The number of Americans with chronic health conditions continues to grow, so that today more than half of insured individuals are taking a prescription medication to treat at least one chronic health condition. With a health care system more attuned to treating episodes of illness rather than long-term chronic conditions, employers can find themselves especially challenged to come up with ways to moderate the health care costs and productivity losses that result from their employees’ chronic illnesses.
Reports from various sources document the increase in the number of Americans with chronic health conditions, along with the costs associated with these long-term illnesses—
- According to a report from the Kaiser Family Foundation, the number of working age adults with at least one of seven major chronic conditions (heart disease, hypertension, stroke, diabetes, asthma, emphysema, cancer) grew 25% since 1997, to a total of 58 million by the end of 2006. Individuals with these conditions account for three-quarters of all personal medical spending in the United States. However, even at that rate of spending, these folks still might not be receiving the care and treatment they need to effectively manage their conditions: Among the insured with a chronic health condition, the share unable to meet their prescription drug needs doubled from 5% in 1997 to 9.5% in 2006.
- Pharmacy benefit manager Medco Health Solutions reports that, in 2007, 51% of insured Americans were taking prescription drugs to treat at least one chronic health condition, and 20% used three or more medications for chronic conditions. Though this trend was most pronounced among seniors, it also was seen among younger individuals. For example, 48% of women ages 20–44 are being treated for a chronic condition, with the most common condition being depression. But, in general, prescription drug treatments for high cholesterol and high blood pressure were the ones most used by those with chronic health conditions, with more than 20% taking hypertensives and almost one in seven taking cholesterol-lowering drugs.
- According to a report from researchers at Johns Hopkins University, 65¢ of every health care dollar spent in the United States is for treatment of people with two or more chronic health conditions, and this group represents only 26% of the population. Individuals with at least one chronic condition have yearly health care spending more than five times greater than those with no chronic conditions. After pondering this data, it’s clear that employers will want to do what they can to moderate the impact of their employees’ chronic health conditions on health care costs and workplace productivity. It’s best to attack the problem on a number of fronts, and here are some approaches to consider—
- Since prescription drugs are a staple in the treatment of chronic health conditions, a prescription benefit with employee copayment pricing that strongly encourages use of generics will be important to cost management.
- Many chronic conditions are closely related to obesity (hypertension, high cholesterol, diabetes, osteoarthritis). Therefore, wellness programs that feature weight management tools can motivate and assist employees in their efforts to exercise, lose weight and develop eating habits that avoid the high fat/high sodium/high sugar foods that can exacerbate certain chronic conditions.
- Disease management programs can target individuals with chronic conditions and actively work with them to help them manage their diseases. Services can include monitoring prescription drug compliance and sending refill reminders, educating members on their chronic condition, providing information on self care, and making sure that individuals are seeing a physician as is appropriate for their condition.
With any of these approaches, the goal is that better management of a chronic condition will reduce hospitalizations and emergency room visits—which are among the costliest forms of health care—and decrease the times that a chronically ill employee must miss work on account of the illness. Realizing these goals can help to control health care costs and improve employee productivity, while enhancing the quality of chronically ill employees’ lives.