Why Wellness

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These slides present the business case for wellness

These slides present the business case for wellness

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  • 1. Aging Population Rising Medical Costs Epidemic of Chronic Disease
  • 2. Medical Costs by Age and Risk N=43,687 Source: StayWell Health Management
  • 3. Medical Costs as a % of GDP
  • 4. Medical Costs as a % of GDP
  • 5. Medical Costs as a % of GDP 16% US Military 3.2%
  • 6. Medical Costs as a % of GDP 19.5%
  • 7. Spending Trend Per Capita
  • 8. Annual Spending Per Capita
  • 9. Health Care Costs for Each Person Centers for Medicare and Medicaid Services
  • 10. Health Care Costs for Each Person Centers for Medicare and Medicaid Services $7490
  • 11.  
  • 12. Infant Mortality General Accounting Office, 2004
  • 13. Life Expectancy in 60 Countries Swaziland Japan
  • 14. Life Expectancy in 60 Countries Swaziland Japan
  • 15. What Have We Done?
  • 16. Cost Shifting Employer Health Benefits 2005 Annual Survey
  • 17. Why Are Costs Going Up?
  • 18.
    • Pharmaceutical companies?
    • Malpractice and law suits?
    • High tech equipment?
    • Medical profession salaries?
    • Administration?
    • Waste/fraud?
  • 19. The Number 1 Culprit?
    • Chronic Disease is the biggest factor behind the increase
    • 75% of total health care costs
  • 20. The Cause Behind the Cause Unhealthy behaviors Health risks Chronic disease Health care costs
  • 21. This will grow to 66% with the next 25 years CD is responsible for 50% of global mortality
  • 22. Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
  • 23. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%
  • 24. Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19%
  • 25. Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19%
  • 26. Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19%
  • 27. Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19%
  • 28. Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% ≥20%
  • 29. Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% ≥20%
  • 30. Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% ≥20%
  • 31. Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% ≥20%
  • 32. Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% 20%-24% ≥25%
  • 33. (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2002 No Data <10% 10%–14% 15%-19% 20%-24% ≥25%
  • 34. Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% 20%-24% ≥25%
  • 35. Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% 20%-24% ≥25%
  • 36. Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% 20%-24% 25%-29% ≥30%
  • 37. Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% 20%-24% 25%-29% ≥30%
  • 38. Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%-19% 20%-24% 25%-29% ≥30%
  • 39.  
  • 40. Percent of adults who are overweight or obese 2/3 of adults are overweight or obese 67%
  • 41. Percent of adults who are overweight or obese 81%
  • 42. Excess Body Weight and Reduction of Lifespan Ann Intern Med. 2003;138:24-32 -3.3 -3.1 -7.1 -5.8
  • 43. But it not just adults…
  • 44.  
  • 45.  
  • 46. Diabetes Trends* Among U.S. Adults BRFSS 1991-92 Source: Mokdad et al., Diabetes Care 2000;23:1278-83. No Data <4% 4%-6% 6%-8% 8%-10% 10%+
  • 47. Diabetes Trends* Among U.S. Adults BRFSS 1995 Source: Mokdad et al., Diabetes Care 2000;23:1278-83. No Data <4% 4%-6% 6%-8% 8%-10% 10%+
  • 48. Diabetes Trends* Among U.S. Adults BRFSS 1997-98 Source: Mokdad et al., Diabetes Care 2000;23:1278-83. No Data <4% 4%-6% 6%-8% 8%-10% 10%+
  • 49. Diabetes Trends* Among U.S. Adults BRFSS 1999 Source: Mokdad et al., Diabetes Care 2001;24:412. No Data <4% 4%-6% 6%-8% 8%-10% 10%+
  • 50. Diabetes Trends* Among U.S. Adults BRFSS 2000 Source: Mokdad et al., J Am Med Assoc 2001;286:10 . No Data <4% 4%-6% 6%-8% 8%-10% 10%+
  • 51. Diabetes Trends* Among U.S. Adults BRFSS 2001 Source: Mokdad et al., J Am Med Assoc 2001;286:10 . No Data <4% 4%-6% 6%-8% 8%-10% 10%+
  • 52. Diabetes and Reduction in Lifespan JAMA 2003;290:1884-1890 -11.6 yrs -14.3 yrs
  • 53. Lifetime Risk of Diabetes for Children Born in 2000 Venkat Narayan, JAMA 2003;290:1884 49%
  • 54. What Happened?
  • 55.  
  • 56. Food Marketing = $25 Billion 5-a-day = $1 million
  • 57.  
  • 58. Texas Double Whopper 1910 mg 80% of daily Sodium 69 grams 106% of daily Fat grams 26 grams 130% of daily Saturated fat 1050 Calories
  • 59. Serving Sizes Have Increased
  • 60.  
  • 61. 16 oz 32 oz 44 oz 52 oz 64 oz 48 Teaspoons Sugar
  • 62. Motionless Lifestyle
  • 63. Displaced Activity
  • 64.  
  • 65. Why is All This a Big Deal?
  • 66. The Cause Behind the Cause Unhealthy behaviors Health risks Chronic disease Health care costs
  • 67. Percent of Chronic Diseases That Are Caused by Poor Lifestyle Sources: Stampfer, 2000; Platz, 2000; Hu, 2001 71% 70% 82% 91%
  • 68. $1,500-$3,500 in Excess Claims for Each Additional Health Risk Source: Dee Edington, Health Management Research Center
  • 69. Average 2003 Medical Care Costs N=1,706 Source: StayWell Health Management
  • 70. Days Absent in 2003 N=941 Source: StayWell Health Management
  • 71. Percent with Worker’s Comp Claims in 2003 N=23,916 Source: StayWell Health Management
  • 72. Percent with STD Claims in 2004 N=23,916 Source: StayWell Health Management
  • 73. So What Is To Be Done?
  • 74. Employee Population Health Management
  • 75. Well Risk Urgent Disease
  • 76. Well Risk Urgent Disease 25%
  • 77. Well Risk Disease Urgent 5%
  • 78. Well Risk Urgent Disease 60%
  • 79. Well Risk Urgent Disease 10%
  • 80. Well Risk Urgent Disease 10% 60% 5% 25% Top 15% of employees with disease = 85% of costs
  • 81. Well Risk Urgent Disease 10% 60% 5% 25% The rest = 15% of costs
  • 82. Well Risk Urgent Disease
  • 83. Disease 25% Disability Management Case management Decision support Risk management Disease management Clinical management Compliance support Risk management
  • 84. Disease 59% Turnover
  • 85. Urgent 5% Demand Management Self care information Nurse advice line Decision support Coaching
  • 86. Risk 60% Risk Management Targeted intervention Targeted screening Reimbursement
  • 87. Well 10% Wellness Management
  • 88. Who Needs Help Adopting and Maintain Healthy Behaviors?
  • 89. 100% Who Needs Help Adopting and Maintain Healthy Behaviors?
  • 90.  
  • 91.  
  • 92.  
  • 93. The Solution
  • 94. Return on Investment (ROI) 32 studies 14 studies
  • 95. Health Care Costs for Each Person Centers for Medicare and Medicaid Services $7490
  • 96.  
  • 97.  
  • 98.  
  • 99. Relative Costs of Poor Health Edington, Burton. A Practical Approach to Occupational and Environmental Medicine (McCunney). 140-152. 2003. Health Care Costs Worker’s Comp Absenteeism Presenteeism
  • 100. Productivity losses = Presenteeism + Absenteeism
      • inability to concentrate
      • poor interpersonal communication
      • need to repeat a job
      • work more slowly
  • 101. Value of Lost Productivity Your Annual Health Care Costs 3 X
  • 102. Create a Culture of Health
    • Awareness/education
    • Motivation
    • Tools, strategies
    • Policy and environment
  • 103. Individual Family Worksite Community Nation/ world
  • 104. Individual
  • 105.  
  • 106.  
  • 107. Individual Family
  • 108.  
  • 109.  
  • 110. Individual Family Worksite
  • 111.  
  • 112.  
  • 113.  
  • 114. Individual Family Worksite Community
  • 115.  
  • 116. Which group has the most skin in the game? Individual Family Worksite Community Nation/ world
  • 117. What Can Worksites Do?
    • Include spouses, significant others, families in programs
    • Change worksite policies and environments
    • Use the right incentives
    • Give employees tools
  • 118. Why Should I Care?
  • 119. Mortality Rate from Chronic Living
  • 120. Compression of Morbidity Lifespan in years Morbidity 76 0 critical illness Ann Intern Med, 2003:139:455-459
  • 121. Lifespan in years Morbidity 0 ? 76 86 critical illness Compression of Morbidity
  • 122. Lifespan in years Morbidity Lifespan in years Morbidity 10-20 Years Compression of Morbidity
  • 123. Lifespan in years Morbidity Compression of Morbidity
  • 124. Lifespan in years Morbidity Compression of Morbidity
  • 125. Lifespan in years Morbidity Compression of Morbidity
  • 126. Lifespan in years Morbidity Compression of Morbidity
  • 127.