Transcript Slide 1

Community Initiative on
Cardiovascular
Health and Disease
Health Policy Forum on Cardiovascular
Health and Wellness
September 29, 2006
Marti Macchi, MEd
Director, Special Studies
Kansas Department of Health and Environment
Today’s Objectives
 Why Worksites
 Private/Public Partnership
 The CICV Project
 Next Steps
Why Worksites?
 Most people spend more of their waking
hours at work than anywhere else
 Worksite organizational culture and
environment are powerful influences on
behavior
 Heart disease, stroke and multiple risk factors
are costly to employers
 Productivity, absenteeism and presenteeism
cost concerns of employers
Employees’ Hearts
 About 1 in 4 Americans have a cardiovascular
condition.
 Heart disease and stroke-related costs in the
United States for 2005 are estimated at $393
billion, and are expected to rise by the year
2010.
American Heart Association. Heart disease and stroke statistics: 2005 update.
Dallas, TX; 2005
In 2002, U.S. employers paid an average of
$18,618 per employee per year for all
health and lost productivity costs.
Parry T. Integrated Benefits Institute; 2004
$6,052
$4,845
$5,617
$945
$981
$178
GH
WC
STD
LTD
Direct payments
Sick
Leave
Unpaid
leave*
Lost productivity costs
2002 Benefit Data
Figure 1 Legend
GH – Group health (employees and dependents)
WC – Workers compensation
STD – Short term disability
LTD – Long term disability
*Unpaid leave (incidental absences) – unpaid leave associated with an employee’s or dependent’s
serious health condition, as permitted under the Family Medical Leave Act
What is keeping executives up at night?
CEOs: What cost is your company’s
biggest concern in 2005?
50%
43%
45%
40%
35%
30%
20%
25%
19%
20%
11%
15%
10%
4%
4%
5%
0%
Health Care
Litigation
Energy
Materials
Labor
Pensions
Source: Business Roundtable questionnaire of 131 CEOs of companies with a combined workforce of more than 10 million
employees and $4 trillion in annual revenue. Percentages do not equal 100% due to rounding.
Source: Mercer Health and Benefits Consulting 2006
Public-Private Partnerships
Building Blocks of
Success
Heart Disease
and Stroke
Prevention
CAUSES of DEATH
Kansas, 2003
Percentage Distribution of Leading Causes of Death,
Kansas 2003
16.9
20.4
7.2
2.7
2.8
3.2
4.4
12.7
5.8
21.6
CHD
Cancer
Alzheimer's disease
All other causes
Stroke
Chronic lower repiratory disesae
Pneumonia and Influenza
All Other CVD
Unintentional injuries
Diabetes Mellitus
Note: Other CVD deaths were deaths due to essential hypertension, atherosclerosis and other circulatory
diseases defined by ICD-10 codes I00-I99.
Source: 2003 Kansas mortality data. Office of Health Care Information. KDHE.
Causes of Death
Missouri, 2004
3%
3%
3%
3%
3%
4%
37%
6%
8%
30%
Heart Disease
Cancer
Stroke
Resp. disease
Accidents
Diabetes
Pneumonia & influenza
Alzheimer's
Digestive diseases
MVA
The Partnership
 Public Health (partial project funding source through
the HDSPP funding from Centers for Disease Control
and Prevention)



Kansas Heart Disease and Stroke Prevention Program
Missouri Heart Disease and Stroke Prevention
Program
CDC, CMS
 Mid-America Coalition on Health Care (non-
profit/non-governmental)
 Private Organizations

For-profit – private large employers both health care
and non-health care industries (14 employers)
The Coalition
Public Health
Mid-America Coalition on
Healthcare
Private Industry
Mid-America Coalition on
Health Care
 Key to linking Public Health with multiple large employers
 An employer-driven coalition – 501(c)(3) – non-profit
Number of employers/stakeholder organizations
 In existence for almost 30 years
 Mission:
 To improve the health of employees and their families
 Promote employee and community wellness and illness
prevention
 Develop strategies and initiatives for containing business
health care costs
 Generate and communicate health care information to the
community
 Membership
 60 members (large and small employers)

Mid-America Coalition on
Health Care
 Activities





Break down barriers
Focuses employer energies
Reduces health system complexities
Develop model programs and informs stakeholders
Serves as a national model
Mid-America Coalition on Health Care
Community Initiative on Cardiovascular Health and Disease
Employers
Worksite
Employers
Health Plans
Clinical
Community
Employers
Stakeholders
Public
Employers
Worksite
Assessments
Oct 05 – May 06
Coordination of Care
Barriers
Assessment
Jan – Dec. 05
Public Need
Assessment
Jan – May 06
Interventions
Fall 06 – May 08
Interventions
Jan 06 – May 08
Interventions
May 06- May 08
Measurement
Late 2008
Measurement
Late 2008
Measurement
Late 2008
2005  Mid-America Coalition on Health Care
What is the Community
Initiative on Cardiovascular
Health and Disease
Worksite
Project Objectives
 Increase employee participation in
employer/plan programs
 Increase knowledge of CV risks, prevention
strategies and individual CV health status
 Improve long-term health of employees
 Assess the continuum of care
 Reduce overall employer health care costs
CICV Phases and Timeline
 Phases I, II, III and IV
 Phase I – Information Gathering (Literature review,
Research Design: Jan – June, 2005)
 Phase II – Employer Buy-in and Baseline
Assessments
(Fall 2005 – Summer 2006)
 Phase III – Goals, Objectives and Implementation
(Fall 2006 - 2008)
 Phase IV – Measurement
(2009)
Phase II: Baseline Assessment Tools
1.
2.
3.
4.
Productivity Measurement
Medical Claims Analysis
Health Risk Appraisals
Medical Screenings
5.
Leadership Survey
6.
7.
8.
Heart Healthy Lifestyles Employee Attitudinal Survey
Employer Worksite Wellness Environment Inventory
Cardiovascular Health Plan Benefit Design Survey (CDC
Heart-Healthy and Stroke-Free Worksites Toolkit)
Heart Healthy Lifestyles
Employee Survey
To measure employees’:
1.
2.
3.
4.
5.
6.
Knowledge of signs and symptoms of heart attack and
stroke and heart disease risk factors
Attitudes about employer Involvement in health
improvement
Health behavior most likely to improve and barriers
Perceptions of worksite health improvement support,
including leadership, management and co-workers.
Preferences for receiving and use of employer health
improvement information.
Attitudes about health benefits
Demographics
 Response rate: 7,404 (22.4%)
 65% female
 Age



Under 35 = 31%
35-54 = 56%
55 and older = 14%
 Ethnic



83 % Non-Hispanic
3% Hispanic
15% No Response
 Race




85% White
6% Black/ African American
3% Asian, Native Hawaiian, American Indian
7% No response
Demographics, cont.
 Education
 High School or Less = 5.1%
 Some College or Trade = 18.9%
 College Degree or beyond = 76%
 Position
 Non-Manager = 74%
 Manager = 26%
 Smokers – No = 93%
 Exercise 3 times per week or more – 60%
 Overweight – 49%
Knowledge
 60% and 76% of respondents were able to
identify five or more signs and symptoms
correctly for heart attack and stroke,
respectively.
 75% of respondents were able to identify the
majority of heart disease risk factors.
Employer Involvement
Table 34 Role of Employer in Employee Health
Percent
60
40
66.63%
20
26.31%
7.06%
0
Provide health insurance only
Neutral
Active participation
Support
Perception of Support by Leadership, Manager and
Co-workers in Efforts to Improve Health
100%
19.5
16.4
22.9
75%
34.7
36.8
36.32
50%
25%
45.7
46.8
41
0%
Leadership
Manager
Supportive
Neutral
Co-Worker
Unsupportive
Health Benefits
Perception of Employee Health Improvement
Participation on Health Benefits and Costs
100%
80%
60%
40%
76.9
68.4
49.9
20%
0%
Participation=Lower Insurance
Premiums
Unhealthy behaviors - no
participation = Higher Insurance
Premiums
Supportive
Neutral
Active Role in Health Improvement
= Lower Costs
Unsupportive
Information
Preferences for Receiving General Health of Health
Improvement Information From Employer
100
75
50
25
0
Printed material E-mail/web- Printed material
mailed to home based programs
at work
at work
Yes
No
Seminars at
work
Over the phone
What’s Next ?
 Reporting Plan
 Individual Employer Report
 Integration Plan
 Combined with other CICV Employer assessment
activities. (e.g. Benefit Design, Environment Inventory)
 Use results to:
 Identify and design CICV Employer interventions.
 Identify community resources to address findings (e.g.
American Heart Association and Public Health)
CICV Phase III
 Establish Goals, Objectives and Benchmarks
(F06)
 Intervention Design: Connecting the Dots (F06)



Based on Employee Survey and other assessments
Incorporated into existing employer wellness plans
Create an evaluation plan (i.e. Phase IV)
 Implementation (Early 07 – Fall 08)
 Individual and group activities
 Total Time Frame: Fall 2006 – Fall 2008
Connecting the Dots
•
Productivity
Measurement
•
Medical Claims Analysis
•
Health Risk Appraisals
•
Medical Screenings
Intervention
Design
• Leadership Survey
• Heart Healthy Lifestyles
Employee Attitudinal Survey
• Employer Worksite Wellness
Environment Inventory
• Cardiovascular Health Plan
Benefit Design Survey
CICV Phase IV
 Measurement, Measurement, Measurement


“Score Cards”
Improvement in baseline assessment scores



Environment Inventory
Benefit Design
Leadership
 Creation of Replicable Model
 Time Frame: Early 2009
Lessons Learned Up To This Point:
 Public-Private Partnerships can work
 Be willing to learn from each other
 Don’t assume employer viewpoints or concerns
 “Private” Partnership Language
 “Realism” of the project
 Length of time
 MACHC role in bringing Public Health and private
companies together
Contact Information
Marti Macchi, MEd
Director, Special Studies
Kansas Department of Health and Environment
Office of Health Promotion
1000 SW Jackson, Suite 230
Topeka, KS 66612
(785) 291-3743
[email protected]