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 Prevalence (%) 51.2 1999 to 2000 Prevalence (%) 62
Weight Category Overweight (BMI > 25)
Obesity (BMI > 30) Severe Obesity (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 Group Black (nonHispanic) Overweight (BMI > 25) 78 Obesity (BMI > 30) 50.8
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
Metabolism Behavior Environment
**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% 50% 20%
Acce ss to Care
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 Medical
Annual Costs Per Employee Per Year
Any Cancer Depression/
Sadness Mental Illness
Source: Goetzel, Long, Ozminkowski, et al. JOEM 46:4, April ,2004)
What has Horizon BCBSNJ Done?
Horizon –BCBSNJ Wellness Programs
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. any medical Mhypertension,conditions, such as can be affected by the way you live your life. It is not only beneficial to live a hearthealthy life, but it is important to manage your own health conditions and monitor your vital signs. The Horizon Health Kiosk provides the information, resources and tools to help you become aware of, and actively involved in, the management of your health and any risk factors you may have. It has an interactive touch-screen with color graphic display, allowing you to measure: • weight. • blood pressure. • heart rate. • body fat. • BMI. • blood oxygen levels. A barcode is used to access the System. The system recognizes and welcomes the user, prompting you to select an ID and password. This allows measurement data to upload into a private, protected graphical health chart, viewable from any computer. at <www.lifeclinic.com>.
You can access health information, obtain information about medical conditions you may have and record and track changes important to you and your physician in choosing and monitoring treatment. You can also learn various ways to make positive health changes to your lifestyle. Charts and reports may be printed to help you discuss lifestyle modifications and treatment changes with your physician.
The Horizon Health Kiosk is one more way we’re Making Healthcare Work for our members.
Health Risk Assessment and Analysis
Immediate Results / Comparison to Universe of peers
Horizon generates output for use in Disease Mgmt, Prevention, Group Reporting, etc. Confidential
Highlights Risk Factors and Action Steps
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. - Members who received written materials or have been contacted by a Care Specialist are more likely to say they have lost weight. • About forty percent of members have measured their waist since participating in the Weight Management Education Program. - Of those members, nearly 70% say they noticed a decrease in their waist measurement and 40% had a decrease in their clothing size.
50% 40% 30% 20% 10% 0% 1 to 5 6 to 10
Pounds Lost 29%
Amount of Weight Lost
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 get sick and miss work/school or daily activities I occasionally get sick, but I still go to work/school or carry out other daily activitites I occasionally have to miss work/school or other daily activities because of illness My/child's health significantly interferes with my life I frequently have to miss work/school or other daily activities because of illness
8% 23% 61%
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 Change (*)
On Site Clinical Resources
Integrator / Navigator / Dispatcher
Disease Management Claims / Predictive Modeling
Moderate Risk/Acuity Health Risk Appraisal
EAP / Behavioral Health
* includes health coaches and web based and telephonic programs
Data Warehouse: Comprehensive Reporting & Outcomes
Lifestyle change and education promotes decreased prevalence of obesity Diet Exercise Behavior Modification Improves overall health Decreases healthcare costs
Questions or Open Discussion?