Employers Intensifying Efforts to Manage Chronic Health Conditions
According to Hewitt Associates, a global human resources consulting firm, the number of Americans with chronic illnesses continues to grow at an alarming rate. According to a report published by the Milken Institute, the total cost spent on managing chronic health diseases in the United States is estimated to be $1.3 trillion annually, with $1.1 trillion spent in lost productivity and another $277 billion on treatment.
To mitigate these costs, Hewitt's survey of more than 340 large U.S. employers found that almost two-thirds (65 percent) continue to make significant investments in improving the health and productivity of their workforce. Approximately 80 percent of companies said they were targeting specific health conditions in their employee population, up from 51 percent just a year ago. The top conditions employers are targeting included diabetes, cardiovascular disease, asthma and depression.
Target chronic conditions. While more employers are targeting specific conditions, researchers found that only a small percentage of workers who are eligible to participate in condition management programs actually do. Even fewer were satisfied with the programs' results.
"The long-term success of these initiatives depends heavily on members changing behavior to manage their conditions," said Jennifer Boehm, a principal in Hewitt's health management consulting practice. "Many of the root causes of chronic conditions, particularly diabetes, are lifestyle-related, which means they are avoidable."
"Employers with well-designed condition management programs that encourage healthy people to stay healthy and help at-risk individuals reduce their chances of becoming chronically ill will ultimately see the best returns," she added. "Even moderate changes in participant behavior can result in significant annual cost savings and a healthier workforce over time."
To ensure condition management programs achieve optimal results, Hewitt recommended employers take these four steps:
1. Analyze claims. Employers should perform a detailed review of health care claims to determine the prevalence of chronic conditions within their population and ensure they are not missing undiagnosed individuals or individuals who are at risk. According to multiple reports, an estimated 30 percent of an employer's population has an undiagnosed chronic condition and another 25 percent may be considered at risk.
2. Improve techniques used to engage targeted enrollees. Traditional techniques, such as nurse outreach calls, have shown to engage only a small percentage of the population. Not being able to reach employees is one of the leading barriers to engagement. In some cases, Hewitt researchers found that condition management vendors are provided with inaccurate phone lists or lists that do not contain the telephone numbers of the members they are trying to reach.
Measuring program performance is also critical, Hewitt said. Companies should work with their vendors to set up aggressive performance guarantees around participant engagement and hold them accountable for meeting those goals.
3. Implement more compliance incentives. Preventing and/or managing chronic conditions require workers to change behaviors. In many cases, employers have incentives in place, but they either do not encourage behavior change or reward the wrong behaviors. Hewitt recommended a value-based design approach, which can reduce or remove financial barriers to care and improve compliance by offering certain condition-specific medications at reduced or waived co-pays. The firm said employers should also consider implementing programs through which members can earn wellness points for participating. These points can be exchanged for additional dollars put into health savings accounts or flexible spending accounts, or toward decreasing employees' health care premiums.
4. Communicate and market effectively. According to Hewitt, an effective communication strategy is a critical element of any condition management program. Employers need to ensure they are delivering appropriate messages to the right audiences and with specific frequency. The firm also recommended launching condition management programs with the same level of effort as they would a new product or service. Developing a clear and structured marketing strategy for each chronic condition management program can create a buzz among participants, highlight the benefits of these programs, and encourage participation and compliance.
April 20, 2009
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