bending the curve · surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%...

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Bending the Curve

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Page 1: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

Bending the Curve

Page 2: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

The best time to plant a tree

was 20 years ago…

(Chinese proverb)

Page 3: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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who is claiming how much?

Breast cancerHypertension

StrokeHeart disease$987

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

$1,800A

ve

rag

e A

nn

ua

l Pa

id A

mo

un

t

Plan Member Age Band

Rx claims by age band & gender

Page 4: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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what are they claiming?

Breast cancerHypertension

StrokeHeart disease

Average covered costs per prescription:

$30 $42 $2,242A M S

15%

56%

29%

Acute Maintenance Specialty

% of Total

Covered

Amount

26%

73%

1%

% of Count

of Claims

Page 5: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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what are they claiming?

Breast cancerHypertension

StrokeHeart disease

Ages 25-29 Ages 55-59

Rank Therapeutic Class% Total Paid

CostTherapeutic Class

% Total Paid

Cost

1 Biologic Disease-Modifiers* 19.5% Diabetes 11.4%

2 Depression 6.8% Blood Pressure 10.3%

3 Skin Disorders 6.2% Viral Infections / Hepatitis 9.1%

4 Diabetes 6.1% Cholesterol Disorders 8.3%

5 Narcotic Analgesics 5.0% Biologic Disease-Modifiers* 8.3%

Page 6: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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what are they claiming?

Breast cancerHypertension

StrokeHeart disease

Page 7: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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the projections for chronic disease!

Breast cancerHypertension

StrokeHeart disease

Page 8: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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scary thought?

Breast cancerHypertension

StrokeHeart disease

every 10 seconds…

3 more people

develop diabetes

Page 9: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

9

more Canadians living with diabetes

Breast cancerHypertension

StrokeHeart disease

Page 10: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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diabetes meds +

Breast cancerHypertension

StrokeHeart disease

Page 11: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

11

blood pressure meds +

Breast cancerHypertension

StrokeHeart disease

Page 12: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

12

depression meds +

Breast cancerHypertension

StrokeHeart disease

Page 13: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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depression & chronic conditions

Breast cancerHypertension

StrokeHeart disease

“The association between depression and chronic disease appears attributable to

depressive disorders precipitating chronic disease and to chronic disease exacerbating

symptoms of depressions”

Individuals with symptoms of depression report three times as many chronic physical

conditions as the general Canadian population

50% of individuals with depression and a chronic condition report limitations on their day to

day activities

Page 14: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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depression & chronic conditions

Breast cancerHypertension

StrokeHeart disease

Canadians with Depression rate their work function as 62% of capacity

Medical outpatients with depressive symptoms or disorders experienced worsened quality

of life and had almost twice as many days of restricted ability or missed work as a result of

illness compared to those without depression

“Depression is clearly associated with poorer prognosis and more rapid progression of

chronic illness”

Page 15: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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depression & chronic conditions

Breast cancerHypertension

StrokeHeart disease

Chronic Disease

Limitations of abilities and/or

activities

Worsened mood

Depression

Lack of motivation

Poor management of lifestyle related health factors*

Page 16: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

The best time to plant a tree

was 20 years ago.

The second best time is now

(Chinese proverb)

““

Page 17: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

smoking trends

Page 18: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

what if we don’t start now?

50% of Canadians smoked in 1960

– now only 20% smoke

It’s taken us 5 decades to improve

But – we’ve replaced one bad habit with another – poor diet and lack of exercise

Do we have 5 decades?

Page 19: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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the ROI of changing one risk factor

Type 2

Diabetes

43%

17%26%

29%

27%

30%

Breast

cancerHypertension

Colon

cancer

StrokeHeart

disease

Being physically active reduces a

person’s lifetime probability of developing:

Page 20: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

individual behaviour change

precontemplation

contemplation

preparation

action

maintenance

pro

gre

ss

rela

pse

Page 21: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

how can employers influence change?

Healthy food options in the cafeteria

Smaller plates

Healthy food subsidies

Sit stand workstations

Well lit and appealing stair cases

Walking work meetings

Physical and social surroundings

Page 22: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

comprehensive health & “wellbeing” strategy

At Work healthyAt work at

riskOff work

injury/illnessReturning to

work

Wellness & Prevention Absence & Disability Management

Page 23: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

steps to rolling out wellness

Gain Senior

Leadership

Support

Create your wellness team

Create your plan

Select appropriate interventions

Rollout and Evaluate

Communicate

Collect and assess your data

Page 24: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

driving employee engagement in wellness

Awareness Communication

Personalize Incentivize

Engagement

Page 25: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

know your employeesSurveys

35% 34%24%

34%

75%

89% 91%84%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

stress or mental healthscreening

heart diseasescreening

cancer screening diabetes screening

Plan Sponsorslikely to offer

Plan memberslikely to use

2014 Sanofi Canada Health care survey found the following:

Page 26: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

personalize and make it meaningful

Integrate wearable fitness technology

Disease specific screening clinics

Sleep management (shiftworker support)

“bicycles to borrow”

“Suppers to go”

Vaccination clinics (flu, hepatitis, shingles,

twinrex)

Flex time

“walking with dogs” for humane society

(exercise and volunteerism)

Eldercare support

Financial wellness

Page 27: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

measuring successmeasure what’s important to you

VOI= $ Invested

Unit Outcome

ROI= $ Savings

$ Invested

Page 28: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

tailoring VOI to your workplace

Employee participation

Engagement surveys

Casual absence

STD incidence and duration

Disability & drug disease trends and spend

Improvement in health risks

WSIB data

EFAP utilization

Gathering your data

Page 29: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

Canadian success stories

Irving Paper – provide comprehensive wellness programming

with subsidies to encourage healthy living.

– STD costs dropped by 50% over 5 yr period

– Union grievances dropped from 50 to 11 per year

Sanofi Canada – following a 100 day challenge

– 36% improvement in employee engagement scores

– 74% reported reduction in stress levels

– 90% reported overall health as good or better (up from 66%)

Husky Energy

– absenteeism rate of 2.25 days compared to industry average of

9.6 days

– Annual drug cost of $153/ee compared to sector average of $495

Page 30: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

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the VOI of wellness

Breast cancerHypertension

StrokeHeart disease

Control health care

and group insurance

plan costs

Attract and retain

best talent

Help employees to

adopt and maintain a

healthy lifestyle

Increase the energy,

productivity and

engagement of employees

Reduce absenteeism,

presentism and disability

Page 31: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

If you don’t take time for wellness,

be prepared to make time for illness“ “

Page 32: Bending the Curve · Surveys 35% 34% 24% 75% 89% 91% 84% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% stress or mental health screening heart disease screening cancer screening diabetes

questions?