About an equal amount is paid by public funds – Medicare (20%) and Medicaid (17%). The rest of healthcare costs are paid by Donations (19%) and Out-of-pocket expenses (10%). Each year, we spend more because of poor health than we spend on the military and national security.

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

Healthcare for Business and Industry

Employer-sponsored healthcare began during World War II. The Stabilization Act of 1942 limited wage increases. To attract new employees, US businesses used employer-sponsored health insurance. Employees didn’t have to pay taxes on sponsored healthcare and they got coverage for themselves and their families.

Other types of benefits included Life insurance, Retirement plans and Disability insurance. Medical insurance was the most popular.

Since then, employer-sponsored healthcare has increased. Initially, only large corporations were self-insured and implemented their own insurance plans. Especially in industries where employees had a high risk of injury.

Now, increasing costs of healthcare and changes in healthcare regulations have caused small and medium-sized businesses to become self-insured. Along with opportunities and incentives to reduce healthcare costs.

Designing and implementing healthcare programs for business and industry has become an industry of “Professional Employer Organizations.”

Employee Health Benefits

Most large US employers offer a health-contingent program as part of their employees’ health benefits. These support employees in making changes to health behaviors. Including changes to reduce risk for certain chronic medical conditions and manage them more effectively.

They include health screening for risk factors as well as education and coaching for cessation of tobacco use, promotion of physical activity, stress reduction, and weight management. Some programs also include chronic disease management.

Most large employers ask for personal health information. The majority use a health risk assessment (HRA) questionnaire and some use screening by a physical examination or lab test. In addition, some large employers collect information through wearable technologies. Approximately a third of large firms offer incentives to disclose health information.

A small percent also offer incentives to reduce body weight or improve blood cholesterol levels. These health-contingent wellness programs were authorized first in 2006, and later by the Affordable Care Act.

Randomized Controlled Clinical Trials

The health, economic and employment effects of education and coaching have been studied in the US. Effects of health and wellness programs in 20 worksites were compared with health, economic and employment outcomes for 20 worksites without health-contingent programs. Each group included about 4,000 employees.

Over an 18-month period, programs offered at treatment worksites included 8 sequentially delivered sessions instructed by dietitians, each of 4 to 7 weeks in duration. Approximately 35.2% of employees in the treatment worksites completed at least 1 set of education and coaching sessions.

After 18 months, 29% of employees in the untreated groups had high cholesterol, 23% had hypertension, and 43% were obese. No statistically significant differences were detected between the employees in the untreated group worksites and treatment group worksites. Also, there were no significant differences in mean medical care spending or utilization.

Data from all worksites were examined to determine absenteeism, job tenure, and performance review scores. Here again, there were no significant differences in productivity or performance between employees in the treated and untreated worksites.

Financial Incentives

In 1996, the Health Insurance Portability and Accountability Act (HIPAA), allowed financial incentives for programs of health promotion and disease prevention. Initial limit was 20% of total healthcare coverage. In 2010, the Affordable Care Act lifted the ceiling on health-contingent program incentives to 30 percent. This limit was close to $1,800 annually for an average employee-only plan.

Employers offering health and wellness programs frequently include monetary incentives to encourage participation. Surveys show incentives are associated with higher participation rates. Especially in larger firms with comprehensive programs. They have the highest participation rates. Access to a more expensive plan elicits a participation rate of 40%. Incentives structured as penalties for not participating have an even higher participation rate of 73%.

Chronic conditions are the major cause of illness, disability, and death in the United States. A RAND Wellness Programs Study showed 87% of participants in worksite wellness programs had risk factors for costly disease. Only 13% had chronic disease requiring daily management.

Savings in healthcare costs resulted from about $30 per participating employee per month. This reduction was caused almost entirely by a 30% reduction in hospital admissions among 13% of employees who had chronic conditions. Most of the reduction in hospital admissions was the result of improved disease management.

In 2010, the Affordable Care Act allowed incentives for health outcomes up to 30% of the cost of the group health plan. However, few employers offer this type of health program. In 2019, only 7% of large employers offered health-contingent wellness programs.

Coronavirus Infection, Symptoms and Severe Illness

COVID-19 is a viral infection that spreads from person to person. It surely started in animals but it spreads in people. Everywhere as fast and as far as an airplane can fly. What can we do?

We hear the most instruction about using public health and social measures. Actions by individuals, communities, governments and travel that slow down spread. What else can we do? Each of us can improve our health enough to prevent getting really sick.

The best sources of information report that about 25% of people in the US already have been infected by COVID-19. About a third of those infected didn’t even know it and another third had minor symptoms. Others became so ill they had to be hospitalized and one or two percent died.

Many of those who became seriously ill were already sick with heart disease, lung disease or diabetes. But the biggest group of seriously ill were simply overweight or obese. Especially high % body fat with visceral obesity. Something that can be prevented, recognized, measured, and corrected.

All are indicators of Subcutaneous Adipopenia and Chronic Inflammation.

All are avoidable, measurable and correctable in a corporate health program.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

This includes $237 billion in direct medical costs for diagnosed diabetes and $90 billion in reduced productivity.

One third of people going to work every day have Metabolic Disease including Diabetes. Are you in this group? We can help you out!

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

Epidemic Of Metabolic Syndrome

The combination of insulin resistance, abdominal obesity, high blood pressure and abnormal fat metabolism occurs in 30% of adults in this country.

Compared to all others, those adults have twice as much cardiovascular disease, stroke, arthritis, chronic kidney disease, schizophrenia, dementia and several types of cancer.

As shown in the Figure, Caucasian men and women have more metabolic disease than either Hispanic or African-American men and women.

Also, over two-thirds of US adults are either overweight or obese. More than 10% of people over 60 years of age and 50% over 80 years have low muscle mass.

These physical features are preventable. The costs of poor health, disability and premature death can be avoided.

What can we do? Each of us must look after ourselves.

What can we do to improve health, wealth and happiness of everybody else? We can promote programs to reduce poor health and save money doing it.

Productivity Costs And Medical Expenses

In the past, the guiding principle for workplace health programs was keep everybody happy. Serious illness was not much considered. Heart attack and stroke could happen but that would be sometime in the future. By then, the worker will be employed somewhere else!

Not so! Now we know that workers with Metabolic Disorders including Diabetes have huge medical expenses and miss more days at work. They have more than twice as many missed days at work because of illness or injury as workers without cardiometabolic risk factors.

Workers with Metabolic Disorders had medical costs more than 50% higher than other workers. Most of the increase was spent on treatment of diabetes.

Healthcare costs for people with Type 2 Diabetes amount to about 25% of all healthcare costs. More than half of that spent because of diabetes. The Figure shows that people with diabetes have medical expenditures about 2.3 times higher than in the absence of diabetes.

Indirect costs related to diabetes include increased absenteeism ($3.3 billion) and reduced productivity while at work ($26.9 billion).

All these reports show that most costs for illness and injury come from 30% of employees with Metabolic Disorders including Diabetes.

Costs of Employee Healthcare are close to $15,000 for every employee. For most employers, labor costs are the greatest operating expense. As a result, costs of employee healthcare amount to almost 10% of operating expenses.

Out Of Pocket Expenses for employees are costs that aren’t reimbursed by the employer, insurance or reinsurance company. They include deductibles, copays and coinsurance for covered services up to any limit for out of pocket expenses in an insurance plan. Average healthcare deductible through an employer plan is about $1,500 for individual coverage. Average copay insurance is about 20%.

Small Firms with over 50 full time employees pay at least 60% of premiums for healthcare insurance coverage. Large corporations pay closer to 80% of premiums for their employees.

About 10% of workers do not have any healthcare insurance. They are part-time employed, working for small business with fewer than 50 full-time employees or unemployed. They pay out of pocket for all their healthcare services.

Health And Wellness Incentive Programs

A Majority of Corporations with more than 50 employees offer Health and Wellness Programs. Most of them use incentives to promote program participation. Incentives include gift cards, merchandise, cash, contributions to health savings accounts and lowering of healthcare insurance fees.

Only about one-third of smaller corporations with fewer than 100 employees offered Health and Wellness Programs. This means that about 20% of all employees in the American workforce do not have access to H&W Programs.

The annual $ value of program incentives is actually quite small. As shown in the Figure, half of all programs in 2017 offered less than $500 and only about 20% offered as much as $1,000. However, incentives did bring about 20% higher participation rates.

Incentives, generally speaking, were not used to promote outcomes. The only exceptions were a few programs which charged smokers larger fees for healthcare insurance.

Weight and Physical Fitness Impact of incentives is small. An analysis of published clinical trials using financial incentives has been reported.

Results from 11 clinical trials produced data showing improvements in physical activity and weight loss. These trials included 126 subjects receiving on the average a maximum total possible payout per week of $28 (range $8 to $77).

The effect on physical activity was an average increase in total daily steps from about 5,000 steps per day to 7,000 steps per day.

The effect on weight loss was an average loss of -5.2 lb.

Results reported do not include any information about how many subjects produced most of the changes.

It’s possible that a maximum payout of $4 per day simply is not enough to produce much improvement except in a very small percentage of subjects.

Summary

Most costs for illness and injury come from 30% of employees with Metabolic Disorders including Diabetes. The 10% with Type 2 Diabetes have by far and away the most costly illness presenting in the American workforce. In addition, other family members with type 2 diabetes also increase the cost of providing healthcare insurance for employees and their families.

Health and Wellness Programs reduce both corporate expenses and out of pocket expenses for employees. Managing %Body Fat and increasing Physical Activity improves long term prospects for good health and relief for individuals with Metabolic Disorders including Diabetes.

Enthusiastic corporate support including financial incentives for employee participation makes it possible for employees to accept help reversing their diabetes. Measures specifically designed to target employees with diabetes would make them uncomfortable and probably would be illegal. As part of a corporate culture promoting health and wellness, employees suffering effects and costs of diabetes would be more likely to come out of the shadows of poor health.

Once identified and recruited to participate, improvement in health and performance should follow. Intensive efforts including substantial financial incentives to make that happen would be good investments.

Success would relieve those employees and their employers from direct and indirect cost of Metabolic Disorders including Type 2 Diabetes.

Let us help you build, promote and implement a Corporate Health and Wellness Program to improve employee performance and reduce healthcare costs.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com