Employer's Role in Chronic Disease Management

Article Written By: Dr. Steven Driggers-Chief Medical Officer

Typically, employers have focused on worker compensation and workplace safety issues as the only effective points in which they can directly affect both healthcare costs and employee productivity. While keeping employees safe and avoiding large increases in Worker’s Compensation Fund contribution rates are important, many progressive employers are beginning to recognize even greater potential benefits from helping their employees manage their chronic disease states.

In most insurance pools, about 20% of the enrollees use almost 80% of the resource costs, mainly due to the costs of treatments and hospitalizations related to poorly managed chronic disease states such as diabetes, high blood pressure, and vascular diseases related those processes, smoking and elevated cholesterol levels. Insurance premiums for both employer and employee rise as the cost of treating the progression of disease and resulting complications rises. In addition, even when employees are able to work with their disease state, productivity decreases and absenteeism rises. Indirect human resource costs also increase as issues of repeated absence and benefit management demand attention. If the employee occupies a critical position in the organization, other individual’s productivity may also be negatively influenced.

One of the ways to minimize both direct and indirect costs for these type of employees, as well as demonstrating an interest in your employees well-being, is to assist the employee to aggressively manage their disease according to current best-practice medical protocols, even if the protocol may cause a short-term cost increase. Ways to achieve this include the use of on-site health coaches or navigators, encouraging enrollment in a patient-centered medical home environment, or participation as an employer in some form of accountable care organization (ACO).

The medical home is a group of providers (physicians, physician extenders, nurses, educators, nutritionists, etc.) organized as a coordinated team that shares records and evidence-based treatment regimens. ACOs often use medical home processes and techniques, but are basically groups of providers that are incentivized for measurable quality outcomes in different chronic disease states. If the patients do well on specific measurements the providers share in the savings from unused funds that would have paid for complications and hospitalizations in a similar population of patients. Employers benefit from decreased care costs and increased productivity in happier, healthier employees. Using your decision on the choice of insurer and provider group to encourage or provide such services can greatly influence the cost of your health care.

If you would like to learn more about this article please email: HFMBusinessConnect@hfmhealth.org
or call 920.320.6541

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