HEALTH CARE COST FACTORS

WHAT'S KILLING US AND WHY

• Chronic diseases caused approximately 60% of deaths worldwide in 2005, including cardiovascular disease (stroke and heart disease), cancer, chronic respiratory diseases and diabetes. (PricewaterhouseCoopers, Working Towards Wellness. Feb 2007 Report*)
• The United States spent over $2.0 trillion in healthcare in 2005 --$6,683 for every man, woman, and child. (Borger et al., Health Affairs, 22 February 2006, as featured in "Measuring Clinical & Financial ROI from DM Programs," presented by Ron Z. Goetzel, Ph.D., NMHCC Special Web Summit Edition, May 22 - May 26, 2006.)
• It is projected that 388 million people will die worldwide from chronic disease in the next 10 years. (PricewaterhouseCoopers, Working Towards Wellness. Feb 2007 Report*)
• Almost half of those who die from chronic diseases are younger than 70 years of age. (PricewaterhouseCoopers, Working Towards Wellness. Feb 2007 Report*)
• A 10% reduction in mortality from heart disease and cancer could save the US $10.4 trillion annually. (PricewaterhouseCoopers, Working Towards Wellness. Feb 2007 Report*)
• Only 3 percent of all health expenditure was directed at prevention and public health in 2004 in the member countries of the Organization for Economic Cooperation and Development (OECD). (PricewaterhouseCoopers, Working Towards Wellness. Feb 2007 Report*)
• About 56,000 Americans die from colorectal cancer, and 150,000 new cases are diagnosed each year. (Agency for Healthcare Research & Quality, January 11, 2007)
• About one-third of American adults are obese, increasing the risks of high blood pressure, type 2 diabetes, stroke, heart disease and osteoarthritis. (Agency for Healthcare Research & Quality, January 11, 2007)
• Only 49 percent of people with asthma said they were told how to change their environment, and 28 percent reported receiving an asthma management plan. (Agency for Healthcare Research & Quality, January 11, 2007)
• Only 48 percent of adults with diabetes received all three recommended screenings—blood sugar tests, foot exams and eye exams—to prevent disease complications. (Agency for Healthcare Research & Quality, January 11, 2007)
• In 2005, nearly 9 percent of children - 6.5 million children under age 18 - were reported to currently have asthma. The percentage of children who had asthma more than doubled between 1980 and 1995, from 3.6 percent to 7.5 percent. (The State of Childhood Asthma, Centers for Disease Control and Prevention)
• Obese Employees 20% More Likely to Report Health-Related Lost Productive Time (Journal of Occupational & Environmental Medicine. 47(12):1227-1234, December 2005)
• Obese workers cost an estimated $42.29 billion in lost productivity time (LPT), an excess of $11.70 billion compared with normal-weight workers. Presenteeism accounted for 67.8% of the cost. Health-related LPT costs employers an average of $1,627 per obese worker per year. (Journal of Occupational & Environmental Medicine. 47(12):1227-1234, December 2005)

·         Annual Costs of Selected Chronic Conditions-CHF (Heart Failure): $37,032 (841%) -CAD (Heart Disease): $21,912 (457%) -Diabetes: $13,164 (235%) -COPD (Emphysema): $25,308 (543%) -Asthma: $7,212 ( 83%) ("Empowering Consumers to Make Better Healthcare Decisions – The Next Frontier," Jerry Reeves, M.D., Chief Medical Officer, Hotel Employees and Restaurant Employees International Union (HEREIU) Welfare Funds. at the Fifth Annual Managing Health Care Cost Web Summit in November 2006).

• More than 105 million people in the United States suffer from one or more chronic diseases. Approximately 75% of all employers offer some form of DM services to their employees with chronic diseases. (American Medicare Association)

• 20% of the workforce uses 80% of the health care resources (Hewitt Associates at the Defined Care 2003 Healthcare Web Summit)

• Disease Management industry revenue was estimated by the Disease Management Purchasing Consortium to be $491 million in 2001, up from $366 million in 2000 and $80 million in 1997. The Boston Consulting Group pegs 2002 at a much bigger number, estimating at will hit $1 billion, up from their estimated $68 million in 1997, and they project it will hit $10 billion in 2010. 

• There are now about 170 disease management vendors nationwide, with 1.5 million people enrolled, but fewer than 25% actively engaged in the self-monitoring/reporting process. American Healthways is noted as the nation's largest disease-management company.  (Modern Healthcare, July 1, 2002)

• 44% of employers offered disease management in 2000, up from 14% in 1995. (Pharmacy Benefit Management Institute). 

• Some 100 million Americans have a chronic illness, which will increase to 157 million by 2020. (National Chronic Care Consortium).

• 69% of health plan executives named lack of physician cooperation as the biggest challenge in implementing a successful disease-management program. (Forrester Research).

• 56% of companies report that disease management staff manage only 1-10 cases per day.  (URAC)

The Disease Management Association of America (DMAA) defines disease management as "system of coordinated healthcare interventions and communications for populations with conditions in which patient self-care efforts are significant."  The DMAA goes on to state that Full Service Disease Management must include six components:

• (1) Population Identification processes
• (2) Evidence-based practice guidelines
• (3) Collaborative practice models to include physician and support-service providers
• (4) Patient self-management education (may include primary prevention, behavior modification programs, and compliance/surveillance)
• (5) Process and outcomes measurement, evaluation, and management
• (6) Routine reporting/feedback loop (may include communication with patient, physician, health plan and ancillary providers, and practice profiling)

For more information on how to fix and control your company's health care cost, visit: http://www.strictlyhr.com or call 330-575-2029.