Blueprint VA: Industry Council for Healthcare
Employee Wellness
August 12, 2013
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Chronic Disease in VA
CHRONIC DISEASE IN RICHMOND CITY
HEALTH DISTRICT, 2010
13% of Virginians report having fair to poor health in general.
The state adult smoking rate is 18%.
Two-thirds (62%) of Virginia adults are at an unhealthy weight (i.e.,
overweight or obese). Current obesity rate is 30%.
50% of Virginians do not get enough physical activity.
Three-fourths (74%) of Virginians do not meet the daily requirements for
eating five or more servings of fruits and vegetables.
Cumberland Plateau has the highest age-adjusted rate of death from
heart disease (213 per 100,000), which is double the state rate (102 per
100,000). Southside has the highest rate of death from cerebrovascular
disease (67 per 100,000), which is 60% greater than the state rate (42 per
100,000).
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$
Diabetes & cardiovascular disease make up
1/3 of health care costs
American Diabetes Association. "Economic Costs of Diabetes in the U.S. in 2007". Diabetes Care. Vol. 31, No. 3, pp. 1-20; American Heart Association. "Heart Disease and Stroke Statistics 2010 Update". Circulation.
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$
The combined cost of the two diseases is more than
$606 billion each year
American Diabetes Association. "Economic Costs of Diabetes in the U.S. in 2007". Diabetes Care. Vol. 31, No. 3, pp. 1-20; American Heart Association. "Heart Disease and Stroke Statistics 2010 Update". Circulation.
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CVD, Diabetes & Obesity
Diabetes = #1 Risk Factor for Cardiovascular
Disease
Obesity = #1 Risk Factor for Developing
Diabetes
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1 in 10 adults in the United States has been
diagnosed with diabetes
"Diabetes Basics." Diabetes Statistics. American Diabetes Association, n.d. Web. 11 June 2012.
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1 in 3 adults is
pre-diabetic
www.cdc.gov/features/diabetesalert/
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1 in 3 adults has been diagnosed
with cardiovascular disease
Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation. 2012: published online before print December 15, 2011, 10.1161/CIR.0b013e31823ac046.
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Average cost for one person to manage
cardiovascular disease for a year
Wang G, Pratt M, Macera CA, Zheng ZJ, Heath G. Physical activity, cardiovascular disease, and medical expenditures in U.S. adults. Ann Behav Med 2004;28:88-94.
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Average cost of a stent procedure
Health Care Costs To Top $8,000 Per Person." CBSNews. CBS Interactive, 04 Mar. 2009. Web. 11 June 2012.
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Average cost of coronary bypass surgery
Healthcare Blue Book." Healthcare Blue Book. N.p., n.d. Web. 11 June 2012.
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Relationship between CVD and Diabetes
Adults with diabetes have 24x higher death rates due to
heart disease and stroke than
adults without diabetes.
2-4x
People with prediabetes have
an increased risk of developing
diabetes, heart disease,
and stroke.
Centers for Disease Control and Prevention. National Diabetes Fact Sheet: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
Mottillo S, et al. The metabolic syndrome and cardiovascular risk. J Am Coll Cardiol 2010;56(14):1113-32.
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Relationship between CVD and Diabetes
Just over 1/3 OF U.S. ADULTS meet the criteria for
metabolic syndrome (MetS), a cluster of CV risk
factors related to overweight/obesity and IR
(abdominal obesity, hypertension, dyslipidemia, dysglycemia)
Centers for Disease Control and Prevention. National Diabetes Fact Sheet: http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf
Mottillo S, et al. The metabolic syndrome and cardiovascular risk. J Am Coll Cardiol 2010;56(14):1113-32.
Summary Of VA Employees In Past 2 Years
Sample Size: 68,477 (46,001 with Biometrics)
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VA Employees (cont)
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Disease Risk Levels In Employees
High Risk Levels
100%
93%
90%
80%
70%
65%
70%
60%
50%
42%
39%
40%
25%
30%
20%
10%
0%
Traditional Lipid
Profile
Risk for CVDAtherogenic
Lipoproteins
Inflammation
Risk for Diabetes
Omega-3 Index
Vitamin D
Deficiency
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Diabetes Risk
70%
61%
Risk for Diabetes in Virginia Employees
60%
50%
40%
28%
30%
20%
10%
7%
4%
0%
Optimal
Insulin Resistance
Suggestive of Pre-Diabetes
Suggestive of Diabetes
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Hidden Risk in VA
Hidden High Risk for Diabetes
Hidden High Risk for CVD
31%
45%
55%
69%
All HbA1c and GLUC was normal
All had normal lipid panel
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Main Drivers of Health Care Costs
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
What were the top 3 contributors to your company's
healthcare costs in 2012?
41.1%
33.9%
28.6%
26.8%
21.4%
12.5%
14.3%
10.7%
7.1%
0.0%
0.0%
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Critical Conditions in Employee Populations
What conditions are most critical to your employee
population?
50%
41%
40%
30%
20%
10%
27%
43%
45%
32%
32%
29%
25%
16%
13%
5%
0%
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Employee Wellness: Cost
How much does your organization spend per year per
employee for your wellness program?
25.0%
21.2%
20.0%
15.0%
18.2%
18.2%
15.2%
15.2%
12.1%
10.0%
5.0%
0.0%
< $100
$100-$250
$251-$500 $501-$1000
>$1000
Unsure
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Prominent Issues
Aging population
Increased chronic disease
(heart disease, diabetes,
cancer and obesity)
Age adjusted rate for heart
disease is decreasing, but
events are happening at an
earlier age
Dissatisfaction with health
insurance, continual rising
costs
Business impact of ACA
VA is not ranked in top 10
states for any of the health
indicators – impact on
attracting business and
maintaining resources
Changes in Virginia’s Population by Major Group
(Actual and Projected)
Under 19
20 to 44
45 to 64
Over 65
600,000
500,000
400,000
300,000
200,000
100,000
0
‐100,000
2010
2020
2030
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Primary Recommendations
All out war on disease –
• public education on health risks & impact to life
• support and promotion of health – all ages
State support of best practices for employer
programs
Insurance Reform- “value based” health
insurance N Engl J Med 2011;365:2088-97
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Secondary Recommendations
Employers Share what works
Bring HC Providers into the loop of Employers
Initiatives
Measure, Quantitate
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