Preventive Care: Pay Now or Pay (More) Later By ERIC P. JUSTIN
For more information on Lockton, please contact Ashley Pace in Lockton’s Memphis office. 901 757 6902 apace@lockton.com The implementation of a health risk management strategy as a way to reduce medical costs is a trend that continues to gain traction with employers. Even so, your organization may be hesitant to take such a step due to concerns about higher costs at the outset. In fact, these concerns are legitimate, to some degree. Because of their focus on preventive care, wellness programs do, in fact, raise certain costs – at least initially. Why? Because if a wellness program works properly, it drives increased utilization of preventive care and subsequent increases in medication use.
Revealing Employee Risk Factors and Gaps in Care
The first step in any health risk management strategy is to understand the health risks that exist in the employee population. Lockton assists in this process via InfoLock® Employee Benefits, our proprietary datamining warehouse. With InfoLock, we aggregate all of you employees’ health-related data – medical and pharmacy claims, results from biometric screenings, and self-reported health risk assessment information. Next we analyze it carefully to identify trends in chronic disease, high-cost claims, and utilization patterns. Our experience demonstrates that health risk assessments and biometric screenings will yield data indicating that anywhere from one-fourth to one-third of your employee population will likely possess health risk factors – many that may have gone undiagnosed. And with knowledge of these risk factors comes the realization that many employees will now need evaluation and treatment from clinical providers.
Armed with insight regarding risk factors and gaps in care, Lockton can help you implement a program tailored to address both.
In addition to revealing risk factors, close scrutiny of your data can help uncover gaps in your employees’ care. Examples of gaps in care include: v Lack of follow-up visits for chronic conditions like diabetes, asthma or high blood pressure. v Not taking medications as prescribed. v Skipping preventive care services. Armed with insight regarding risk factors and gaps in care, Lockton can help you implement a program tailored to address both. Clearly, however, this new focus on your employees’ health is likely to drive some increased costs, particularly in the beginning. For example, consider a newly diagnosed diabetic employee who was identified during a biometric screening. This individual will need a range of services that might include medication, nutritional counseling, more frequent eye exams, and supplies for home blood testing. In addition, evaluation and treatment for related conditions such as hypertension, obesity, and coronary artery disease may become a reality. The same kind of scenario would hold true for individuals diagnosed with other conditions or risk factors.
An Example of How to Avoid Future Costs: Smoking Cessation
A clear example of a wellness effort that shows long-term payoff potential from an initial investment is smoking cessation, which offers both shortand mid-term gains when it is successful. When you help your employees quit smoking, you can expect to experience: v Decreased healthcare costs over those typically associated with smokers, due to their double the risk for heart disease and high risk for lung cancer and chronic lung disease. v Improved overall health and productivity within one year of quitting, which leads to a decrease in healthcare costs for the former smoker. v Reduction in lost productivity costs on an annual basis ($4,430 for current smokers versus $3,246 for former smokers).
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