Prevention wins momentum via health care law

Some aspects of the health care reform law, including the wellness and prevention provisions, have gained traction and will continue as scheduled in part because employers are taking up the cause by recognizing the importance of implementing prevention and wellness programs to enhance the health of their employees as well as the bottom line.

“It’s really encouraging to see the planks of prevention [laid] in the foundation of the health care reform law. What’s equally encouraging is that it seems like prevention transcends politics,” says Dr. Ron Loeppke, vice chairman of U.S. Preventive Medicine and co-chair of the company’s international advisory board.

Federal grants for small businesses implementing wellness programs were included in PPACA, as well. Though the money is not appropriated yet for employers with less than 100 employees without wellness programs, $200 million was designated. Ultimately, the future of this program depends on the final appropriation and implementation set forth by Congress and the federal agencies.

PPACA creates a National Prevention, Health Promotion and Public Health Council to be composed of departmental secretaries with the surgeon general as chair to develop “a national prevention strategy.”

In addition, the President will appoint an advisory group of health professionals to advise the council. There also is a fund to provide a sustained investment in prevention and public health programs.

“Prevention is an idea whose time has finally come because we have a health care cost crisis that is largely driven by an underlying health crisis in our society. We are facing an increasing burden of chronic illness and a burden of health risks that are leading to those chronic conditions that account for 70% of all deaths and around 75% of the current health care expenditures. However, the good news is that the Centers for Disease Control and Prevention has shown that 80% of type 2 diabetes and heart disease, as well as 40% of cancers, are preventable if Americans eat healthier, exercise more regularly and do not smoke,” says Loeppke.

The retailer Sam’s Club/USPM has designed a prevention plan that tailors a prevention blueprint for the individual and includes a health risk assessment and at-home blood test, as well as consultations with a personal health coach. The coverage is $99 per participant per year, and the individual must be a Sam’s Club member.

Dr. Loeppke published a study in 2010, assessing the health of 2,606 employees across three diverse employers through a health risk assessment, including lab tests and biometric measures, such as blood pressure and blood sugar, performed at baseline and then after one year of participating in their personalized prevention plan. 

He found that 42% of individuals in the study population reduced one or more health risk factors. Of those individuals who were originally in a high-risk category with five or more risk factors, 64% moved to low or medium risk. Of those at medium risk, 46% became low-risk.

These are significant figures when you consider that 57 million Americans have pre-diabetes, yet less than 10% know it.

“From the employer perspective, reducing the burden of health risks and illness represents a very significant value proposition for them, a business case, because when you reduce health risks, you not only reduce medical and pharmacy costs, you reduce health-related productivity costs,” explains Loeppke.

In fact, several research studies have shown that for every $1 employers pay in medical and pharmacy expenses, $2 to $3 are spent on health-related productivity loss, including absences, short- and long-term disability, and low productivity while at work.