3 Questions Featured

8:00pm EDT May 26, 2010


Dr. Lee B. Sacks has served as president of Advocate Physicians Partners, the care management and contracting partnership between Advocate and 3,400 physicians, since its creation in 1995. He assumed the additional responsibilities of executive vice president and chief medical officer of Advocate Health Care in 1997. He is responsible for clinical excellence, information systems, research, medical education, managed care contracting and PHO operations.

Q. How should an employer handle chronic diseases in the workplace?

It takes a comprehensive approach. You need to look at your benefit plan design and your claims experience and understand which chronic diseases are more prevalent in your population. There’s an opportunity for education in the workplace, without trying to reinforce appropriate behavior. The other thing is to really appreciate the cost to your business of chronic disease — both the actual cost of medical care and the lost hours and days at work. There is a significant loss of productivity related to that. When you appreciate that, you realize it makes good economic sense to make investments up front.

Q. What can an employer do to minimize or eliminate chronic diseases in the future?

Even a small employer who doesn’t have a sophisticated benefits department needs to be asking about data on chronic disease management from the health plan that provides their benefits. Unfortunately, there’s not a lot of data that can be tied back specifically to that employer. So there are large variations in the health care delivery system, in terms of managing chronic disease. You want to make sure you’re getting optimal results, whether it’s the near-term control for the measures of metrics for diabetes, long-term complications, the number of emergency room visits or days in the hospital, or blood pressure and cholesterol control for patients with cardiovascular disease.

Q. When should employers expect to see a return on their investment?

You should start to see it moving in the right direction in a year, albeit in small amounts. Some chronic diseases have much more visible benefits immediately. For other diseases, like high blood pressure, high cholesterol and diabetes, you’re looking at 20, 30, 40 years to see the full benefits. There’s probably a three- to five-year investment before you start to see real savings to a health plan expense.