North Carolina Supplemental Cardiovascular Disease Prevention Project: Design and Objectives

1
(No Transcript)
2
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

3
(No Transcript)
4

• 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
5
U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
6
in 9 years
20
7
Kaiser/HRET Survey of Employer-Sponsored Health
Benefits, 1999-2007
8
(No Transcript)
9
Obesity Trends Among U.S. Adults1985
No Data lt10 1014
10
Obesity Trends Among U.S. Adults1986
No Data lt10 1014
11
Obesity Trends Among U.S. Adults1987
No Data lt10 1014
12
Obesity Trends Among U.S. Adults1988
No Data lt10 1014
13
Obesity Trends Among U.S. Adults1989
No Data lt10 1014
14
Obesity Trends Among U.S. Adults1990
No Data lt10 1014
15
Obesity Trends Among U.S. Adults1991
No Data lt10 1014
1519
16
Obesity Trends Among U.S. Adults1992
No Data lt10 1014
1519
17
Obesity Trends Among U.S. Adults1993
No Data lt10 1014
1519
18
Obesity Trends Among U.S. Adults1994
No Data lt10 1014
1519
19
Obesity Trends Among U.S. Adults1995
No Data lt10 1014
1519
20
Obesity Trends Among U.S. Adults1996
No Data lt10 1014
1519
21
Obesity Trends Among U.S. Adults1997
No Data lt10 1014
1519 20
22
Obesity Trends Among U.S. Adults1998
No Data lt10 1014
1519 20
23
Obesity Trends Among U.S. Adults1999
No Data lt10 1014
1519 20
24
Obesity Trends Among U.S. Adults2000
No Data lt10 1014
1519 20
25
Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024 25
26
Obesity Trends Among U.S. Adults2002
No Data lt10 1014
1519 2024 25
27
Obesity Trends Among U.S. Adults2003
No Data lt10 1014
1519 2024 25
28
Obesity Trends Among U.S. Adults2004
No Data lt10 1014
1519 2024 25
29
Obesity Trends Among U.S. Adults2005
No Data lt10 1014
1519 2024 2529
30
30
Obesity Trends Among U.S. Adults2006
No Data lt10 1014
1519 2024 2529
30
31
Obesity Trends Among U.S. Adults2007
No Data lt10 1014
1519 2024 2529
30
32
Percent of adults who are overweight or obese
67
2/3 of adults are overweight or obese
33
Percent of adults who are overweight or obese
86
Obesity July, 2008
34
Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
35
Diabetes Among Adults in the U.S.,BRFSS 1990
36
Diabetes Among Adults in the U.S.,BRFSS 1992
37
Diabetes Among Adults in the U.S.,BRFSS 1994
38
Diabetes Among Adults in the U.S.,BRFSS 1996
39
Diabetes Among Adults in the U.S.,BRFSS 1997
40
Diabetes Among Adults in the U.S.,BRFSS 1998
41
Diabetes Among Adults in the U.S.,BRFSS 1999
42
Diabetes Among Adults in the U.S.,BRFSS 2000
43
Diabetes Among Adults in the U.S.,BRFSS 2001
44
Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
45
Percent of Chronic Diseases That Are Caused by
Poor Lifestyle
91
82
71
70
Sources Stampfer, 2000 Platz, 2000 Hu, 2001
46
How did we get this way?
47
(No Transcript)
48
(No Transcript)
49
(No Transcript)
50
The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
51
Employee Population Health Management
52
Well
Risk
Urgent
Disease
53
Well
Risk
Urgent
Disease
25
54
Well
Risk
Urgent
Disease
55
Well
Risk
Disease
Urgent
5
56
Well
Risk
Urgent
Disease
57
Well
Risk
Urgent
Disease
60
58
Well
Risk
Urgent
Disease
59
Well
Risk
Urgent
Disease
10
60
Well
Risk
Urgent
Disease
61
Disease
25
62
Urgent
5
63
Risk
60
64
Well
10
65
Who Needs Help Adopting and Maintaining Healthy
Behaviors?
66
Who Needs Help Adopting and Maintaining Healthy
Behaviors?
100
67
Traditional Wellness Programs Work What About
the Rest?
68
LifeWorks
69
(No Transcript)
70
(No Transcript)
71
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

72
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

73
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

?
?
?
?
?
?
?
?
?
?
74
Traditional Wellness Programs Work What About
the Rest?
75
(No Transcript)
76
Return on Investment (ROI)
32 studies
14 studies
77
(No Transcript)
78
(No Transcript)
79
(No Transcript)
80
(No Transcript)
81
Effective Wellness Programs

• Create a worksite culture of health by
• Creating awareness/educate
• Motivating
• Providing tools and skills
• Promoting wellness policies and environments

82
5 Steps

• 1. Build the Business Case
• 2. Assessing Your Worksite
• 3. Plan and implement wellness strategies
• 4. Change the worksite culture and environment
• 5. Evaluating Your Program

83
(No Transcript)
84
1. Build the Business Case
85
(No Transcript)
86
2. Assessing Your Worksite
87

• Health Risk Appraisal
• Free?
• Vendor?
• Clinical risk measures?

88

• Health Risk Appraisal
• Free?
• Vendor?
• Clinical risk measures?

An HRA is NOT a wellness program!
89
How long will it take to get the program going?

• The planning process can take from 3-7 months
• Data collection, risk, health care costs,
  pharmaceuticals, behaviors
• Look at worksite health culture
• Understand the benefits package and how wellness
  fits in. What will the package look like with a
  wellness program?

90
Whats it going to cost?

• What does your insurance company offer?
• What does your health care provider offer?
• What about vendors?
• Can it be done for free?

91
Whats it going to cost?
92
3. Plan and implement wellness strategies
93
Its All About Behavior
Employee related costs
Unhealthy culture and behaviors
Health risks
Chronic disease
94

• Flyers
• Posters
• Email notifications
• Television/video programs
• Books

• Payroll stuffers
• Internet sites
• Magazines
• Lunch and learns
• Special speakers
• Newsletters

95
Behavior Change Programs..

• Move It!
• The Culprit and The Cure
• TV Timeout
• Random Acts of Kindness
• The Fast Food Guide
• Maintain Dont Gain
• Food Makeover

• Earth Wise
• What's Your Pressure
• Good to the Bone
• Silver Buckle
• Fall into Fitness
• Drive Sober
• Chopping Block
• Finding Fiber
• Fat Fighters

96
(No Transcript)
97
(No Transcript)
98
(No Transcript)
99

• Low hanging fruit
• Preventive screenings
• Flu shots
• Seat belts
• High hanging fruit
• Onsite fitness facility
• One-on-one coaching/training

100
4. Change the worksite culture and environment

• Physical Environment
• Policy
• Culture

101
Wellness requires benefits plan changes

• Different health care plan for participants
• Lower copays, deductibles and premiums for
  participants
• Contribute to FSA or HRA with participation
• Others

102

• Policies
• Medical coverage for preventive services
• No smoking policies
• Flex time
• Time on the clock to be healthy
• Free from overly stressful work

103
Supportive Environments

• Physical environments
• Healthy food in cafeteria
• Healthy food in vending machines
• Farmers market
• Realistic work demands
• Opportunities to be physically active
• Walking paths
• Time to exercise
• Onsite shower or lockers

104
5. Evaluation

• Participation and satisfaction
• HRA data (behavior and biometric)

105
www.welcoa.org
106
(No Transcript)
107
Why Should I Care?
Morbidity
Lifespan in years
76
0
critical illness
Ann Intern Med, 2003139455-459
108
Morbidity
Lifespan in years
0
?
76
86
critical illness
109
End of Life Benefits
Morbidity
Lifespan in years
10-20 Years
Morbidity
Lifespan in years
110
End of Life Benefits
Morbidity
Lifespan in years
111
End of Life Benefits
Morbidity
Lifespan in years
112
End of Life Benefits
Morbidity
Lifespan in years
113
End of Life Benefits
Morbidity
Lifespan in years
114
(No Transcript)