Too much of what today is called healthcare is actually “sick care.” Our medical establishment treats disease after it’s appeared, rather than preventing it before it ever shows up. Worse, today’s fee-for-service model incentivizes a focus on procedure, not result, and is flawed for rewarding volume over quality (e.g., when a provider tries to head the need for care off at the pass preventatively, the system punishes them because reimbursements go down). Rather than rewarding primary prevention with the aim of healthcare to keep healthy people healthy, the system rewards and incentivizes illness as our ultimate end state. The losers are most definitely individuals, but also health insurers – employers and health plans who are left intervening too late and holding a very expensive bag. The best approach to mitigating chronic health risks instead is to help employees establish healthy new habits, and the right kind of healthcare platform will help employees do exactly that.
The scope of our population’s chronic disease problem is tremendous: Up to 40% of all Americans who died from Covid-19 – approximately 400,000 people – had type 2 diabetes, and by almost all measures the nation’s problem with chronic disease grew worse during the pandemic. Here’s a review of some challenges that chronic disease presents us with and a discussion of what kind of approach makes people healthier, happier, more productive and ultimately reduces their healthcare premiums, too.
Covid exacerbates growing problem
The United States and its workforce is increasingly aging, obese and suffering from chronic disease. A full 24% of the workforce is 55 or older, according to the CDC, and arthritis and hypertension affect almost half of that population. And that aging population is growing: The median age of the U.S. population is expected to grow from age 38 today to age 43 by 2060. Today’s top causes of death include heart disease, cancer, stroke, chronic lower respiratory diseases and diabetes. All appear far more prevalent among today’s workforce than in generations past because of both age and a more sedentary lifestyle.
If that doesn’t sound bad enough, Covid has made everything especially worse for national health in the last two years. Surveys show that millions of us have gained weight. NPR reports we almost universally took on bad habits, becoming more sedentary, drinking more and neglecting our care in everything from cholesterol checks to cancer screenings. Psychological stress grew. Various studies reported increases in post-traumatic stress disorder, depressive disorders, delirium, somatic symptoms, panic disorder, psychosis, harmful substance use, despair, self-harm and even suicide. If ever there was a moment ripe for a radical new approach in the way we treat chronic disease for Americans, it is now.
Build healthy habits that last
Our healthcare system today isn’t built to do much other than stand helplessly by as people get sicker and sicker, and then offer them pills or surgery to ease the problems they have once they’re sick. Experts on the right and left agree: Our health care system is a mess because the incentives are wrong, reports one national think tank. The key source of the problem is fee-for-service payments to physicians, hospitals, nursing homes and other health care providers, which bill separately for each service or product they provide. This structure has created a series of perverse incentives and an utter lack of accountability. As a result, fee for service hurts patients and drives up costs.
It doesn’t help that in a trend that hasn’t changed in 50 years, health spending has increased sharply. As measured per capita in constant 2020 dollars, spending has risen from $1,875 per person in 1970 to $12,531. Despite various reforms, costs have more than tripled in the last decade alone.
So what’s the solution?
The answer is a preventive, habit-based approach that focuses on reducing BMI and other chronic disease health risks. This sort of program is being used effectively today by individuals and on a larger scale by employers.
A preventive, habit-based approach to health care involves a whole health orientation that assesses both physical and behavioral health measures. That includes waist circumference, blood pressure, blood glucose and cholesterol, as well as anxiety, depression, sleep and mood. Nutrition and exercise regimes need to be specific for each person to actually work. After all, there is only one health. Remember that it’s difficult to achieve success alone. A behavioral coach can serve as a confidant, accountability partner and resource while we establish new healthy habits for life.
Employers can track multiple metrics and achieve success in numerous ways through smart platforms. Key metrics include how often employees reach their health goals, how fully they remain engaged with their new habits over time and how likely they are to refer others to the program. Ideally, these measures should exceed 80 percent. A decline in healthcare costs is expected and usually realized. As employees and their employers work together to build and maintain a healthier workforce, further measures track the decline year-over-year.
Happier, more productive employees
We’re all increasingly plagued by chronic diseases and face additional mental and physical health trials because of the pandemic, which itself set society up for an increased incidence of chronic diseases that will prove life-threateing if not addressed. At the same time, employers today evaluating future healthcare expenses for their workers universally realize they face steep cost pressures.
A revolution of relief is within reach through a personalized platform that creates positive lifelong habits. Numerous companies are already finding success. Peer reviewed evidence proves that it saves costs and is profitable and self-funding within a year. Ultimately, employees require healthcare that is far more affordable for the company, as they develop healthy habits to become happier and more productive.
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