1 / 64

The Rewards of Wellness

The Rewards of Wellness. Gaston Regional Chamber October 3, 2008. Wellness questions to start with…. How do you define Wellness? Do you believe Wellness works? Do you believe Wellness works for: Large employers Small Group . Wellness questions to start with….

omer
Download Presentation

The Rewards of Wellness

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Rewards of Wellness Gaston Regional Chamber October 3, 2008

  2. Wellness questions to start with… • How do you define Wellness? • Do you believe Wellness works? • Do you believe Wellness works for: • Large employers • Small Group

  3. Wellness questions to start with… • Who pays for Sickness, in the absence of Wellness? • What are the obstacles? • Do you believe that Wellness can be effective?

  4. What Does This Chart Tell Us? Average Cost Per Employee vs. Consumer Price Index SOURCE: [Add source here]

  5. Traditional Drivers • The skyrocketing price of health benefits: Medical costs for employers have outpaced inflation in all but four of the past 20 years. • Among the culprits: expensive technology, less stringent HMO cost management, and rapidly rising drug costs. SOURCE: Mercer National Survey Of Employer-sponsored Health Plans 2003; Bureau Of Labor Statistics

  6. What Are the Real Culprits? • Unhealthy Lifestyles • Demographics • Lack of Personal Responsibility

  7. Sick to Healthy Health Care Spending

  8. Sick to Healthy 3/4 of spending is due to diseases caused by unhealthy lifestyles Health Care Spending

  9. Unhealthy Lifestyles Blood Pressure Smoking Overweight Exercise Diet 1 out of 4adults smoke 1 out of 3 has high blood pressure 2 out of 3are overweight or obese 3 out of 4lack proper exercise 4 out of 5have poor diets SOURCE: [Add source here]

  10. Unhealthy Lifestyles Blood Pressure Smoking Overweight Exercise Diet STRESS 1 out of 4adults smoke 1 out of 3 has high blood pressure 2 out of 3are overweight or obese 3 out of 4lack proper exercise 4 out of 5have poor diets SOURCE: [Add source here]

  11. Personal Responsibility % of Selected Chronic Diseases That Are Likely Lifestyle Related and Avoidable SOURCE: “The Culprit & The Cure, Why lifestyle is the culprit behind America’s poor health.” Steven G. Aldana, PH.D

  12. Cost per Risk Factor Annual Medical Cost SOURCE: Employee Benefit News; May 1997

  13. The Chronic Impact • Average number of lost annual work days per person/condition • Depression – 25.6 days • Cancer – 16.9 days • Respiratory Disorders – 14.7 days • Asthma – 12 days • Migraines – 10.7 days • Allergies – 8.2 days • Heart Disease – 6.8 days • Arthritis – 5.9 days • Diabetes – 2 days • Hypertension – 1 day Chronic disease has $1 TRILLION impact on U.S. lost productivity each year.

  14. Prevention • Preventable illness makes up approximately 80% percent of the burden of illness and 90% of all healthcare costs • Is “Prevention” the Solution? • Prevention vs. Wellness • www.preventdisease.com

  15. What is Wellness? • Wellness is a process involving the integration of many dimensions – social, physical, emotional, environmental, spiritual, vocational, intellectual – that enhance the health and well-being of any individual. The process is designed to help a person make choices that result in positive lifestyle changes; thus, improving individual and community health and well-being. DEFINITION: Ball Brothers Foundation.)

  16. What is a Wellness Program? • Corporate, or workplace Wellness can be defined as… “An organized program in the worksite that is intended to assist employees and their family members in making voluntary behavior changes that reduce their health and injury risks, improve their health consumer skills and enhance their individual productivity and well-being.”

  17. Does Wellness Really Work? • A meta-review of 42 published studies of worksite health promotion programs shows: • Average 28% reduction in sick leave absenteeism • Average 26% reduction in health costs • Average 30% reduction in workers’ compensation and disability management claims costs • Average $5.93-to-$1 savings-to-cost ratio

  18. A 40-year-old who quits and puts the savings into a 401(k) could save $220,000by age 70 A smoker costs $3,856 a year in added healthcare costs and lost productivity to their employer The High Cost of Smoking Employees Employers SOURCE: National Business Group on Health

  19. What Does Smoking Cost Your Company? Calculating the Cost of Smoking: Number of employees x 0.25 Tobacco use is about 25% of the total population. x $3,856 per year Companies spend $3,856 per smoker per year in direct medical costs and lost productivity. = Estimated cost per year in excess medical expenditures and lost productivity

  20. What Does Smoking Cost Your Company? Example: 100 employees x 0.25 (25 employees who use tobacco) x $3,856 per year = $96,625 cost per year in business-borne costs associated with smoking

  21. A 112% Increase in Stress Rx • In 2005, 357 million new prescriptions were written for psychotherapeutic drugs such as Ativan, Klonipin, Paxil, Prozac, Serzone, Zoloft, Xanax and Wellbutrin • Now the most commonly prescribed medications

  22. Dementia • Those who most often are anxious or depressed were 40 times more likely to develop mild cognitive impairment, a form of memory loss that is often a transitional stage between normal aging and dementia. • The latest research suggests that chronic stress may harm parts of the brain responsible for responding to stress.

  23. Overweight & Obesity Rates 1999-2004 • 67% of adults – 71% of Men • Stabilized for women- 62%. Still higher obesity overall • 33% of teens overweight • 17% of teens obese, up from 15% • BMI is no longer best indicator – waist size is more accurate for disease SOURCE: UC Berkeley Wellness newsletter

  24. Obesity Trends* Among U.S. Adults -- 19931 No Data <10% 10%–14% 15%–19% *BMI ≥30, or ~ 30 lbs overweight for 5’4” person

  25. Obesity Trends* Among U.S. Adults -- 20052 *BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  26. Unhealthy Demographics % of Americans That Are Overweight or Obese SOURCE: “The Culprit & The Cure, Why lifestyle is the culprit behind America’s poor health.” Steven G. Aldana, PH.D

  27. Health Risks Type-2 Diabetes 300%Increased Risk High Cholesterol 200%Increased Risk Heart Disease 200%Increased Risk JointArthritis 200%Increased Risk High Blood Pressure 200%Increased Risk

  28. Cardiovascular CVD Hypertension Congestive Heart Failure Pulmonary Sleep apnea Asthma Endocrine Type 2 diabetes Metabolic Syndrome Cholesterol disorders Infertility Increased pressure in the brain Headache, ear or vision problems (not due to tumor) Gastrointestinal Gastric reflux Gallbladder disease Nonalcoholic fatty liver Musculoskeletal Osteoarthritis Gout DVT & Pulmonary Embolus Certain cancers Breast Prostate Colon Macular Degeneration Obesity Increases Risk for Disease in Virtually Every Organ System SOURCE: A. McDermott, Cal Poly, San Luis Obispo

  29. A Weighty Issue A Duke University Medical Center analysis found that obese workers filed: 2xworkers' compensation claims 7xhigher medical costs from those claims 13more days of work lost from work injury or work illness(than non-obese workers)

  30. Epidemic • But far more dramatic was the increase of spending on diabetes drugs, which jumped 14.5 percent during the year. • Diabetes-related spending is projected to rise between 60 and 80 percent by 2009. • “The potential future incidence of diabetes based on obesity statistics is staggering,” the report stated.

  31. Definition of Obesity • What is it? • How do Obese people define it? • How do Obese people view themselves? • Morbid Obesity • We need new terms

  32. The Cost of Obesity Obesity Surgeries RYGB Patients RYGB Surgeries 600% Increase 200% Increase 36% Increase Hospitalization SOURCE: WebMD

  33. Number of Bariatric Surgeries in the US SOURCE: American Society for Metabolic and Bariatric Surgery

  34. The Cost of Obesity Complications After Surgery HealthcareServices Medications 20% of patients return to hospital 36% Higher 77% Higher Hospitalization SOURCE: Surgeon General, Obesity in America, national health Policy Forum, July 2003

  35. 1/3 of US Adults Diabetic or Pre-Diabetic • Average American has very high risk of diabetes • Jun 16 (Reuters Health) - Body mass index (BMI), the ratio of body weight to height, is tightly linked to lifetime risk of diabetes mellitus, researchers reported at the Scientific Sessions of the American Diabetes Association. "On average, every American has a very high risk of diabetes," CDC investigators told conference participants.

  36. Rx for Exercise • Moderate physical activity can decrease the risks for heart disease (by 18% to 84%) • Stroke (by 21% to 34%) • Diabetes (by 16% to 50%) • Colon malignancies (by 30% to 40%) • Dementia (by 15% to 50%)

  37. Accountability for Health Employees Employers 74% feel that employees should be held accountable 4%of employees feel they should be held accountable

  38. If Personal Responsibility Fails • Law Firm Predicts Workplace Wellness Programs Will Become Mandatory • Legal Fallout • Protect yourself – HIPAA, ADA, ERISA rules all have impact

  39. Move to Wellness-based System • Why do we wait for someone to become diseased and then spend huge sums of money to manage their disease? • Millions of Dollars spent on developing drugs that could be spent on prevention and avoiding disease. • Qualified Wellness coaches plus MD’s

  40. Core Topics & Programs – 1999 • Back Care and Injury Prevention • Physical Exercise • Stress Management • Tobacco Use • Substance Abuse Prevention

  41. Additions to the Big 5 • Weight Management • Medical Self-Care • Consumer Health Education • Cholesterol Reduction • Nutritional Interventions • Selected Biometrics Testing • Hypertension Management

  42. Quick-start Wellness

  43. Personal Health Profiles Employers Employees

  44. Real Solutions • Foster Personal Responsibility for Individual Health • Motivation, tools, incentives, and rewards to stay well and reduce Healthcare costs • Workplace is the ideal environment • Companies must develop a Culture of Health and Wellness

  45. Elements of a Successful Wellness Program • Support from ALL levels of management • Buy-in from Employees • Heath Risk Assessments and Appraisals • Establish Wellness Team/Coordinator • Develop program based on interest, needs, appropriate interventions • Effective use of Incentives • Measure results and effectiveness

  46. Required Elements of Compliant Wellness Plan 1 The value of the reward must not exceed 20% of the total premium for an individual employee’s health coverage (may be available to dependents) 2 The program must be reasonably designed to promote good health or prevent disease 3 The program must allow employees to qualify at least once per year The reward must be available to all similarly situated individuals and a reasonable alternative standard must be offered if the general standard cannot be met due to a medical condition 4 5 Plan materials must offer and clearly disclose the alternative standards

  47. What’s a Wellness Program? • *Disclosure of Alternative Standard sample pre-approved verbiage8… • “If it is unreasonably difficult due to a medical condition for you to achieve the standards for the reward under this program, or if it is medically inadvisable for you to attempt to achieve the standards for the reward under this program, contact us at (INSERT PHONE NUMBER) and we will work with you to develop another way to qualify for the reward.” • “If it is unreasonably difficult due to a medical condition for you to achieve a cholesterol count under 200, or if it is medically inadvisable for you to achieve a cholesterol count under 200, call us at the number below and we will work with you to develop another way to get the discount.”

  48. Is it Compliant or Not? • The total annual premium (employer and employee) for a single coverage under an employer’s plan is $2,500 per year • A wellness program offers a reward that waives the annual $250 deductible for the next plan year for participants who have a BMI of between 20 and 27 • The BMI is determined shortly before the beginning of the calendar year and tested at the end of each plan year • Materials state that participants who have medical conditions and for whom it would be unreasonable to attain the BMI standard will be given the same discount if the participants each walk for 20 minutes three days a week • If a member cannot follow the walking schedule, he or she will be given the same discount if he or she implements a dietary regimen

More Related