Health risk management Featured

12:55pm EDT April 26, 2004
Regardless of how well an organization develops and maintains a competitive advantage through financial performance, its human capital remains the core of its success. An organization's ability to attract, retain, protect, motivate and renew quality people is the most critical factor for long-term viability.

Part of that ability includes offering attractive health care benefits. But health care costs are on the rise. In 2003, the nation's health care costs reached $1.7 trillion, more than 14 percent of GDP. And, with an average 15 percent annual increase in health insurance costs, most benefit consultants predict that health insurance costs will double within the next five years; some say within the next three years. So how long can your organization sustain these kinds of increases?

Chronic conditions -- which create a greater demand for health care services -- play a key role in rising costs.

* Approximately 125 million Americans have chronic conditions; almost half of these have two or more. More than 64 million Americans have one or more forms of cardiovascular disease -- including high blood pressure -- that cost our nation $298 billion in direct and indirect costs each year.

* 18 million Americans -- 5 million of them undiagnosed -- have diabetes, at an annual cost of $132 billion.

* The Centers for Disease Control and Prevention (CDC) finds that treatment for obesity-related illnesses is a major driver of surging U.S. health care costs, carrying a $93 billion annual tab, $12 billion of which is charged to employers.

* According to the CDC, obesity-related health conditions, such as diabetes and heart disease, are gaining on smoking complications as the costliest preventable illnesses in the nation. Chronic diseases cause approximately 70 percent of all deaths in the United States each year, and a large portion of these diseases-- including lung cancer, diabetes, heart disease and stroke -- are considered preventable.

Seeking answers

Double-digit increases in health insurance costs, combined with a troubled economy, are challenging financial and benefits managers to be more creative in designing their health plans. Most employers believe that changing plan design by increasing co-pays and deductibles and reducing benefits is not the only answer for controlling costs in the future.

Many are turning to health risk intervention programs as a way to proactively manage health care costs while improving the health of their employees.

Once considered a "warm and fuzzy" benefit, health improvement programs are now considered the last resort for stabilizing health insurance costs.

Today, more employers recognize that employees themselves represent a huge opportunity to reduce health care costs. They offer wellness or health management programs that encourage employees to lead healthier lifestyles, and disease management programs that target employees with conditions that can be improved with self-care efforts.

These programs, in which employees work one-on-one with a personal health coach, help create a structured process within which an individual can make a lifestyle change.

The health educator or personal health coach assists the participant in developing a plan of action to work on behavioral changes, which include short- and long-term goals. The coach provides focused, personalized coaching over the phone based on the participant's personal needs and stage of change.

Getting results

Most people really do want to change a bad health habit. Unfortunately, many have other life issues, such as financial concerns or problems with their children or relationships that prevent them from focusing on their health.

The coach can help remove some of these barriers to change by bringing the service directly to the participant. The goal isn't to provide participants with a quick fix; instead, the coach gives them the tools and education they need to understand their problems and continue a healthier lifestyle.

The return on investment for health improvement programs can be high; however, not all the return can be measured in dollars. Other benefits include reduced absenteeism, increased productivity and increased employee satisfaction.

Health improvement programs will continue to offer employers highly effective tools to stabilize health insurance costs and to protect their most valuable asset: their employees. Organizations that create an environment that supports their employees in living healthy lifestyles can make a difference.

Sally L. Stephens, RN, is president of Spectrum Health Systems. Stephens and her husband founded Spectrum Health Systems, an independent health management company, in 1997 to provide Fortune 100 quality health risk management programs to middle market employers. Reach her at (317) 573-7600 or