Chronic conditions in particular, such as diabetes, low-back pain and asthma, take their toll on businesses through frequent absences, lower productivity and higher health insurance premiums.
In Ohio, diabetes triggers enormous social and economic costs. Statewide in 1996, diabetes led to more than 11,000 deaths, nearly 3,000 amputations and close to 150,000 hospitalizations. Diabetes-related medical costs and lost productivity costs in Ohio totaled about $5 billion that year.
Low-back problems affect virtually everyone at some time during their life. Surveys indicate that one-half of working-age adults have back symptoms each year. Next to the common cold, low-back problems are the most common cause of work absenteeism in the U.S. and the most common reason for filing workers' compensation claims. Nationally, the financial toll on businesses ranges from $50 billion to $100 billion.
Back problems also affect co-workers, who must take on the disabled employee's workload. Although the causes of low-back pain are usually not serious, the discomfort can affect emotions, lifestyle and job performance.
Recognizing the challenges of low-back pain and other high-cost conditions, health insurers are responding by offering employers a new initiative known as care management. Care management programs seek to help patients better manage their conditions; reduce disease-related complications; better comply with their physicians' recommendations; and improve their quality of life. Keeping employers' health care costs affordable is another goal.
Under a low-back pain care management program, employees are identified to participate based on their claims history. Low-back programs emphasize basic patient education. Research shows that when patients better understand their illness, they tend to take better care of themselves and avoid behavior that could increase the risk of back injury.
Once identified, employees are asked to fill out a questionnaire about how their back pain affects their lifestyle. Answers are forwarded to the employees' primary care physicians on a confidential basis to help guide discussions at physician office visits.
Participants receive a guide that helps them understand the causes of low-back pain and how to prevent it. It offers tips about proper lifting, bending and sitting techniques; simple exercises for strengthening the lower back and maintaining flexibility; ideas for making one's home and workplace more safe and comfortable; and suggested lifestyle changes that can improve one's back health.
Participants also receive a video which answers frequently asked questions and explores the latest treatment options. The video offers tips on how to talk to your doctor and provides resources for additional information. Toll-free information lines are available for employees to speak to a nurse or listen to tapes about back pain.
Care management programs seek to support physicians' patient education efforts and help them achieve clinical excellence in treating patients. Physicians receive care guidelines -- prepared by the nation's leading medical authorities -- on the treatment of back problems. The programs are not intended to be a substitute for physicians' judgment or experience.
Care management programs are yielding measurable dividends. In one CIGNA pilot program, low-back pain-related hospitalizations decreased 17 percent and emergency room visits dropped by 16 percent in one year. Additionally, employers' medical costs for low back pain declined 16 percent during that period. Although still in its early stages, care management shows great promise for keeping employees healthier, reducing disease-related absences from work, and containing employers' health care costs. Jannifer Harper, M.D., is medical director of CIGNA HealthCare of Ohio.
Still not convinced a healthier workplace can help your company's bottom line? Consider these facts:
- Low-back pain, diabetes and other chronic illnesses take an enormous toll through employee discomfort, absences at work and high health care costs.
- Care management programs, offered by insurers to employers, identify employees with high-cost chronic conditions, promote prevention and offer appropriate medical care.
- Program participants receive educational materials to help them better understand their condition and take better care of themselves.
- These programs seek to reduce disease-related complications, decrease absences at work, improve patients' quality of life, and contain employers' health care costs.