North Carolina Supplemental Cardiovascular Disease Prevention Project: Design and Objectives

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Who

• Delivers basic medical care inexpensively
• Delivered to the masses, not via house calls
• Do not work with insurance or TPAs
• Developed and used disease identification tools
  and methodologies
• Gained substantial clinical lab work expertise
• Touches 130,000 lives everyday

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• Delivers basic medical care inexpensively
• Delivered to the masses, not via house calls
• Do not work with insurance or TPAs
• Developed and used disease identification tools
  and methodologies
• Gained substantial clinical lab work expertise
• Touches 130,000 lives everyday

Onsite clinics
HRA
Biometric Screening
Wellness Web portal
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U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
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in 9 years
20
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Kaiser/HRET Survey of Employer-Sponsored Health
Benefits, 1999-2007
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U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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U.S. Health Care as a Percentage of the GDP
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Doctor Day, January 1, 2226
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Obesity Trends Among U.S. Adults1985
No Data lt10 1014
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Obesity Trends Among U.S. Adults1986
No Data lt10 1014
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Obesity Trends Among U.S. Adults1987
No Data lt10 1014
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Obesity Trends Among U.S. Adults1988
No Data lt10 1014
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Obesity Trends Among U.S. Adults1989
No Data lt10 1014
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Obesity Trends Among U.S. Adults1990
No Data lt10 1014
24
Obesity Trends Among U.S. Adults1991
No Data lt10 1014
1519
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Obesity Trends Among U.S. Adults1992
No Data lt10 1014
1519
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Obesity Trends Among U.S. Adults1993
No Data lt10 1014
1519
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Obesity Trends Among U.S. Adults1994
No Data lt10 1014
1519
28
Obesity Trends Among U.S. Adults1995
No Data lt10 1014
1519
29
Obesity Trends Among U.S. Adults1996
No Data lt10 1014
1519
30
Obesity Trends Among U.S. Adults1997
No Data lt10 1014
1519 20
31
Obesity Trends Among U.S. Adults1998
No Data lt10 1014
1519 20
32
Obesity Trends Among U.S. Adults1999
No Data lt10 1014
1519 20
33
Obesity Trends Among U.S. Adults2000
No Data lt10 1014
1519 20
34
Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024 25
35
Obesity Trends Among U.S. Adults2002
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
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Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
38
Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
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Obesity Trends Among U.S. Adults2006
No Data lt10 1014
1519 2024 2529
30
40
Obesity Trends Among U.S. Adults2007
No Data lt10 1014
1519 2024 2529
30
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Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
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Percent of adults who are overweight or obese
86
Obesity July, 2008
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Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
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Diabetes Among Adults in the U.S.,BRFSS 1990
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Diabetes Among Adults in the U.S.,BRFSS 1992
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Diabetes Among Adults in the U.S.,BRFSS 1994
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Diabetes Among Adults in the U.S.,BRFSS 1996
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Diabetes Among Adults in the U.S.,BRFSS 1997
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Diabetes Among Adults in the U.S.,BRFSS 1998
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Diabetes Among Adults in the U.S.,BRFSS 1999
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Diabetes Among Adults in the U.S.,BRFSS 2000
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Diabetes Among Adults in the U.S.,BRFSS 2001
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Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
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Percent of Chronic Diseases That Are Caused by
Poor Lifestyle
91
82
71
70
Sources Stampfer, 2000 Platz, 2000 Hu, 2001
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How People Died in 2007
Cancer 24
Accidents Suicide Infections Kidney failure Lung
failure Others 40
Cardiovascular Disease 36
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How People Died in 2007
CVD
Cancer
Other
Up to 70 of all causes of death are lifestyle
related and preventable
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How did we get this way?
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5-a-day 1 million
Food Marketing 25 Billion
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Texas Double Whopper
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Employee Population Health Management
69
Well
Risk
Urgent
Disease
70
Well
Risk
Urgent
Disease
25
71
Well
Risk
Urgent
Disease
72
Well
Risk
Disease
Urgent
5
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Well
Risk
Urgent
Disease
74
Well
Risk
Urgent
Disease
60
75
Well
Risk
Urgent
Disease
76
Well
Risk
Urgent
Disease
10
77
Well
Risk
Urgent
Disease
78
Disease
25
79
Disease
59 Turnover
80
Urgent
5
81
Risk
60
82
Well
10
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Who Needs Help Adopting and Maintaining Healthy
Behaviors?
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Who Needs Help Adopting and Maintaining Healthy
Behaviors?
100
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1,500-3,500 in Excess Claims for Each
Additional Health Risk
Source Dee Edington, Health Management Research
Center
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Average 2003 Medical Care Costs
N1,706
Source StayWell Health Management
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Average 1997-1999 Medical Care Costs
N43,687
Source StayWell Health Management
91
Days Absent in 2003
N941
Source StayWell Health Management
92
Percent with Workers Comp Claims in 2003
N23,916
Source StayWell Health Management
93
Percent with STD Claims in 2004
N23,916
Source StayWell Health Management
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360Health

• Health care decision tools
• Hospital comparison, treatment cost estimator,
  treatment decision guide
• Coverage Advisor
• Quality Insights
• Precision Rx Specialty Solutions
• The Drug List
• MyHealth Record
• Behavioral Health Advisors
• Time Well Spent worksite screenings, flu shots
• Anthem EAP
• 24/7 Nurse Line
• Future Moms

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LifeWorks
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Whats the ROI on

• Lifestyle coaching
• Disability management
• EAP
• Nurse hotline
• Case management
• Disease management

• Wellness
• Self help materials
• Onsite health clinics
• Web based info
• Flu shots
• Preventive screenings

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Independent Evidence That They Are Cost
Effective

• Lifestyle coaching
• Disability management
• EAP
• Nurse hotline
• Case management
• Disease management

• Wellness
• Self help materials
• Onsite health clinics
• Web based info
• Flu shots
• Preventive screenings

?
?
?
?
?
?
?
?
?
?
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Return on Investment (ROI)
32 studies
14 studies
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• Pharmaceutical companies
• Malpractice and law suits
• High tech equipment
• Medical profession salaries
• Administration
• Waste/fraud

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A Worksite Culture of Health

• Awareness/education
• Motivation
• Tools, strategies
• Policy and environment

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Individual
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16 oz
32 oz
44 oz
52 oz
64 oz
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Individual
Family
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Individual
Family
Worksite
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Individual
Family
Worksite
Community
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Somewhere in Florida
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8 Week Changes by Risk Level
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BMI
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Systolic Blood Pressure Reductions mm/Hg
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Diastolic Blood Pressure Reductions mm/Hg
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Total Cholesterol Reductions mg/dl
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Why Should I Care?
Morbidity
Lifespan in years
76
0
critical illness
Ann Intern Med, 2003139455-459
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Morbidity
Lifespan in years
0
?
76
86
critical illness
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End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
140
End of Life Benefits
Morbidity
Lifespan in years
141
End of Life Benefits
Morbidity
Lifespan in years
142
End of Life Benefits
Morbidity
Lifespan in years
143
End of Life Benefits
Morbidity
Lifespan in years
144
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