The ROI of Diabetes Management
Look around you—that’s leftover Halloween candy. It marks the start of the blood sugar season, which runs from Oct. 31 through Jan. 1 and includes pies for Thanksgiving and baked goods for Christmas. The sugar and carbohydrates in all those sweets can lead to weight gain, which is a risk factor for developing Type 2 diabetes. It is a chronic medical condition in which your body can’t produce enough insulin to convert the sugar in your blood into energy in your cells. It’s like the gas tank in your car being disconnected from the engine while it’s running.
Prediabetes happens when your blood sugar is high, but not high enough to have Type 2 diabetes. (Type 1 diabetes also is a chronic medical condition, but one you’re born with. It means your body produces little or no insulin from the start.)
DIABETES RISK FACTORS
Workplace wellness programs that target diabetes prevention and management should focus on mitigating these diabetes risk factors:
- High blood glucose
- High blood pressure
- High cholesterol
- Overweight and obesity
- Physical inactivity
Having too much sugar in your blood and not enough energy in your cells can lead to all kinds of short- and long-term medical problems. That makes Type 2 diabetes a risk factor for your business.
A new report from the Centers for Disease Control and Prevention sheds some light on the size of the risk (bit.ly/2tnbN35). The CDC says 114.3 million people in the U.S. age 18 or older had diagnosed diabetes, undiagnosed diabetes or prediabetes in 2015. That’s nearly 36 percent of the U.S. population that year—or quite possibly more than one in three of your employees.
The CDC says diabetes led to 7.2 million hospitalizations in 2014, along with 14.2 million emergency room visits. It says diabetes was the seventh-leading cause of death in the U.S. in 2015. But a separate study in the journal PLOS One suggests the CDC is selling the disease short as a gravedigger. Researchers from Boston University and the University of Pennsylvania say the percentage of deaths in the U.S. caused by diabetes is more than three-times higher than previously believed (bit.ly/2xCIB6H). They estimated that diabetes causes between 11 and 12 percent of all deaths in the U.S.
“Diabetes may represent a more prominent factor in American mortality than is commonly appreciated, reinforcing the need for robust population-level interventions aimed at diabetes prevention and care,” the researchers said.
If you don’t want a third of your workforce in the hospital, in the ER or below ground permanently, what can you do? Here are a few thoughts from some recent reports:
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- Some 148 large employers surveyed by the National Business Group on Health cited “specific diseases or conditions” as the third-leading driver of their rising health care costs (bit.ly/2gw0ijX). In response, 80 percent of the employers said they intend to offer disease-management tools and programs to their workers in 2018, up from 74 percent this year.
- Some 54 percent of the employers surveyed by the NBGH have on-site health centers or nearby on-site health centers for employees. Of those with centers, 47 percent offer chronic care management services.
- Half of 450 employers surveyed by Aon said they are considering developing or contracting with high-performance provider networks over the next three to five years that specialize in treating chronic medical conditions (bit.ly/2iOmdDY).
- An Express Scripts study of 11.6 million commercially insured people prescribed oral medications in 2016 to treat their diabetes found, not surprisingly, that those who took their medicine had fewer hospitalizations, fewer ER visits and avoided more than $210 million in health care spending (bit.ly/2vy1PNa). The study urged employer-sponsored health plans to pursue tactics that promote medication adherence by enrollees with diabetes.
- A study in the journal Preventing Chronic Disease found that health coaching can be particularly helpful to diabetic patients who have the most trouble controlling their blood sugar levels and who have the lowest self-reported health status (bit.ly/2wtBP2G).
The alternative is to do nothing, which can be quite costly. A report released earlier this year by the Health Care Cost Institute said total annual health care spending by a commercially insured adult under the age of 65 with diagnosed diabetes was $16,021 in 2014 (bit.ly/2evuwDf). The same person without diabetes incurred $4,396 in total annual health care spending that year, or almost 73 percent less.
You’d be hard-pressed to find another workplace wellness target that offers a higher return.
In August, we discussed medication errors, which are more prevalent than commonly believed, and the need for employers to steer workers to pharmacies, hospitals and doctors with excellent drug safety records (bit.ly/2hkOK37). Here are two more bullet points to add to the discussion:
- Drug Topics, a trade publication for pharmacists, recently ranked Minnesota as the No. 1 state to be a pharmacist in the U.S. (bit.ly/2uVKKcv). The publication used 12 measures to calculate where life is good for pharmacists. Minnesota placed first for three of the 12 measures: overall well-being, financial savvy and stress; the state placed 31st for cost of living. It was 35th for location quotient, which measures local concentration of pharmacists, and it was 40th for pharmacy robberies. “Minnesota is the only state in our top 10 that made the DEA’s top 10 for pharmacy robberies,” the publication says.
- New rules promulgated by the Minnesota Board of Pharmacy do not allow pharmacists in the state to work more than 12 consecutive hours in one 24-hour period (bit.ly/2u159Qn). The rules, which took effect July 1, also require pharmacies to give pharmacists a 30-minute uninterrupted break if they work more than six consecutive hours in one day. They also require pharmacies to give pharmacists at least one restroom break every four hours.
If I ran a business, I’d want my employees to avoid pharmacies where pharmacists are waiting to go to the bathroom—that is, when they’re not worried about getting robbed.
David Burda (twitter.com/@davidrburda, firstname.lastname@example.org) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.