The Linchpin to Controlling Costs

July 20, 2017

Author: Scott Pashley, Director – Business Development/Sales

Do you find yourself struggling to move the needle on employee health and cost containment?

You need to find the missing piece to the health puzzle!

Cost Containment

Holistic population health programs offered by employers have typically provided wellness programs focused on nutrition, physical activity, maybe biometrics or a health risk assessment. They have also offered programs to target those employees who have been diagnosed with a disease state. Both are very important programs but there’s an important piece missing.  What about a program to address those employees who are not completely healthy but also not yet in a disease state; those at risk for developing a disease?

Research from Dee Edington1 disclosed what he dubbed ‘Natural Risk Flow’ and revealed that over a span of three years individuals can move either way on a spectrum of health and some people do get healthier all by themselves. However, without interventions, today’s workforce with a continuously more sedentary lifestyle and aging population, are moving in the wrong direction. Couple those figures with natural risk flow the lack of quality programming to address at-risk population and you have a real problem brewing.  Have you ever seen the old black and white episode of I Love Lucy where Lucy simply can’t keep up with the flow of chocolates coming down the conveyor belt as she futilely attempts to packaged them? That’s essentially what many if not most companies are setting themselves up for; more and more employees with increased claims due to illness and chronic disease will continue and costs will continue to rise and employers will find themselves unable to sustain those rising healthcare costs.

Thirty-five percent of all U.S. adults are estimated to have metabolic syndrome2. Metabolic syndrome is a combination of health risks that contribute to heart illness and death such as obesity, high blood pressure, type 2 diabetes and high cholesterol. Without targeted interventions which do you think is more likely – individuals moving toward the healthy end of the Spectrum of Health™ or continue their regression toward a disease state?

Wellness programs are important to help keep the healthy people healthy and create an atmosphere in which people proactively address any beginning health issues. Disease management programs are effective in helping people take control of their disease and curb costs to the employer in many cases.  That missing puzzle piece is still there, however. You have this middle group of employees that represent a significant portion of your population that are in the veritable ‘waiting room’ for your DM program.

Enter Telligen’s At-Risk Coaching. We are very proud of our world class wellness program, disease management program and high ROI programs such as case management and utilization management but there is something very unique about our At-Risk program. This program is the linchpin that ties all programming together for many of our clients.

How the Program Works

Telligen’s at-risk program analyzes biometric and claims data (if available) to identify members who are in a pre-disease state. We then educate and coach the member with tailored interventions to their specific risk factors to slow the progression of their emerging disease.

The missing piece of the health puzzle for cost containment and employee health is to look at individuals with beginning health issues. Programming such as at-risk health coaching targets those individuals to get your population moving in the right direction along the Spectrum of Health!

 

1 Edington, D.W. (2009). Zero trends: health as a serious economic strategy. Ann Arbot, MI: Health Management Research Center, University of Michigan.
2 JAMA – Journal of the American Medical Association. (2015, May 19). High prevalence of metabolic syndrome found in U.S.. ScienceDaily. Retrieved July 20, 2017 from www.sciencedaily.com/releases/2015/05/150519121529.htm
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