Long-term outcomes of a cardiovascular and diabetes risk- reduction program initiated by a self-insured employer

Nicole D. White, Thomas L. Lenz, Maryann Z. Skrabal, Jessica J. Skradski, Louis Lipari

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Cardiovascular disease remains the leading cause of death in America and poses a significant challenge for self-insured employers attempting to improve employee health and well-being while controlling healthcare costs. Disease state management programs can be an effective means of achieving these outcomes, but the durability and long-term effects of such programs have limited evaluation. OBJECTIVE: To assess the 5-year health, economic, and quality-of-life patient outcomes of an employer-sponsored disease state management program. METHODS: This was a longitudinal, 5-year, quasi-experimental, pre-/postenrollment study. Self-insured health plan members with hypertension, hyperlipidemia, diabetes, or a combination of these conditions met with a pharmacist regularly (monthly for the first year, then varied by participant) to implement lifestyle medicine programs, optimize medication therapy, and facilitate the coordination of care. Biometric markers, lifestyle behaviors, quality of life, and work productivity were assessed on an annual basis. RESULTS: The significant biometric improvements (mean) seen after 5 years of program participation compared with pre-enrollment included decreased low-density lipoprotein cholesterol levels (96.71 mg/ dL vs 84.83 mg/dL, respectively), increased high-density lipoprotein cholesterol levels (39.32 mg/dL vs 46.12 mg/dL), and decreased systolic blood pressure (132.04 mm Hg vs 123.63 mm Hg) and diastolic blood pressure (85.75 mm Hg vs 75.83 mm Hg). The average exercise time increased (50 minutes weekly vs 156.04 minutes weekly), as did fruit and vegetable consumption (3.98 servings daily vs 5.27 servings daily). The program participants reported improved general health and a reduced number of unhealthy days. The combined healthcare and productivity return on investment for the program at 5 years was $9.64 for every $1 invested. CONCLUSIONS: Significant changes in employees’ health, well-being, and health-related costs are possible through sustained participation in an employer-sponsored disease state management program.

Original languageEnglish (US)
Pages (from-to)177-181
Number of pages5
JournalAmerican Health and Drug Benefits
Volume11
Issue number4
StatePublished - Jun 1 2018

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Risk Reduction Behavior
Disease Management
Blood Pressure
Occupational Health
Health Care Costs
Life Style
Health
Quality of Life
Hyperlipidemias
Pharmacists
Vegetables
LDL Cholesterol
HDL Cholesterol
Cause of Death
Fruit
Cardiovascular Diseases
Economics
Medicine
Exercise
Hypertension

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Strategy and Management

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Long-term outcomes of a cardiovascular and diabetes risk- reduction program initiated by a self-insured employer. / White, Nicole D.; Lenz, Thomas L.; Skrabal, Maryann Z.; Skradski, Jessica J.; Lipari, Louis.

In: American Health and Drug Benefits, Vol. 11, No. 4, 01.06.2018, p. 177-181.

Research output: Contribution to journalArticle

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AB - BACKGROUND: Cardiovascular disease remains the leading cause of death in America and poses a significant challenge for self-insured employers attempting to improve employee health and well-being while controlling healthcare costs. Disease state management programs can be an effective means of achieving these outcomes, but the durability and long-term effects of such programs have limited evaluation. OBJECTIVE: To assess the 5-year health, economic, and quality-of-life patient outcomes of an employer-sponsored disease state management program. METHODS: This was a longitudinal, 5-year, quasi-experimental, pre-/postenrollment study. Self-insured health plan members with hypertension, hyperlipidemia, diabetes, or a combination of these conditions met with a pharmacist regularly (monthly for the first year, then varied by participant) to implement lifestyle medicine programs, optimize medication therapy, and facilitate the coordination of care. Biometric markers, lifestyle behaviors, quality of life, and work productivity were assessed on an annual basis. RESULTS: The significant biometric improvements (mean) seen after 5 years of program participation compared with pre-enrollment included decreased low-density lipoprotein cholesterol levels (96.71 mg/ dL vs 84.83 mg/dL, respectively), increased high-density lipoprotein cholesterol levels (39.32 mg/dL vs 46.12 mg/dL), and decreased systolic blood pressure (132.04 mm Hg vs 123.63 mm Hg) and diastolic blood pressure (85.75 mm Hg vs 75.83 mm Hg). The average exercise time increased (50 minutes weekly vs 156.04 minutes weekly), as did fruit and vegetable consumption (3.98 servings daily vs 5.27 servings daily). The program participants reported improved general health and a reduced number of unhealthy days. The combined healthcare and productivity return on investment for the program at 5 years was $9.64 for every $1 invested. CONCLUSIONS: Significant changes in employees’ health, well-being, and health-related costs are possible through sustained participation in an employer-sponsored disease state management program.

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