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Carol Calvin RN MS CPHQ UnitedHealthcare Current U.S. Healthcare situation unsustainable Achieving individual health ownership may help. 80% Increase in family coverage costs since 20031 Patients who leave their doctor’s appointment not knowing what they were told or what they are supposed to do5 52% Estimated U.S. population 100,000 Number of deaths every expected to have diabetes/ prediabetes by 20202 (UnitedHealth Group) 41% Consumer health care decisions that are less than optimal4 2 3 Centers 50% year linked to poor health literacy6 50% Medications not taken as prescribed.1 50-75% Healthcare costs 25-30% Employer health care driven by lifestyle decisions3 costs due to avoidable diseases 1 2013 Kaiser/HRET Survey of Employer Health Benefits. 2 UnitedHealth Center for Health Reform & Modernization study “The United States of Diabetes: Challenges and Opportunities in the Decade Ahead.” for Disease Control, “Healthy Communities,” www.cdc.gov/chronicdisease/resources/publications/aag/healthy_communities.htm. 4,8 UnitedHealthcare Consumer Activation Index 2011. 5&6 AHIP Coverage 2013. 7 Annals of Internal Medicine. Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review. Dec. 4 2012, Vol 157, No. 11. 2 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Defining health risk factors Risk factors are behaviors or conditions that increase your chance of developing a disease. Many risk factors are related. For example, if someone is not physically active, that person is more likely to become overweight and more likely to develop high blood pressure Modifiable Risks Non-Modifiable Risks Tobacco Use Age Physical Inactivity Sex Poor Diet Race and ethnicity Overweight and obesity Family history High blood pressure Genetics Type 2 Diabetes Multiple risk factors 3 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Progression of Modifiable Health Risks Chronic disease Preventable Events • • • • • Stroke Heart Attack Blindness Amputations ESRD progression happens gradually. Population data demonstrate how conditions worsen CAD or CHF with Diabetes Diabetes with Hypertension and Comorbidities Diabetes • Diabetes + CAD • Diabetes + CHF year-over-year • Diabetes + Hypertension • Diabetes + Renal Failure • Diabetes, may also have obesity and hyperlipidemia Metabolic Syndrome Proxy • 2 or more of hypertension, hyperlipidemia, pre-diabetes, obesity Early Risk • Hypertension, Hyperlipidemia. • Pre-diabetes, Obesity Healthy 4 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. • Healthy • unknown health risks Health Decisions impact costs heath care Health decision Potential impact on health care costs* Lose significant weight $2,5001 More effectively manage a chronic illness $2,4092 Stop smoking $1,6883 Select a specialist rated on quality and efficiency $1,026 savings/episode4 1. National Institute of Health (National Institute of Diabetes, Digestive and Kidney Disease). 2. UnitedHealthcare Book of Business data, 2007. 3. OptumHealth savings study. 4. UnitedHealthcare client study 2003-2005, 2006 claims data. 5. World Health Organization (WHO), Preventing Chronic Diseases: A Vital Investment, Geneva: 2005 * potential health care savings per individual per year 5 Lifestyle Behaviors & Health 50 - 85% of all diseases are associated with modifiable health risks – and are therefore preventable; 80% of all heart disease, stroke, type 2 diabetes and up to 40% of cancer could be prevented if people; (1) ate healthier; (2) exercised more; (3) stopped using tobacco 1 1. World Health Organization (WHO), Preventing Chronic Diseases: A Vital Investment, Geneva, 2011 6 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Health behaviors and longevity People who Live an extra Are vegetarian 1.5 years Exercise regularly 2.4 years Eat nuts five times a week 2.5 years Have normal blood pressure 3.7 years Do not have diabetes 6.6 years Maintain normal weight 11 years 7 Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Tools to improve healthoverview ownership UnitedHealth wellness Awareness • Annual Wellness Exam • Biometric Screening • Health Assessment Education Create Awareness Encourage & Reward Support Behavior Change Educate & Inform • Newsletters • Videos • Articles/Tips on Bulletin Boards • Onsite Seminars • Webinars and Podcasts Behavior Change Support • Coaching Programs • Disease Management • On-Site Support Groups • On-Site Fitness Equipment • Health & Wellness Discounts • Wellness Challenges • Environmental Enhancements 8 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.