Preventing Health Issues and Advocating Healthy Life Styles

The first step in understanding how prevention affects health care costs is to define exactly what is meant by "prevention." Its broadest definition includes anything that prevents disease, including healthy lifestyle habits and programs that usually fall under the "wellness" umbrella. Its narrowest definition is preventive care such as screenings for various types of cancer and other health risks.

Ideally, a health benefits program should include both clinical screenings and healthy lifestyle programs. Over the past several decades, the focus has shifted toward providing more preventive care benefits, but a stronger focus on preventing disease is still needed.

Preventive care in the United States
Prevention takes many forms: vaccines that prevent disease completely; medications that reduce the risk of developing disease; screening tests that detect disease at an early stage when treatment is more effective; and lifestyle changes - smoking cessation, exercise, diet - that keep people healthy longer.

Through a combination of public education and the growth of managed care, the use and coverage of many preventive care strategies has become more common. But preventive health care statistics in the United States still fall short of expectations. For example:
An estimated 30 percent of the more than 20 million Americans with diabetes remain undiagnosed.

The lifetime risk of developing hypertension is approximately 90 percent for adults between the ages of 55 and 65, but one-third of those affected don't know they have it. Americans receive appropriate preventive, short-term and long-term health care as recommended by professional guidelines only about 55 percent of the time. Approximately 45 percent of the U.S. population has a chronic medical condition, and about half (60 million people) have multiple chronic conditions.

Preventable causes of death, such as tobacco smoking, poor diet and physical inactivity, and misuse of alcohol have been estimated to be responsible for 900,000 deaths annually - nearly 40 percent of total yearly mortality in the United States. One reason why the use of preventive care is not as high as it should be is the large number of uninsured.People without health insurance are much less likely to receive recommended preventive services and medications or have access to regular care by a doctor than those who are insured. But simply having health insurance isn't the solution - it's important to have a plan that encourages the use of preventive care. In one study, screening rates dropped 5.5 percent in insurance plans that introduced cost sharing during the study period, yet increased by 3.4 percent in plans that maintained full coverage.5 By reducing or eliminating cost-sharing in health plans, plan sponsors can increase the use of key preventive services such as adult immunizations and tobacco cessation programs.

Another is lack of education. People often don't consider themselves to be at risk, don't know what preventive services they should receive based on their age, gender and risk factors, or are unsure about their effectiveness.7 It took a concerted effort by doctors, parents, government agencies, health insurers, employers and advocacy groups to achieve higher vaccination rates for children.

Saving lives and money with preventive care.
While immediate costs may be higher in some cases, preventive care can provide significant savings in both short- and long-term health-related costs. Preventable illness and chronic disease are major causes of employee absenteeism and presenteeism (decreased on-the-job effectiveness), causing a financial drain on businesses. A recent study found that increasing the use of just 5 clinical services to 90 percent of the target population would prevent 113,000 premature deaths each year. At least half of the deaths from cancers could be prevented by greater use of established screening tests and existing knowledge. Chronic conditions account for 70 percent of all deaths in the United States and the costs associated with them account for more than 60 percent of national medical care costs.

Studies indicate that prevention, early detection and chronic disease management would reduce the economic impact of disease by 27 percent, or $1.1 trillion annually by 2023 and the number of cases of chronic disease by 40 million. Flu vaccination reduced absenteeism by as much as 45 percent. Based on these numbers, you would expect that most plan sponsors would include coverage for preventive care in their health benefits plans. Unfortunately, that's not the case.

One study found that:
Only 57 percent of employers covered the flu vaccine. Less than 25 percent offered any kind of smoking cessation program. Colorectal cancer screening is offered by just over 70 percent of employers. Cost is the primary reason cited by plan sponsors for not providing more comprehensive health benefits that include preventive care. But some employers are beginning to realize that they can reduce absenteeism and presenteeism by investing in a healthy, productive workforce.2 In your role as a consultant, you can help your clients decide which preventive care services and programs will be most beneficial to their employee population.

Consumerism is also helping to increase the use of preventive care services. As consumers assume greater financial responsibility for their health care and become more informed about their risks, they're more likely to demand additional tests and procedures to protect their health.

Ask about the many Insurance Company special programs and benefits to help maintain health, healthy life styles and screenings for early detection of health issues. Contact, info@amsinsure.com or call 800-334-7875 or you can go online at http://www.amsinsure.com/ .