive Medicine The Potential Impact of Comprehensive Prevention The Future/Thoughts/Issues. Overview. THE SITUATION.

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THE PRESENTATION

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  1. THE PRESENTATION Preventive Medicine – The Best DM Strategy Frederic S. Goldstein President

  2. THE AGENDA • The Situation • What is Preventive Medicine • The Potential Impact of Comprehensive Prevention • The Future/Thoughts/Issues Overview

  3. THE SITUATION • Total Medical Spend: $2.3 trillion a year • Productivity cost for those with chronic conditions: • 4x greater than medical & pharmacy costs* • Each employee: 8 days of productivity lost annually; • employer cost is $2,598 yr* • 133 million people with expensive chronic illnesses Unsustainable system: • Loeppke, 2008 ,International Journal of • Workplace Health Management

  4. Of every dollar spent… …75 cents went towards treating patients with one or more chronic diseases THE SITUATION Patients with chronic diseases account for 75% of the nation’s health care spending During 2005, the U.S. spent almost $2 trillion on health care In public programs, treatment of chronic diseases constitute an even higher portion of spending: More than96 centsin Medicare… …and83 centsin Medicaid “The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases.” -- Centers for Disease Control and Prevention 4 4

  5. THE SITUATION Two-thirds of the increase in health care spending is due to increased prevalence of treated chronic disease Level 0f health spending among the noninstitutionalized U.S. population, 1987–2000 $627.9 (in billions of nominal dollars) = Increase attributable to rise in prevalence of treated chronic disease ~$211 billion $313.5 Years 5 5

  6. THE SITUATION Unsustainablesystem: • Health premium costs are expected to increase • another 9.9%-10.6% over the next 12 months* • By 2023, a 42% increase in cases of 7 chronic diseases… another $4.2 trillion** • By 2040, about 160 million Americans will have chronic conditions… nearly doubling medical costs* * PricewaterhouseCoopers, Aon ** Milken Institute Research, “An Unhealthy America”

  7. Our current system doesn’twork: THE SITUATION • System set up to treat illness instead prevent it • More than half of Americans have at least one • chronic disease* • 75% of all health care costs stem from, chronic health conditions such as type 2 diabetes, hypertension and obesity* Milken Institute Research, “An Unhealthy America”

  8. Our current system doesn’twork: THE SITUATION • Fragmented and superficial programs don’t engage the eligible population: 7-12% is the norm • Unsuccessful in changing behavior • No meaningful incentive for employee to participate Milken Institute Research, “An Unhealthy America”

  9. What is Prevention: WHAT IS PREVENTION • Primary Prevention • Secondary Prevention • Tertiary Prevention

  10. Primary Prevention: WHAT IS PREVENTION •  generally refers to the elimination of risk factors for disease in asymptomatic persons.

  11. Secondary Prevention: WHAT IS PREVENTION •   is defined as the early detection and treatment of disease

  12. Tertiary Prevention: WHAT IS PREVENTION •  consists of measures to reduce impairment, disability, and suffering in people with existing disease.

  13. WHAT CAN WE DO ABOUT IT • One solution in sight: • Milken Institute study finds • Prevention (Primary) • Early detection (Secondary) • Chronic condition management • (Tertiary) could save U.S. $1 trillion annually… “An Unhealthy America” 2007 study Nonprofit, nonpartisan economic think tank

  14. PREVENTIVE MEDICINE • We have known this since Ben Franklin coined “An ounce of prevention is worth a pound of cure.” • Stop the problems before they occur • Reverse the Trend It’s Just Logical

  15. THE FUTURE • Legislative • Engagement/Incentives • Incentives • Grand Programs The Future

  16. FUTURE AREAS • Health Care Reform • Using the Tax code • Funding programs Legislative

  17. FUTURE AREAS • Engagement levels must go much higher • Carrots and Sticks • High Deductible Health Plans Engagement/Incentives

  18. FUTURE AREAS • Comprehensive Community/Statewide/National • All Players • All Payers Grand Programs

  19. FUTURE AREAS • Can it work? • But people will live longer/cost more! • Genetic testing????? • Can we afford to not do it? Some Issues/Concerns

  20. CAN IT WORK • Milken • The Value of Health and the Power of Prevention Ronald Loeppke, MD* Studies are now documenting success * International Journal of Workplace Health Management Vol. 1 No. 2, 2008 pp. 95-108

  21. THE LIVING LONGER ARGUMENT • Compression of Morbidity, James F Fries But people are living longer and will cost more

  22. GENETIC TESTING • More data, but • is it valid • is it actionable • Incorporation into programs How will genetic testing affect prevention

  23. CAN WE AFFORD NOT TO DO IT • We have a growing incidence of chronic diseases • Can we turn back the clock • What if we don’t Look at how we got here

  24. FUTURE AREAS • At the end of the day, its all about changing one person’s behavior, we often forget that and we create programs but nobody comes.. The Big Caveat

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