Why health screening?

"The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease" - Thomas Edison, 1902

 

 

The ROI view: Preventive care pays

Chronic disease drives 74% of healthcare cost

U.S. Healthcare is a $2.4T industry (2008) growing at 7%.  Most of this is spent on curing illness as opposed to promoting, achieving and maintaining health.  Healthplans really are 'sick-plans'. Only 3% of healthcare spending in the U.S. is targeted at prevention.  This is counterproductive because 70% of Healthcare costs are driven by behavior (smoking, obesity, lack of exercise, uncontrolled hypertension and cholesterol). These behaviours lead to the big four chronic conditions (Cardiovascular disease, Cancer, Diabetes and Obesity) which combined drive 74% of the total healthcare cost. Six in 10 adults over the age of 18 have at least one chronic condition

Agency for Health care Research and Quality, 2009
CDC, HHS, 2005 data, Safeway analysis, see also Thorpe, et al, Health Affairs, June 2007
American Institute for Preventive Medicine 2005; American Journal of Health Promotion 1991, 1993, 2000; Milliman & Robertson 1995; Safeway analysis
McKinsey & Company, Why understanding medical risk is key to US Healthcare reform, McKinsey Quarterly June 2009
Center for Medicare and Medicaid Services; Modern Healthcare by the Numbers 2008

Employers bear the brunt of these costs since they cover about 75% of the health insurance premiums for their covered employees, with family coverage costing on average $12,700 in 2008. 

In a typical U.S. company the sickest 15% of employees will drive 78% of medical expenses.

Interactive Health Solutions, 2010

Beyond this direct cost of preventable disease unhealthy employees are less productive because of sick days, presenteeism and lower quality work. Furthermore, as preventable disease progresses so do healthcare costs and productivity losses.

What can employers do?

There is good news in all of this: 80% of Heart disease, 30% of cancers, 80% of diabetes (Type 2) and nearly all weight problems can be addressed or prevented by behavioral changes and disease management, including proven medication. 

CDC, HHS, 2005 data, Safeway analysis, see also Thorpe, et al, Health Affairs, June 2007

If employees who are at risk or have undiagnosed disease can be identified and encouraged to see their physician treatment can be simple and cheap. Compare for instance average hospital charges for treating an acute heart attack of $54,000 in 2007 with the cost of cholesterol medication of less than $50 per year for generic statins.

Washington Post, July 26. 2009; Price before negotiated insurance discounts, but also before physician fees

Many employers have begun to pursue preventive programs and to promote workforce health. Safeway for instance has been very public about their success.

Steve Burd (Safeway Chairman, President and CEO) presentation at the World Health Congress 4/14/2009
Kaiser Family Foundation /Health Research Educational Trust Survey of Employer-Sponsored Health Benefits, 1999-2008
Kaiser Family Foundation /Health Research Educational Trust Survey of Employer-Sponsored Health Benefits, 1999-2008

The medical view: Preventive care works

Simple lifestyle changes, in some cases together with medication can drive risk factors down substantially:

In all of these cases (and there are more) the first step is to diagnose and monitor the disease progression. In addition we have found incentives to be critical to encourage employees to participate in a screening and in maintaining a healthy lifestyle.