Health Management Programs May Cut Health Care Costs
Employers looking to lower their health care expenditures while improving the health of their employees should consider implementing a "population health management" program, Bruce Hochstadt, M.D. and Patricia Curran, R.N. recommended in a two-part paper published by Buck Consultants.
The incidence of chronic illnesses such as heart disease, hypertension, diabetes, high cholesterol, depression, and arthritis is rising among American workers, the authors noted, and these conditions are often made worse by behavioral factors such as obesity, lack of exercise, stress, and substance abuse. At the same time, they added, previous attempts by health insurers to control health care expenditures and improve care through utilization management have largely been abandoned due to opposition from physicians and patients, leading to an escalation in the cost of treating these conditions.
As a result, the authors observed, nearly half of all patients suffering from chronic illnesses are not getting the care they need or following the therapies prescribed, while those who are receiving treatment are often at advanced stages of the disease, thereby driving up costs.
To address these problems, the authors suggested employers focus on helping employees to avoid illness and to treat their illnesses at the early stages by implementing a population health management program. As the first step, employers should conduct an analysis of their employees’ patterns of care, which allows them to identify gaps in care and categorize workers according to risk level. The analysis can be based on detailed health questionnaires completed by employees.
After establishing where the health problems lie within the employee population, employers should consider instituting care management programs in specific areas, Hochstadt and Curran advised. Employers are likely to see the greatest return on investment, the authors said, by concentrating their efforts on providing patient education and coaching for conditions that can be most easily prevented or managed through behavioral changes, including diabetes, cardiac problems, lower back pain, depression, high risk pregnancy, and respiratory illness.
To encourage participation in the analysis and subsequent care management programs, the authors recommended, employers should offer incentives, which may include cash, gift certificates, reduced health insurance costs, and the opportunity to participate in wellness initiatives, such as subsidized gym memberships or weight management programs.
