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Work Site Solutions and Wellness Programs Premila Mary Kumar Senior Clinical Manager Health and Wellness Education Programs Facts about Obesity Recent estimates state obesity accounts for $117 billion per year in national healthcare expenditures 2/3 of American adults are overweight or obese (BMI >25) 14% of adolescents 12-19 years old are overweight 300,000 deaths each year are related to obesity Obesity on verge of surpassing smoking as #1 cause of preventable death Obesity is a factor in increase of disability Diabetes rates will double worldwide by 2030 Increase in Overweight, Obesity and Severe Obesity Prevalence Among U.S. Women* 1988 to 1994 1999 to 2000 Weight Category Prevalence (%) Prevalence (%) Overweight 51.2 62 (BMI > 25) Obesity 26 34 (BMI > 30) Severe Obesity 4 6.3 (BMI >40) Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002. Flegal et. al. 2002;288:1723-7. *Ages 20 to 74 for overweight and obesity prevalence and ages 20 and older for severe obesity. Increase in Overweight and Obesity Prevalence (%) Among Women by Racial / Ethnic Group Racial / Ethnic Overweight Obesity Group (BMI > 25) (BMI > 30) Black (non- 78 50.8 Hispanic) Mexican 71.8 40.1 American White (non- 57.5 30.6 Hispanic) Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002. Causes of Obesity Greater calories consumed than used Sedentary lifestyle Genetics Metabolism Behavior Environment Cultural influences Socioeconomic influences **National Center for Chronic Disease Prevention and Health Promotion Conditions Affected by Obesity Diabetes Mellitus Arteriovascular Disease (CAD, CVD, HTN, Hyperlipidemia) Heart Failure COPD ESRD (DM, HTN) CA (many forms) Healthcare Implications of Obesity 65% of Americans are overweight or obese Additional expenses for employers Disability Absenteeism Presenteeism Orientation Impact on children 1st generation that will not outlive their parents Unchecked, the cost of healthcare in our children’s generation will be staggering Who’s in Control of Your Health? Contributing Factors to an Individual’s Health Status Life style be haviors Environme nt Ge ne tics 10% Acce ss to Care 20% 50% 20% Source Centers for Disease Control and Prevention (2000) Retrieved August 11, 2003, from http//www.cdc.gov How Health Impacts Business Costs The Payback from Behavior Change $450 Presenteeism $400 Absence RX Annual Costs Per Employee Per Year $350 Medical $300 $250 $200 $150 $100 $50 $0 Allergy Arthritis Asthma Any Cancer Depression/ Hyper- Migrane/ Infections Diabetes Heart Sadness tension Headache Mental Illness Disease Source: Goetzel, Long, Ozminkowski, et al. JOEM 46:4, April ,2004) What has Horizon BCBSNJ Done? Horizon –BCBSNJ Wellness Programs Employee Health Center Pharmacy Concierge Services Onsite LabCorp laboratory services Onsite Fitness Center Mobile Mammography Free Flu vaccines for all employees Employee Assistance Program Horizon –BCBSNJ Wellness Programs Healthy food choices offered in the cafeteria Disease Management Programs Lactation Rooms Employee Discount Program Web MD online resources Shape it Up Program in Schools Horizon Health Kiosk Program “Horizon Walks for Health” Community / Corporate Wellness Program Horizon Health Kiosk Better health through awareness In our continuing dedication to Making Healthcare Work, Horizon Blue Cross Blue Shield of New Jersey is making it easier for you to take an active role in managing and enhancing your overall health and well-being through the Horizon Health Kiosk. A barcode is used to access the any medical Mhypertension,conditions, such as can be affected System. The system recognizes by the way you live your life. It is and welcomes the user, prompting not only beneficial to live a heart- you to select an ID and password. healthy life, but it is important to This allows measurement manage your own health data to upload into a private, conditions and monitor your protected graphical health chart, vital signs. viewable from any computer. at <www.lifeclinic.com>. The Horizon Health Kiosk provides the information, resources You can access health information, and tools to help you become aware obtain information about medical of, and actively involved in, the conditions you may have and record management of your health and any and track changes important to you risk factors you may have. It has an and your physician in choosing and interactive touch-screen with color monitoring treatment. You can also graphic display, allowing you to learn various ways to make positive measure: health changes to your lifestyle. Charts and reports may be printed to • weight. help you discuss lifestyle • blood pressure. modifications and treatment changes • heart rate. with your physician. • body fat. • BMI. The Horizon Health Kiosk is one • blood oxygen levels. more way we’re Making Healthcare Work for our members. www.Horizonblue.com Health Risk Assessment and Analysis Interview-style input Immediate Results / Comparison to Universe of peers Horizon generates output for use in Highlights Risk Factors and Action Disease Mgmt, Prevention, Group Steps Reporting, etc. Confidential Weight Management Health Education Program Welcome Kit with Tape Measure, Caloric Counter / Diary, Pedometer etc Tape Measure to assess waist circumference and waist:hip ratio Educational Materials Access to Registered Nurses, Registered Dietician, Social Worker & Certified Diabetes Educators Onsite Lunch & Learn programs Quarterly Educational Mailings Newsletters discussing hot nutritional topics Discount exercise programs Cook Shops at Employer worksite Weight Management Health Education Program Outcomes Measurements Weight loss or reduction Reduction in Body Mass Index (BMI) Waist circumference Clinical Metrics : Cholesterol, Blood Sugar, Blood pressure & A1c Number of ER or Inpatient admissions due to co morbid conditions Weight Loss/Waist Measurements • Overall, about 50% of members who have participated in the Weight Management Health Education Program have lost weight, and a third have lost 11 pounds or more. 50% Amount of Weight Lost - Members who received written materials or have been contacted by a 40% 35% 36% Care Specialist are more likely to say 29% they have lost weight. 30% • About forty percent of members have 20% measured their waist since participating in the Weight Management Education 10% Program. - Of those members, nearly 70% say 0% they noticed a decrease in their 1 to 5 6 to 10 11+ waist measurement and 40% had Pounds Lost a decrease in their clothing size. Q9a: Since you began participating in the Weight Management Health Education Program, have you lost weight? Q9b: Since you began participating in the Weight Management Health Education Program, how much weight have you lost? Q9c: Since participating in the Program, have you measured your waist? Q9d: Have you noticed a decrease in your waist measurement? Q9e: Have you had a decrease in your clothing size? Members Overall Health/Absenteeism Over 60% of members believe they are in very good health and rarely get sick, miss work/school or daily activities. Almost three-quarters (74%) of members currently work full or part-time outside of the home. And of those members, almost none (99%) have missed any days at work because of any weight-related health problems in the past four weeks. Members Overall Health I think I am in very good health and I rarely 61% get sick and miss work/school or daily activities I occasionally get sick, but I still go to 23% work/school or carry out other daily activitites I occasionally have to miss work/school or 8% other daily activities because of illness My/child's health significantly interferes with 6% my life I frequently have to miss work/school or other 2% daily activities because of illness 0% 20% 40% 60% 80% 100% Q13: How would you describe your overall health? Q14: Do you currently work full or part-time outside of the home? Q15: In the past 4 weeks did you miss any days at work because of any weight related health problems? Proposed Horizon Service Delivery Model Coordinated Approach Decision Support & Health Advocacy Nurse Line Lifestyle Behavior On Site Clinical Change (*) Resources Integrator / Navigator / Disease Participant Management Dispatcher Claims / Predictive Case Modeling High Risk/Acuity Management Moderate Risk/Acuity EAP / Health Risk Behavioral Health Appraisal Low Risk/Acuity Data * includes health coaches and web based and telephonic programs Warehouse: ROI Comprehensive Reporting & Outcomes In Conclusion Lifestyle change and education promotes decreased prevalence of obesity Diet Exercise Behavior Modification Improves overall health Decreases healthcare costs Questions or Open Discussion?