Work Site Solutions and Wellness ProgramsWork Site Solutions and Wellness Programs

Premila Mary Kumar

Senior Clinical Manager

Health and Wellness Education Programs

Facts about ObesityFacts about Obesity

Recent estimates state obesity accounts for $117 billion per Recent estimates state obesity accounts for $117 billion per year in national healthcare expendituresyear in national healthcare expenditures

2/3 of American adults are overweight or obese (BMI >25)2/3 of American adults are overweight or obese (BMI >25) 14% of adolescents 12-19 years old are overweight14% of adolescents 12-19 years old are overweight 300,000 deaths each year are related to obesity 300,000 deaths each year are related to obesity Obesity on verge of surpassing smoking as #1 cause of Obesity on verge of surpassing smoking as #1 cause of

preventable deathpreventable death Obesity is a factor in increase of disabilityObesity is a factor in increase of disability Diabetes rates will double worldwide by 2030Diabetes rates will double worldwide by 2030

Increase in Overweight, Obesity and Severe ObesityPrevalence Among U.S. Women*

Weight Category1988 to 1994

Prevalence (%)1999 to 2000

Prevalence (%)

Overweight(BMI > 25)

51.2 62

Obesity(BMI > 30)

26 34

Severe Obesity(BMI >40)

4 6.3

Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002. Flegal et. al. 2002;288:1723-7. *Ages 20 to 74 for overweight and obesity prevalence and ages 20 and older for severe obesity.

Increase in Overweight and Obesity Prevalence (%) Among Women by Racial / Ethnic Group

Racial / Ethnic Group

Overweight(BMI > 25)

Obesity(BMI > 30)

Black (non-Hispanic)

78 50.8

Mexican American

71.8 40.1

White (non-Hispanic)

57.5 30.6

Source: CDC, National Center for Health Statistics, National Health and Nutrition Examination Survey. Health, United States (Table 70) 2002.

Causes of ObesityCauses of Obesity

Greater calories consumed than usedGreater calories consumed than used Sedentary lifestyleSedentary lifestyle GeneticsGenetics MetabolismMetabolism BehaviorBehavior EnvironmentEnvironment Cultural influencesCultural influences Socioeconomic influencesSocioeconomic influences

**National Center for Chronic Disease Prevention and Health Promotion**National Center for Chronic Disease Prevention and Health Promotion

Conditions Affected by ObesityConditions Affected by Obesity

Diabetes MellitusDiabetes Mellitus Arteriovascular Arteriovascular

Disease (CAD, CVD, Disease (CAD, CVD, HTN, Hyperlipidemia)HTN, Hyperlipidemia)

Heart FailureHeart Failure COPDCOPD ESRD (DM, HTN)ESRD (DM, HTN) CA (many forms)CA (many forms)

Healthcare Implications of Obesity

65% of Americans are overweight or obese65% of Americans are overweight or obese Additional expenses for employersAdditional expenses for employers

DisabilityDisability AbsenteeismAbsenteeism PresenteeismPresenteeism OrientationOrientation

Impact on children Impact on children 11stst generation that will not outlive their parents generation that will not outlive their parents Unchecked, the cost of healthcare in our children’s Unchecked, the cost of healthcare in our children’s

generationgeneration will be staggeringwill be staggering

10%20%

20%50%

Lifestyle behaviors

Environment

Genetics

Access to Care

Source Centers for Disease Control and Prevention (2000) Retrieved August 11, 2003, from http//www.cdc.gov

Who’s in Control of Your Health? Who’s in Control of Your Health?

Contributing Factors to an Individual’s Health Status

How Health Impacts Business CostsThe Payback from Behavior Change

Source: Goetzel, Long, Ozminkowski, et al. JOEM 46:4, April ,2004)

Allergy Arthritis Asthma Any Cancer Depression/SadnessMental Illness

Diabetes Heart Disease

Hyper-tension

Migrane/Headache

Infections

What has Horizon BCBSNJ Done?

Horizon –BCBSNJ Wellness Programs

Employee Health CenterEmployee Health Center Pharmacy Concierge ServicesPharmacy Concierge Services Onsite LabCorp laboratory servicesOnsite LabCorp laboratory services Onsite Fitness CenterOnsite Fitness Center Mobile MammographyMobile Mammography Free Flu vaccines for all employeesFree Flu vaccines for all employees Employee Assistance ProgramEmployee Assistance Program

Horizon –BCBSNJ Wellness Programs

Healthy food choices offered in the cafeteria Healthy food choices offered in the cafeteria Disease Management ProgramsDisease Management Programs Lactation RoomsLactation Rooms Employee Discount ProgramEmployee Discount Program WebWeb MD online resources MD online resources Shape it Up Program in SchoolsShape it Up Program in Schools Horizon Health Kiosk ProgramHorizon Health Kiosk Program ““Horizon Walks for Health”Horizon Walks for Health”

Community / Corporate Wellness ProgramCommunity / Corporate Wellness Program

In our continuing dedication to Making Healthcare Work,Horizon Blue Cross Blue Shield of New Jersey is makingit easier for you to take an active role in managing andenhancing your overall health and well-being throughthe Horizon Health Kiosk.

M

Better health through awarenessHorizon Health Kiosk

any medical conditions, such as hypertension, can be affected by the way you live your life. It is not only beneficial to live a heart- healthy life, but it is important to manage your own health conditions and monitor your vital signs.

The Horizon Health Kioskprovides the information, resourcesand tools to help you become awareof, and actively involved in, themanagement of your health and anyrisk factors you may have. It has aninteractive touch-screen with colorgraphic display, allowing you tomeasure:

• weight.• blood pressure.• heart rate.• body fat.• BMI.• blood oxygen levels.

A barcode is used to access theSystem. The system recognizes and welcomes the user, prompting you to select an ID and password. This allows measurementdata to upload into a private,protected graphical health chart,viewable from any computer. at<www.lifeclinic.com>.

You can access health information,obtain information about medicalconditions you may have and recordand track changes important to youand your physician in choosing andmonitoring treatment. You can alsolearn various ways to make positivehealth changes to your lifestyle.Charts and reports may be printed tohelp you discuss lifestylemodifications and treatment changeswith your physician.

The Horizon Health Kiosk is one more way we’re Making Healthcare Work for our members.

www.Horizonblue.comwww.Horizonblue.com

Health Risk Assessment and AnalysisHealth Risk Assessment and Analysis

Confidential

Interview-style input

Immediate Results / Comparison to Universe of peers

Highlights Risk Factors and Action Steps

Horizon generates output for use in Disease Mgmt, Prevention, Group Reporting, etc.

Weight Management Health Education ProgramWeight Management Health Education Program

Welcome Kit with Tape Measure, Caloric Counter / Diary, Pedometer etc

Tape Measure to assess waist circumference and waist:hip ratioTape Measure to assess waist circumference and waist:hip ratio Educational MaterialsEducational Materials Access to Registered Nurses, Registered Dietician, Social Worker & Access to Registered Nurses, Registered Dietician, Social Worker &

Certified Diabetes Educators Certified Diabetes Educators Onsite Lunch & Learn programsOnsite Lunch & Learn programs Quarterly Educational Mailings Newsletters discussing hot nutritional topics

Discount exercise programs

Cook Shops at Employer worksite

Weight Management Health Education Program Outcomes Weight Management Health Education Program Outcomes MeasurementsMeasurements

Weight loss or reduction Reduction in Body Mass Index (BMI) Waist circumference Clinical Metrics : Cholesterol, Blood Sugar,

Blood pressure & A1c Number of ER or Inpatient admissions due to co morbid

conditions

Weight Loss/Waist Measurements

Q9a: Since you began participating in the Weight Management Health Education Program, have you lost weight?Q9b: Since you began participating in the Weight Management Health Education Program, how much weight have you lost?Q9c: Since participating in the Program, have you measured your waist?Q9d: Have you noticed a decrease in your waist measurement?Q9e: Have you had a decrease in your clothing size?

• Overall, about 50% of members who have participated in the Weight Management Health Education Program have lost weight, and a third have lost 11 pounds or more.

- Members who received written materials or have been contacted by a Care Specialist are more likely to say they have lost weight.

• About forty percent of members have measured their waist since participating in the Weight Management Education Program.

- Of those members, nearly 70% say they noticed a decrease in their waist measurement and 40% had a decrease in their clothing size.

29%

35% 36%

0%

10%

20%

30%

40%

50%

1 to 5 6 to 10 11+

Amount of Weight Lost

Pounds Lost

Members Overall Health/Absenteeism

Q13: How would you describe your overall health?Q14: Do you currently work full or part-time outside of the home?Q15: In the past 4 weeks did you miss any days at work because of any weight related health problems?

Over 60% of members believe they are in very good health and rarely get sick, miss Over 60% of members believe they are in very good health and rarely get sick, miss work/school or daily activities.work/school or daily activities.

Almost three-quarters (74%) of members currently work full or part-time outside of the home.Almost three-quarters (74%) of members currently work full or part-time outside of the home. And of those members, almost none (99%) have missed any days at work because of any And of those members, almost none (99%) have missed any days at work because of any

weight-related health problems in the past four weeks.weight-related health problems in the past four weeks.

2%

6%

8%

23%

61%

0% 20% 40% 60% 80% 100%

I frequently have to miss work/school or otherdaily activities because of illness

My/child's health significantly interferes withmy life

I occasionally have to miss work/school orother daily activities because of illness

I occasionally get sick, but I still go towork/school or carry out other daily activitites

I think I am in very good health and I rarelyget sick and miss work/school or daily activities

Members Overall Health

Participant

Data Warehouse:

Comprehensive Reporting & Outcomes

ROI

Health RiskAppraisal

Proposed Horizon Service Delivery ModelCoordinated Approach

Inte

gra

tor

/ N

avig

ato

r /

Dis

pat

cher

High Risk/Acuity

Moderate Risk/Acuity

Low Risk/Acuity

Lifestyle Behavior Change (*)

Disease Management

CaseManagement

EAP / Behavioral Health

Decision Support & Health Advocacy

Nurse Line

On Site Clinical Resources

Claims / Predictive Modeling

* includes health coaches and web based and telephonic programs

In ConclusionIn Conclusion

Lifestyle change and education promotes Lifestyle change and education promotes

decreased prevalence of obesity decreased prevalence of obesity DietDiet ExerciseExercise Behavior ModificationBehavior Modification

Improves overall healthImproves overall health

Decreases healthcare costsDecreases healthcare costs

Questions or Open Discussion?Questions or Open Discussion?