Title: North Carolina Supplemental Cardiovascular Disease Prevention Project: Design and Objectives
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2Winning at ROI Poker
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47
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9Employee Related Costs
- Salary
- Health care
- STD
- LTD
- Workers Comp
- Life Insurance
- 401K
- Vacation
- Sick leave
10U.S. Health Care as a Percentage of the GDP
Today 16 of GDP
US Military uses 3.2
11Cost Shifting
Employer Health Benefits 2005 Annual Survey
12Health Care Costs for Each Person
Centers for Medicare and Medicaid Services
13Health Care Costs for Each Person
7490
Centers for Medicare and Medicaid Services
14Relative Costs of Poor Health
Health Care Costs
Workers Comp
Absenteeism
Presenteeism
Edington, Burton. A Practical Approach to
Occupational and Environmental Medicine
(McCunney). 140-152. 2003.
15Value of Lost Productivity
Annual Health Care Costs
3 X
1. Edington DW, Burton WN. Health and
productivity. In McCunney, RJ A Practical
Approach to Occupational and Environmental
Medicine. PhiladelphiaLippincott Williams
Wilkins. 3rd ed. 2003140-152. 2. Burton WN,
Pransky G, Conti DJ, Chen CY, Edington DW. The
association of medical conditions and
presenteeism. J Occup Environ Med. 200446(6)
supplS38-S45. 3. Pelletier B, Boles M, Lynch W.
Change in health risks and work productivity over
time. J Occup Environ Med. 200446(7)746-754. 4.
Goetzel RZ, Long SR, Ozminkowski RJ, Hawkins K,
Wang S, Lynch W. Health, absence, disability, and
presenteeism cost estimates of certain physical
and mental health conditions affecting U.S.
Employers. J Occup Environ Med.
200446(4)398-412.
16Portion of Total Health Care Costs Caused by
Chronic Diseases
17Obesity Trends Among U.S. Adults1985
18Obesity Trends Among U.S. Adults1993
19Obesity Trends Among U.S. Adults2001
No Data lt10 1014
1519 2024
25
20Obesity Trends Among U.S. Adults2006
21Excess Body Weight and Reduction of Lifespan
-3.1
-3.3
-5.8
-7.1
Ann Intern Med. 200313824-32
22Diabetes Among Adults in the U.S.,BRFSS 1990
23Diabetes Among Adults in the U.S.,BRFSS 1998
24Diabetes Among Adults in the U.S.,BRFSS 2001
25Diabetes and Reduction in Lifespan
-14.3 yrs
-11.6 yrs
JAMA 20032901884-1890
26Lifetime Risk of Diabetes for Children Born in
2000
49
Venkat Narayan, JAMA 20032901884
27Percent of Chronic Diseases That Are Caused by
Poor Lifestyle
91
82
71
70
Sources Stampfer, 2000 Platz, 2000 Hu, 2001
28The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure (2003)
29The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure (2003)
30The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure (2003)
31The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
32So What Should We Do?
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351. Talk about swirlys
361. Reframe ROI Your Way
37An ROI of 11 means free
38Wellness ROI is not Investment ROI
392. How much will you invest? Calibrate the
Investment
40Against the size of the problem
41The greater the investment
- Low Intensity
- HRA, marketing campaigns and/or printed materials
- Under 50 PEPY
- Average ROI of 3.751
1. Aldana SG, Jacobson BH, Harris CJ, Kelley PL,
Stone WJ. Influence of a mobile worksite health
promotion program on health care costs. Am J
Prev Med 19939(6)37883. 2. Berg GD, Thomas E,
Silverstein S, et al. Reducing medical service
utilization by encouraging vaccines Randomized
controlled trial. Am J Prev Med 2004
27(4)284-8. 3. Fries JF, et al. Two-year
results of a randomized controlled trial of a
health promotion program in a retiree population
the Bank of America study, Am J Med, 1993 94
455-462. 4. Fries JF, McShane D. Reducing need
and demand for medical services in high risk
persons. West J Med, 1998 169(4) 201-207. 5.
Gibbs, JO, et al. Work-site health promotion
Five year trend in employee health care costs, J
Occup Med1985 27(11) 826-830. 6. Leigh, JP et
al. Randomized controlled study of a retiree
health promotion program The Bank of America
study, Arch Int Med, 1992152 1201- 1206. 7.
Schultz ALC, Barnett T, et al. Influence of
participation in a worksite health promotion
program on disability days. J Occup Environ Med.
200244776780.
42The greater
- Medium Intensity
- Low intensity plus any type of intervention
- About 100 PEPY
- Average ROI of 61
1. Aldana SG, Merrill RM, Price K, Hardy A, Hager
R. Financial impact of a comprehensive multisite
workplace health promotion program. Prev Med
200540(2)131-137. 2. Chapman L, et al. Ten-year
economic evaluation of an incentive-based
worksite health promotion program, Unpublished
data. 3. Golaszewski T, et al. A benefit-to-cost
analysis of a work-site health promotion program,
J Occup Med1992 34(12) 1164-1172. 4.
Hall-Barrow J, Hodges LC, Brown P. A
collaborative model for employee health and
nursing education. AAOHN J. 200149(9)429-36. 5.
Henritze J, Brammell HL. Phase II cardiac
wellness at the Adolph Coors Company. Am J Health
Promot 1989 4(1) 25- 31. 6. Leutzinger J, Hawes
C, Hunnicutt D, et al. Predicting the ratio of
benefit to cost in a cardiovascular disease
prevention program. Manag Employee Health
Benefits. 1995110. 7. Maniscalco P, Lane R,
Welke M, et al. Decreased rate of back injuries
through a wellness program for offshore petroleum
employees. J Occup Environ Med. 199941813820.
8. Mills P, Kessler RC, Cooper J, Sullivan S.
Impact of a Health Promotion Program on Employee
Health Risks and Work Productivity. AJHP.
200722(1)45-53. 9. Ozminkowski, Ronald J., et
al. A return on investment evaluation of the
Citibank, N.A., Health Management Program. Am J
Health Promot 1999 14(1)31-43. 10. Shephard
RJ, et al. The influence of an employee fitness
and lifestyle modification program upon medical
care costs. Can J Public Health, 1982 73
259-263. 11. Shi L. Health promotion, medical
care use, and costs in a sample of worksite
employees, Evaluation Review,1993 17(5)
475-487. 12. Stave GM, et al. Quantifiable
impact of the contract for health and wellness
Health behaviors, health care costs, disability,
and workers' compensation. JOEM
200345(2)109-17. 13. Thorsen N, Khalil L. Cost
savings associated with smoking cessation for
low-income pregnant women. WMJ 2004 103(5)67-9,
73. 14. Wood FA, et al. An evaluation of
lifestyle risk factors and absenteeism after two
years in a worksite health promotion program. Am
J Health Promot,1989 4(2) 128-133.
43The return.
- High Intensity
- Medium intensity plus cultural or environmental
change - About 150 PEPY
- Average ROI of 7.751
1. Bertera, RL. The effects of workplace health
promotion on absenteeism and employment costs in
a large industrial population, Am J Pub Health
1990 80(9) 1101-1105. 2. Bowne DW, Russell ML,
Morgan JL, Optenberg SA, Clarke AE. Reduced
disability and health care costs in an industrial
fitness program. J Occup Med 198426(11)80916.
3. Dalton, BA, Harris J. A comprehensive approach
to corporate health management, J Occup Med1991
33(3)338-348. 4. Harvey MR et al. The impact of
a comprehensive medical benefits cost management
program for the city of Birmingham results at
five years. Am J Health Promot,1993 7(4)
296-303.
44What Companies Invest PEPY
- 5000 42
- 1000 - 5000 75
- 500 - 1000 105
- 50 - 500 135
- Under 50 250
453. Know Your Investment Allocation
46100 employees
47Well
Risk
Urgent
Disease
48Well
Risk
Urgent
Disease
25
49Well
Risk
Urgent
Disease
50Well
Risk
Disease
Urgent
5
51Well
Risk
Urgent
Disease
52Well
Risk
Urgent
Disease
60
53Well
Risk
Urgent
Disease
54Well
Risk
Urgent
Disease
10
55Well
Risk
Urgent
Disease
10
60
5
25
Top 15 of employees with disease 85 of costs
The rest 15 of costs
56Well
Risk
Urgent
Disease
57Disease
25
59 Turnover
58Disease
25
59Urgent
5
60Risk
60
61Well
10
62The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
63Who Needs Help Adopting and Maintaining Healthy
Behaviors?
64Who Needs Help Adopting and Maintaining Healthy
Behaviors?
100
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684. Change the Game
Benefit Plan Design
69www.wellsteps.com