Integrated program takes aim at co-morbidity

July 1, 2005

Multiple condtions cause a ripple effect

Which came first, the chicken or the egg? Now we should be asking ourselves: which came first, the depression or the chronic back pain? The heart disease or the depression?

While we readily accept the fact that serious illness often triggers depression in patients, research now suggests that depression can lead to a chronic disease.

  • Clinically depressed people have a 50% greater risk of experiencing sudden cardiac death, according to a study by the National Institute of Health and Medical Research.
  • A study by Johns Hopkins Medical School students found that those with a history of clinical depression were twice as likely to develop coronary artery disease.
  • Medscape reports that 43% of employed adults diagnosed with depression have a corresponding chronic medical condition.

No matter what comes first-the depression or the chronic illness-the cycle of co-morbidity traps an employee in a desperate pattern of uncertainty and drains a company’s bottom line. According to Metlife, the top five chronic causes of workplace disability are lower back disorders, coronary heart disease, arthritis, pulmonary diseases and depression. Each year, these illnesses have been estimated to cost employers more than $500 billion in employee absences, diminished productivity and increased healthcare costs. And of the approximately $1.8 trillion spent on healthcare last year, 75% of this amount was spent on treating Americans with chronic illnesses.

As the number of Americans with chronic conditions is expected to grow from 100 million today to 171 million by 2030, employers must take proactive steps to manage this problem head-on for the well-being of their employees and their companies as well.

Integrated program

Because the lines between physical and mental health are blurred, ailments should not be handled in a vacuum. A holistic solution that integrates employee assistance, wellness and disease management is the most effective way to address chronic illnesses. As the individual experiences the various symptoms associated with these intertwined conditions, he must be able to move among the three prongs of treatment, tapping into what he needs, when he needs it.

For example, if an assessment offered through a wellness program uncovers that an individual is at risk for cardiovascular disease, every aspect of that diagnosis can be seamlessly handled through one program. He can continue to monitor his condition though the wellness program, can get information on lifestyle changes through the disease management program, and can tap into an employee assistance program to help manage emotional health.

In addition to enhancing an individual’s health and well being, an integrated program also benefits the employer. Studies show that 80% of a company’s healthcare costs can be attributed to 20% of the employees. Integrated programs take direct aim at these employees by helping them manage their lifestyle. As a result, the number of acute and expensive episodes is reduced, which lessens the number of hospital stays, lowers healthcare costs, and gets employees back into the workforce as quickly as possible.

Management of the program is also simplified. At every juncture and throughout the employee’s case, care is coordinated, communication is streamlined, and information is shared among the partners. The care the employee receives is seamless, and the single point of contact for the employer simplifies overall management of the program.

Prevention center stage

A renewed focus on wellness and prevention could be an important weapon in the fight to manage escalating healthcare costs. Chronic conditions are often preventable. Yet, a very small portion of our healthcare dollars actually go toward prevention. According to Tommy Thompson, former Secretary of Health and Human Services, approximately 95% of the $1.7 trillion spent annually on healthcare goes to direct medical services, with only 5% allocated to preventing disease and promoting health.

Clearly, efforts to contain healthcare costs must target the 20% of employees who generate 80% of medical costs, not the 80% who are healthy. Providing these individuals with an integrated healthcare solution that gives them ready-access to a myriad of educational and preventive services help manage the employee’s issue before it even enters the health plan and promotes an overall healthier working environment.

Sean is the Director of US Sales and Marketing at VMC Behavioral Healthcare.  Based in Gurnee, IL, VMC develops and administers customized, readily accessible, quality EAP solutions designed to help their customers become employers of choice.