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High Risk – High Cost

Why addressing employees with the highest health risk factors may be the best way to look at wellness programs.

If you are a Benefits Administrator, CEO, CFO, or all of the above, the rising cost of healthcare is always on your mind.  Wellness programs are a great way to help employees and their families get healthy and stay healthy, but oftentimes (as we all know) the healthiest people are the only ones who join.  If you want to change the trajectory of healthcare costs within your organization, maybe you should try addressing your highest risk employees . Employees and family members with less healthy lifestyles often have anxiety about participating in worksite wellness programs.  However, targeting this segment of your employee population may be the best way to spend your wellness budget, even if it requires a different type of program offering that is specifically designed to appeal to someone who has not participated in the past.

Let’s look at the numbers:

According to the CDC more than half of all Americans have at least one chronic condition.  Over 100 million Americans are living with diabetes or pre-diabetes.  When you think that the average cost of diabetes is $9,601 per person according to the National Diabetes Statistics Report, addressing this and other preventable conditions within your organization is imperative to controlling healthcare costs.  The CDC reports that just 5% of the population consumes 50% of total health care costs.  (It is likely that the numbers in your organization reflect these statistics).

If you take a look at just a few of the preventable, chronic conditions that wellness programs can target, diabetes is one of the frontrunners associated with high cost.  In a JAMA  (Journal of the American Medical Association) study, the authors showed that the increase of diabetes medications was responsible for approximately 70% of the 64 billion increase in costs of treating this disease.  Unfortunately, poorly controlled diabetes can lead to much worse conditions like heart disease, kidney failure and stroke, so the cost of controlling diabetes are much less than the cost of interventions from poorly controlled diabetes.  This same rule is true for other chronic and preventable conditions like heart disease, obesity, and metabolic syndrome.  The JAMA study also showed that following diabetes, diseases with the highest costs were:

  • Heart Disease $219 billion
  • Low-back and neck pain: $57.2 billion
  • High blood pressure: $46.6 billion
  • High cholesterol: $41.9 billion
  • Depression: $30.8 billion
  • Osteoarthritis: $29.9 billion

So, while the employees who are consistent healthy eaters and exercisers may love the wellness programs, it just makes sense to create targeted programs that attract the highest risk individuals who may be the least likely to participate in the wellness programs typically offered. 

Appealing to these populations takes some time, patience, and nurturing.  However, once you understand how to reach high-risk individuals and encourage their participation, you can not only lower healthcare costs, but you could save a life!

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