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Costly Conditions: How to Address Healthcare Costs Through Workplace Programs

Health coverage represents a significant cost for today’s employers. According to a 2020 estimate, the average cost of an employer-sponsored health plan was $7,470 for single coverage and $21,342 for family coverage. 

Cost aside, many employers are seeking to create a company culture that places high value on employee health and wellness, an effort aimed at helping to attract and retain top talent

But certain health conditions have a greater impact than others. It’s important for employers to understand the costs of major health conditions and how they might implement a strategy to address these conditions in the workplace. Here’s how.

Costliest Health Conditions in the U.S.

The Health Action Council reports that $1.9 billion has been spent on the following five conditions: 

  • Cancer (15% of claims)
  • Musculoskeletal (13% of claims)
  • Cardiovascular (9% of claims)
  • Gastrointestinal (7% of claims)
  • Neurological (6% of claims) 

The remaining 50% represents the cost of all other medical conditions, while this list represents the conditions that carry the highest cost. Here’s how the list breaks down:

Cancer

Cancer alone accounts for 103,000 insurance claims, with $553 million paid by employers. This makes cancer the costliest condition by far. 

What drives the high cost of cancer? Chemotherapy costs an average of $74,000 per patient, nearly a fifth (18%) of the total medical costs.  

Employers will also have to make special accommodations for cancer patients seeking to re-integrate into the workforce. This can include modified responsibilities, a flexible schedule, and support for ongoing treatment.

Musculoskeletal (MSK)

Musculoskeletal conditions represent 317,000 claims, with employers paying $477 million. The greatest cost comes from joint replacement surgeries, particularly knee replacements. 

Fortunately, MSK conditions are typically not completely debilitating, at least not long-term. Well over 90% of joint replacement patients return to work within three months, and 89% can return at the same intensity as they previously maintained. 

Because MSK conditions tend to be exacerbated by lifestyle factors, many employers are adopting proactive strategies that target obesity and repetitive stress conditions, promoting a healthier lifestyle across their workforce.

Cardiovascular Disease

Cardiovascular disease accounts for 169,000 insurance claims, costing employers a total of $357 million. The treatment of abnormal heart rhythms is the biggest cost driver, though any medical intervention can be costly. 

Employers should recognize that the time lost varies based on the procedure performed. For instance, patients undergoing cardiac catheterization can return to work in as little as two days, while an angioplasty will require one to two weeks to recover. 

Lifestyle is again a factor, which means employers can address cardiovascular disease through programs aimed at improving diet, increasing exercise, and addressing risk factors such as smoking or diabetes.

Gastrointestinal (GI)

Gastrointestinal care accounts for 136,000 insurance claims and an employer cost of $284 million. GI diseases cover a range of conditions, including: 

  • Colitis
  • Crohn’s disease
  • Pancreatitis
  • Celiac disease
  • Hernias
  • Gallbladder attack
  • Irritable bowel syndrome (IBS) 

In most cases, these conditions can be managed through medication and changes in diet. The impact on your workforce depends on how well these conditions are managed, which is why it’s important to promote honest dialogue among your workers to address potential absenteeism.

Neurological Conditions

Neurological conditions constitute 240,000 insurance claims, costing employers $225 million. Neurological conditions cover a range of both acute and chronic conditions, including: 

  • Carpal tunnel syndrome
  • Parkinson’s disease
  • Migraines and headaches
  • Multiple sclerosis
  • Epilepsy

In some cases, the condition can be easily corrected through a combination of medication or surgery. Carpal tunnel syndrome, for instance, is generally treated with surgery and some modifications in work habits. Other conditions can be more chronic and may require special accommodations.

How Your Workplace Can Address These Conditions

So what does all of this mean for you as a business owner – and how can you make a measurable and meaningful difference in mitigating these kinds of potentially huge healthcare costs in your company?  Here are four key strategies you can enact today:

Implement Wellness Programs

Lifestyle changes can prevent and mitigate many of these conditions. Employee wellness programs are a great way to promote healthy lifestyle habits that benefit employees and your company as a whole. A good wellness program will be customized to fit the needs and goals of your business and your employees. Focus HR can help you implement a program that’s right for your team by first assessing the needs of your employees, setting goals, providing inclusive options and developing a wellness policy. 

It’s important to have regular check-ins with your team to keep them motivated and on track. It’s also a good idea to set a budget for your wellness program and to consider offering incentives such as cash, gift cards or even extra vacation days. 

Implement Opportunities to Move at Work

Regular movement and exercise are so important in promoting healthy outcomes. Sitting in a hair for 8 hours a day is not healthy. Encourage your employees to regularly get up from their desks, have standing or walking meetings, and offer standing desks or ergonomic chairs for them to use. 

Introduce Pharmacy Step Therapies

Where possible, support the use of lower-cost solutions (e.g., generic prescriptions) rather than relying on higher-cost solutions.

Educate Your Employees

Make sure your workers understand their options and all that is available to them under their employee benefits plan. There may be prevention and wellness benefits that they are not taking advantage of. Your Focus HR Benefits Specialist can host a meeting to go over this information with your staff. 

Find a Solution that Fits

Focus HR offers an outsourced HR solution that can help you manage employee benefits and implement wellness programs to best support your team. Find out how by requesting a free consultation by filling out the form below. 




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