BNLs Wellness and Benefits Initiative

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BNLs Wellness and Benefits InitiativeSome
things you can do to improve your health and help
reduce benefits costs

• Joe Falco, M.D., M.P.H., Manager, OMC
• Michael Thorn, R.N., M.B.A., Manager, Health
  Promotion Program
• Jai Subramani, M.D., M.P.H., Staff Physician, OMC
• Members, BNL Wellness/Benefits Work Group

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BNLs Wellness and Benefits Initiative

• Established in 2007 by HR Manager Bill Hempfling
• Joint effort of OMC, OMCs Health Promotion
  Program and HRs Benefits group
• Purpose To address 2 important, related
  problems
• Spiraling cost of health benefits
• Considerable burden of health risk factors and
  disease in BNL population

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Magnitude of the problemHealth Care Costs and
Burden of Illness in the BNL Workforce

• Each year, BNL spends over 40 Million on health
  care costs, including 10 Million on prescription
  drugs.
• The growth in these costs exceeds inflation 10
  this past year and 10 on avg. for coming year
  (CIGNA/Aetna 19, HIP 9, VYTRA 2)
• These costs contribute substantially to the cost
  of doing business at BNL and are a burden to our
  employees due to premium costs and premium
  increases.
• More than the financial costs are the burden of
  pain suffering
• Every year, a few current BNL employees die or
  are permanently disabled by potentially
  preventable diseases e.g. cancer, heart disease
  
• 15,000 days spent sick/year from chronic or acute
  conditions.

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One approach to this problem Encouraging
screening and prevention

• Screening for
• Modifiable disease risk factors (obesity,
  cholesterol)
• Precancerous growths (cervix, skin, colon
  polyps)
• Diseases when still curable or treatable (or
  before they cause complications)
• Cancers (breast, colon, cervical, skin)
• Hypertension (high blood pressure)
• Diabetes
• Osteoporosis
• Then take preventive measures based upon
  screening results.

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Screening Saves livesExample Cancer Screening

• Breast Cancer At least 15 reduction in
  mortality with regular mammograms starting age 40
• Cervical cancer 90 reduction in incidence of
  invasive cancer with regular PAP tests
• Similar reduction in mortality
• Colon Cancer 50 reduction in incidence and
  mortality with screening (colonoscopy)

-Source Guide to Clinical Preventive Services,
2008
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And yet, BNL Claims data shows employees and
family members are not consistently going for
recommended screening.Example cancer
screening rates
-Based upon CIGNA claims data
-Based upon recommended method schedule of
screening
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Low rates of breast and cervical cancer screening
indicate that some employees spouses are not
going for recommended screenings

• Remember to encourage your spouse to get screened
  !

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A few details on recommended cancer screenings
for average-risk adults
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Colon Cancer

• Starting age 50 (age 45 for African Americans)
• Colonoscopy every 10 years -or-
• Sigmoidoscopy every 5 years plus fecal occult
  blood test (FOBT)
• FOBT alone if unwilling/unable to have
  colonoscopy or sigmoidoscopy (FOBT is less
  sensitive and specific, and doesnt detect
  precancerous abnormalities such as polyps).
• But Regular FOBT alone associated with 1/3rd
  reduction of colon cancer mortality risk
• Recent evidence that virtual colonoscopy (CT
  scan) may be as sensitive as regular colonoscopy
• Has advantages and disadvantages

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Breast Cancer

• Mammogram every 1-2 years, starting around age 40
• Benefits of screening increase with age
• esp. age 50 and above, and extending beyond age
  70 (until life expectancy shortened by other
  illness)
• Male employees Remember your adult female loved
  onesencourage and remind them to get screened
  regularly

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Cervical Cancer

• PAP test at age 21 or within 3 years of start of
  sexual activity (whichever comes 1st)
• Frequency Yearly, but can be reduced to about
  every 3 years after 2-3 normal PAP tests or after
  age 30
• Can discontinue after age 65 if last 2-3 PAPs
  were normal
• Can discontinue after hysterectomy if done for
  benign condition
• Male employees Remember your adult female loved
  onesencourage and remind them to get screened
  regularly
• Note on Prevention New HPV Vaccine (Gardasil)
  recommended for 11-12 year old girls (most
  effective if given when not yet sexually active)
• Can reduce risk of Cervical Cancer by 70.
• Ask your pediatrician about the vaccine if you
  have pre-adolescent or adolescent girls.

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OMC Offers Many Recommended Adult Health
Screenings as part of routine OMC exams
(voluntary/mandatory) Convenient and No Co-Pay
(Weight)
(Cholest/ Triglyc.)
FOBT (Fecal Occult Blood Test)
Source Joint recommendations Of Amer. Cancer
Society, Heart Diabetes. Assns.
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And Special Free Screenings offered periodically
by the OMC Health Promotion Program

• Skin cancer (dermatologist)
• Prostate cancer (urologist)
• Foot problems (podiatrist)

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Additional non-cancer screenings recommended in
older adults

• Men age 65 ultrasound screening for abdominal
  aortic aneurysm (bulging of aorta) if risk
  factors
• Smoking
• Family history
• Women age 65screening for osteoporosis
• Screen earlier age 60 if any risk factors
• Especially if lighter weight (
• Bone mineral density by DEXA scan (special x-ray)
• (Men can also get osteoporosis usually about 10
  years later than women)

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Sleep Apnea Screening if

• Daytime sleepfulness
• Sleep partner notes heavy snoring, long pauses in
  breathing/struggling to take a breath
• Risk factors
• Overweight/obesity
• Large neck size (Men 17 in., Women 16 in.)
• Screening methods
• Screening questionnaire (EAP)
• Sleep study if questionnaire ()

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Conclusion

• Age- and gender-appropriate screening and
  preventive services
• Save Lives
• Preserve Good Health
• Save you and the Lab Money (prevention is cheaper
  than treatment)
• Be sure to get the recommended screeningsthey
  are generally covered under our health plans (but
  always ask)
• Make sure family members do, too
• Take advantage of OMCs free screenings for
  employees

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Sources of Info on Screening Prevention

• OMC web site www.bnl.gov/hr/occmed (including
  Health Promotion and EAP web sites)
• Centers for Disease Control and Prevention
  www.cdc.gov (good source of vaccine info)
• Guide to Clinical Preventive Services by the
  U.S. Preventive Services Task Force (Google the
  phrase URL is too long!)
• American Cancer Society www.cancer.org
• American Academy of Pediatrics http//www.aap.org/
  (Recommended schedule of vaccinations and
  well-child visits)

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This was the 1st in a series of 3 talks. HR
OMC hope to present a couple of brief talks on
the following related topics

• HR- Benefits Group (DiMeglio, Bittrolff, Romero)
• Optimally utilizing your Health Benefits and
  Prescription Drug Plan to save yourself and the
  Lab .
• Useful web resources at the different health
  insurance web sites.
• Employee Assistance Program (EAP) (Losinno)
• Breadth of services available on-site and thru
  CIGNA Behavioral Health well beyond just mental
  health and substance abuse issues.
• De-stigmatizing EAP services.