Can Chronic Disease Management Really Work?

With the Centers for Disease Control and Prevention projecting that 83 million people will soon have three or more chronic diseases, the number of employers working to manage chronic conditions like diabetes, high blood pressure and coronary artery disease is staggering.

Not only do the average medical costs for a diabetic exceed $16,000 per year, but the loss of productivity is estimated to add an additional $1,700. How can your health plan cope?

Begin with Good Information
Reviewing claims data, diagnostic tests and prescription drug data is a critical starting point. Once plan members with chronic illnesses are identified, care managers, nurse navigators or health coaches can talk with them to learn about their lifestyle, ask about medications, nutrition, their family situation and other factors that may be impacting their condition.

Chronic disease management is not a one-step process. It involves partnering with a member’s physician and other professionals to understand the patient’s needs and develop a personalized care plan. This level of personal involvement will not only help the member receive the care they need but also help them better understand how to use their health plan to their benefit.

Experience shows that 80% of a company’s healthcare spend is often attributed to 20% of plan members. Chronic illness is likely the reason, making disease management a critical part of high-quality healthcare plans.

Bundled Payments for “Baby Bundles”

Pregnant-WorkerAnother major insurance carrier has cooperated with selected healthcare providers in two states to introduce a bundled payment program for maternity care. Like bundled payment programs used by Medicare and commercial carriers for total joint replacement, the bundled maternity program reimburses the care provider for an entire episode of care, including prenatal, delivery and postpartum services, with one overall fee. Insurers are encouraged with the positive outcomes, citing early access to care and open lines of communication as significant advantages of this approach.

Protecting Member’s Health Data

ACAThe sensitive nature of information shared with payers and providers makes health plan members prime targets for identify theft. While no legislation is currently moving through Congress, a number of senators are taking steps to learn more about recent breaches of healthcare data involving collection agencies and diagnostics firms.

While some employers are taking very costly measures to protect their business and their employees, there are a few steps employers can implement at little or no cost:

  • Encourage everyone to use strong passwords and change them often.
  • Consider adding an Identify Theft protection service to your benefits package. Lifelock and Identity Guard are two common options.
  • Offer educational sessions or webinars to build awareness to the cyber threats that exist today.

On-going education is critically important because the constant use of technology has made too many of us numb to the serious nature of cyber threats. As prevention measures have evolved over time, so have the ways hackers and cyber criminals go about attacking organizations and individuals.

Water and Weight Loss

A study based on several years of data, published in the Journal of Human Nutrition and Dietetics,showed that increasing water consumption by one to three cups a day decreased total calorie intake by between 68 and 205 calories. Intake of sugar and cholesterol were also reduced as a result of drinking more water.

Some physicians believe that drinking more water before sitting down for breakfast, lunch or dinner will curb the appetite. With other benefits such as better brain function, improved digestion and the ability to maintain energy levels, the old adage of drinking eight to ten glasses of water a day just may be more appropriate then ever.

More Large Employers Offer On-Site Clinics

on-site-clinicSome mega-employers manage clinics on their own while others outsource to clinic vendors or healthcare systems. Many provide clinics within their own facilities, but some offer near-site locations and even share a near-site clinic with other companies. Regardless of which model is preferred, more organizations with 5,000 or more employees are deciding that on-site or near-site clinics can make primary care more convenient and affordable for everyone.

Some of these clinics offer pharmacy services and many have expanded to offer services such as physical therapy, telehealth and even behavioral health. One benefit that clinic operators often emphasize is that by making primary care convenient to employees, and in many cases their family members, fewer employees will neglect primary care because of cost or the inability to take time off to see a doctor.

IRS Increases HSA Limits

hsa-limitEmployees will be able to save some additional healthcare dollars in 2020 as the IRS will increase the limit on deductible contributions to an HSA by $50 for individuals and $100 for families. The limits will be $3,550 for individuals with self-only coverage and $7,100 for family coverage. The minimum deductible for a qualifying high deductible health plan will also increase, rising to $1,400 for single coverage and $2,800 for family coverage

Research shows that the number of HSAs increased by 13% over the past year, topping 25 million accounts with an anticipated increase to 30 million by 2020. Another important statistic revealed that the average employer contribution to HSAs rose from just over $600 in 2017 to $839 in 2018 – an increase of some 39%. Supporters are encouraging legislators to make HSAs even more consumer friendly by allowing adults over 65 to continue using an HSA to save for healthcare costs in retirement. We will continue to report on these efforts going forward.