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High-Priority Wellness Initiatives

High-Priority Wellness Initiatives. Minimizing Health Costs, Promoting Employee Health, and Improving Workforce Productivity Vincent Fonseca, MD, MPH. Overview. High-impact diseases and risk factors Costs of these diseases and risk factors High-value wellness services. Why wellness?.

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High-Priority Wellness Initiatives

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  1. High-Priority Wellness Initiatives Minimizing Health Costs, Promoting Employee Health, and Improving Workforce Productivity Vincent Fonseca, MD, MPH

  2. Overview • High-impact diseases and risk factors • Costs of these diseases and risk factors • High-value wellness services

  3. Why wellness? • Problems: • Large and increasing direct health costs to employers: health service and pharmacy costs • More dollars to health benefits, less for wages • Productivity costs: • Absenteeism costs • Presenteeism costs • Recruitment and retention

  4. Why worksite wellness? • Many health issues are preventable • ~70% of disease burden and cost • ~50% of deaths • Modifiable health risk factors are common • Associated with healthcare costs, productivity losses, and absenteeism • Worksites: • >50% of waking hours • Group of people with common purpose and culture • Communication, organizational norms, support, incentives, measures • Can be improved with worksite health productivity and management programs • Improvements in risk lead to decreased healthcare, absenteeism, and presenteeism costs

  5. Diabetes Prevalence in Texas

  6. Prevalence of Undiagnosed DM, US

  7. Prevalence of Prediabetes or DM, US

  8. Diabetes Excess Medical Costs, US

  9. Diabetes Productivity Losses, US

  10. Cost calculators • http://www.cdc.gov/nccdphp/dnpa/hwi/program_design/cost_calculators.htm • Tobacco • Inactivity • Alcohol • Obesity • http://www.cdc.gov/leanworks/costcalculator/index.html

  11. Potential Solutions • Focus on the most important real causes of premature death, disability, sickness and decreased productivity • Obesity: healthy eating and physical activity • Tobacco • Alcohol misuse • Cardiovascular risk assessment and management • Facilitate access to high-value services

  12. Community Guide Worksite Activities • Interventions to Promote Seasonal Influenza Vaccinations among Non-Healthcare WorkersInterventions with on-site, reduced cost, actively promoted vaccinations • Assessment of Health Risks with Feedback (AHRF) to Change Employees’ HealthAHRF plus health education with or without other interventions • Obesity Prevention: Worksite programs to control overweight and obesity • Point-of-decision prompts to encourage use of stairs • Creation of or enhanced access to places for physical activity combined with informational outreach activities • Smoke-free policies to reduce tobacco use among workers • Incentives and Competitions to Increase Smoking CessationIncentives and competitions when combined with additional interventions

  13. CDC's Division of Nutrition, Physical Activity, and Obesity Promising Practices • Environmental and Policy • Enhanced access to opportunities for physical activity combined with health education • Informational and Educational • Multi-component educational practices • Exercise prescriptions alone • Behavioral Interventions • Weight loss competitions and incentives • Behavioral interventions with incentives • Behavioral interventions without incentives

  14. Promote Access to High-Value Services • Smoking cessation advice and help to quit: • 1-877-937-7848, free counseling and patch • Aspirin to prevent cardiovascular disease • Problem-drinking screening and brief interventions • Hypertension screening and management • Influenza immunization • Pneumococcal immunization • Cholesterol screening and management • Cancer screening (800-ACS-2345) • Calcium supplementation in women

  15. Preventive Services, TX, 2007 BRFSS • Tobacco smokers • Advised to quit: 40% (Hispanic 27%) • Offered NRT: 22% (Hispanic 11%) • Flu vaccine in seniors: 67% (Hispanic 61%) • Cholesterol screening, men: 78% (Hispanic 63%) • Pap test (past 3 yrs; 18-64 yrs old): 81% • Colono/sigmoidoscopy (past 10 yrs; 50+): 59% • Hispanic: 41% • Mammography (past 2 yrs; 40+): 71% • Hispanic: 62% • Received weight advice • Obese: 34% • Overweight: 13%

  16. Target High Value Services • Insurance coverage doesn’t equal delivery of high value services • Target high-value services to specific individuals • Use comprehensive HRA • Aspirin to prevent heart attack • Cancer screening • Immunization need • Tailor the message and program • Evaluate outcomes • Reports for ongoing and retrospective results

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