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What Medical Condition Is The Most Costly To Employers?

Ok…here’s a brain teaser.  What medical condition is the most costly to employers?  I’ll give you a hint.  It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.

If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both criteria…at least in terms of cost and the undiagnosed part.

Four out of every ten people at work or sitting in the doctor’s waiting room suffer from moderate to severe depression.  Prevalence rates for depression are highest among women and older patients with chronic conditions.  Yet despite its high prevalence and costly nature, depression is significantly under-diagnosed (<50%) and under-treated by physicians.

For employers, the cost of depression cost far exceeds the direct costs associated with its diagnosis and treatment    As the graphic above indicates, the cost of lost productivity for on the job depressed workers (Presenteeism) and lost time for depressed workers that are absent from the job (Absenteeism) far exceed the cost of cost of treatment (medical and medication cost).

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*This blog post was originally published at Mind The Gap*

When Doctors Can’t Get Health Insurance

We use a little company called Assurant to administer the employee health insurance plan for our business.  We have about 50 employees, not all of whom are on our insurance (some get theirs through a spouse), so we are in a particularly undesirable segment of the small-business market. Ironically, we have had a fair amount of difficulty in getting coverage which was affordable and sustainable. A lot of insurers wouldn’t even bid on us. Funny, right?  The doctors can’t get health care insurance!  Hysterical! So we wound up with an unusual sort of self-funded plan administered by Assurant, which was working OK.

Recently, however, a couple of our doctors wound up taking family members to the ER for various reasons — nothing serious, but common and reasonable presentations for an ER.  And Assurant denied payment for the claims.  They didn’t deny it outright, actually, just imposed a $500 “penalty for non-emergent use of the Emergency Room” on top of the usual co-pays and deductibles. Read more »

*This blog post was originally published at Movin' Meat*

All Healthcare Is Local: Why Employers Self-Insure

“I’m from Massachusetts,” I told the audience.  “So depending on how you feel about reform, I will say either ’sorry,’ or ‘you’re welcome.”

The audience, made up of large employers and benefits professionals seemed to like this.  But it was clear that they were pleased that the health care reform legislation is Congress is pretty well dead now.

Now, if it’s true that health care costs are rising (they are) and this heavily impacts employers (it does) why would the death of a bill meant to address this problem make those people happy?

I’ve written before that part of the problem with the reform bills in Congress is the huge divide between what benefits professionals know about the real world of health care and the things that get “policy wonks” excited.   And so a big reason why these bills never really had widespread support among professional benefits people was because they never made a whole lot of sense to them. Read more »

*This blog post was originally published at See First Blog*

What’s Hot In The Employer Health World?

Prevention.  Also, prevention, prevention, prevention, prevention,prevention, prevention,prevention, prevention, prevention, and prevention.  Finally, prevention, prevention, prevention, spam, prevention,prevention, prevention,prevention, prevention,prevention, prevention, prevention, prevention.

I’m overstating it, but this was the major theme of the Employer Health and Human Capital Congress which I attended yesterday outside of Washington, DC.  It’s a major event for benefits professionals and in spite of the pending snowpocalypse, was very well attended.  I moderated a panel about how people need help navigating the health care system.  But the gap between all the talk about prevention and the reality that a lot of people are going to get sick no matter what was the talk of this group. Read more »

*This blog post was originally published at See First Blog*

Employer Programs Are Reducing Healthcare Costs

Bad news in the paper today: health care costs are expected to rise another 10.5% next year. It’s a serious problem that affects businesses and families across the country.

But the headlines miss something important: the rate of increase has been steadily slowing.

Are we already bending the health care cost curve?

Here is a chart of the rate of increase in health premiums for a PPO plan beneficiary from 2002-2009 (all data are from today’s Aon press release):

curve1

The data for other plan types are similar.  What’s happening?

Aon’s Chief Medical Officer Paul Berger says it’s because of the variety of measures employers have taken over the last several years to implement programs to improve their employees’ health.  He emphasizes there is still much more to be done.

He has a point. It’s something we have seen in our survey of major employers, and in the work that leading employers like EMC and Genzyme are doing.  It’s what my company does, too.  Employers are getting increasingly sophisticated at understanding what drives their health care expenses and are developing increasingly effective ways at addressing them.

So, yes, of course, we need reform of our health care system, and of course rising health care costs are a serious concern.  But American employers are doing something about these problems all on their own.

*This blog post was originally published at See First Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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