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Why Wellness

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These slides present the business case for wellness

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Why Wellness

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

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