Cost Burden of Illness for Hepatitis C Patients with Employer-Sponsored Health Insurance

The disease burden of hepatitis C virus (HCV) is expected to more than double in the next two decades. Currently, there is very little information about the costs of HCV treatment for employers who pay for treatment and health plans that cover HCV patients. This study reports the medical costs of HCV for workers with health insurance. A retrospective claims data design was used for this study. A sample of HCV patients with health insurance was drawn from the inpatient, outpatient, and enrollment files of the MEDSTAT Group's MarketScan family of databases for 1993-1998. Patients were grouped into cohorts and studied for up to 2 years before and after HCV diagnosis. Sample size varies according to length of follow-up, peaking at 3,077 patients enrolled for at least 6 months. In the first year following HCV diagnosis, average payments for HCV patients ($10,925) were almost six times as high as payments for all patients in the MarketScan database ($1,186). Doctors are encouraged to test high-risk patients to find HCV patients earlier in the course of their disease and to better manage their care in order to avoid unnecessary illness and expenses for this disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63140/1/109350702320229195.pd

Guidance on Development of Employer Value Dashboards

Recent industry surveys indicate that a majority of employers are offering health and well-being (HWB) programs to their employees,1,2 but the reasons for offering them have changed over time. While a desire to improve employee health and contain rising health-care costs remain important, employers increasingly recognize a broader value proposition for investing in workforce HWB. A 2019 survey found employers are more likely to seek outcomes such as improved productivity and employee morale as well as reductions in injury rates and turnover.3 Demonstrating how workplace HWB initiatives are linked to such outcomes is challenging. As consultants, researchers, and practitioners working in the workplace wellness field for decades, we’ve often observed organizations that are benefits and data rich but information poor. Even when organizations invest in data warehouses and have access to sophisticated real-time reporting platforms, they struggle to organize the data into meaningful narratives that convey the value yielded by their investment. In 2018, Health Enhancement Research Organization (HERO) convened a large group of subject matter experts, employers, industry vendor suppliers, consultants, and practitioners to discuss how to approach measurement, evaluation, reporting, and dashboard development within their organization.4 A key point raised by several subject matter panelists was the need to identify who will be using the information that is shared and for what purpose. Additionally, the observation was made that there is a tremendous amount of time and energy invested in the development of client-specific dashboards and that a standardized approach and metrics would be of benefit to all involved. Therefore, the convening launched an effort focused on providing guidance for employers on development of a Value Demonstration Dashboard that informs decision-making regarding ongoing investments in workforce HWB. This article aims to share this guidance, with a focus on steps for development and identification of metrics that will be most meaningful for performance insight and informed decision-making by business leaders. But first, it’s important to clarify what we mean by a Value Demonstration Dashboard

What Can a Pilot Congestive Heart Failure Disease Management Program Tell Us about Likely Return on Investment?: A Case Study from a Program Offered to Federal Employees

In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of$1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout. (Disease Management 2005;8:346-360)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63402/1/dis.2005.8.346.pd

Preventing Chronic Disease in the Workplace: A Workshop Report and Recommendations

Chronic disease is the leading cause of death in the United States. Risk factors and work conditions can be addressed through health promotion aimed at improving individual health behaviors; health protection, including occupational safety and health interventions; and efforts to support the work–family interface. Responding to the need to address chronic disease at worksites, the National Institutes of Health and the Centers for Disease Control and Prevention convened a workshop to identify research priorities to advance knowledge and implementation of effective strategies to reduce chronic disease risk. Workshop participants outlined a conceptual framework and corresponding research agenda to address chronic disease prevention by integrating health promotion and health protection in the workplace

Recommendation to Reduce Patients’ Blood Pressure and Cholesterol Medication Costs

The Community Preventive Services Task Force recommends reducing patient out-of-pocket costs (ROPC) for medications to control high blood pressure and high cholesterol when combined with additional interventions aimed at improving patient–provider interaction and patient knowledge, such as team-based care with medication counseling, and patient education