Human Capital & Careers

Disease Management: Prevent Defense

The best way to reduce employee medical claims? Keep workers from getting sick.
Jennifer CaplanNovember 1, 2002

Typically, 20 percent of employees account for about 80 percent of a company’s health-care costs. Not surprisingly, that statistic has many employers rolling out disease-management programs for chronically ill employees.

In fact, a study by Hewitt Associates released in July found that a whopping 93 percent of 945 companies surveyed currently offer some kind of health-promotion program (that’s up from 89 percent in 1996). By providing employees with preventive education and care, benefits administrators believe they can reduce the chances that workers will require emergency medical attention — or worse, long-term hospital stays.

According to Hewitt, about three out of four employers now provide disease-management programs to workers. Primarily, these programs are offered through self-insured and/or fully insured health plans. Programs range from seminars and workshops to counseling for lifestyle habits that contribute to chronic or acute conditions (alcoholism or poor nutrition, for instance).

About 72 percent of employers offer some kind of education or training program, while three out of four plan sponsors employ health screenings (up from 68 percent in 1996). Most of these companies administer medical screenings to detect high blood pressure or cholesterol, either through their health plans or on-site health fairs. Some companies also provide mobile units for mammography, as well as testing for high blood pressure and cholesterol.

“There is a always a certain percentage of the employee population that’s at high risk for certain illnesses, and it makes sense to set up mechanisms so they get support to decrease their risk,” says Richard Ostuw, a consultant with Towers Perrin.

As part of its disease-management program, Southern Mills sponsors health fairs and on-site mammography mobile units once every two years. “We catch one or two cases of breast cancer each time,” says Allan Ray, vice president of human resources at the bag-maker. “That alone pays for the expense and is a great thing for our employees.”

Typically, disease-management programs target high-risk and chronically ill individuals. A program might target diabetics, for example, by sending out reminders about dietary habits that can reduce the risks of an attack, or notices when follow-up care is needed. Some employers also make nurse-lines available so workers can phone in with their medical questions. In some cases, plan sponsors even hire nurses to make outbound calls to provide support and encourage employees to take steps to reduce their health risks.

Often, a company’s health-plan vendor administers a client’s disease- management program. Many large health-insurance providers these days include disease management as part of their overall services. Some employers, however, contract with a specialty vendor to provide a disease-management program.

It’s surprising more companies have not adopted similar plans. Disease-management programs not only save money, but lives. Says Ray: “If we can catch cancer or diabetes in time, we all end up winning.”