Welcome to our latest blog on the March 24th Benefits Breakfast Club session where our expert presenters addressed the burden of chronic disease, the prevention and management of chronic disease, and the potential for workplace health and wellbeing programs to prevent absence and disability.
At this session we were fortunate to be joined by presenters:
- Joe Farago, Executive Director, Private Payers and Investment, Innovative Medicines Canada;
- Lara Kassem, Pharm.D., Family Medicine Group Consulting Pharmacists, GMF du Chemin de la Station St-Henri
- Kim Steele, Director, Government and Community Relations, Cystic Fibrosis Canada
- Dr. Steven Grover, M.D., Professor of Medicine, McGill University and Director, The McGill Comprehensive Health Improvement Plan (CHIP), and
- Liz Scott, Ph.D., CEO and Principal of Organizational Solutions Inc. (OSI).
Based on polling of attendees we learned a few interesting things about our mostly advisor and insurer audience and their interest in chronic disease management, including:
- There is a big opportunity in workplace supported chronic disease management programs. Almost 90% attended because they wanted to know more about chronic disease management and learn more about what they, or their clients, could do about it, and 32% were concerned about increases in chronic disease claims.
- Advisors and plan sponsors need more information on the common chronic diseases that impact their own or their clients’ benefit plans, particularly when they lead to disability:
- 50% are somewhat aware of the most common chronic diseases that impact their own or their clients’ extended health and drug plans, but only 39% are very aware.
- 60% are somewhat aware of the chronic diseases that are resulting in their own or their clients’ short- and long-term disabilities, 21% are very aware.
- There are many chronic diseases that are concerning to attendees, including:
- Anxiety and stress (82%)
- Depression (76%)
- Diabetes (68%)
- Chronic pain (55%)
There is an opportunity to do more to address these issues in the workplace.
- More than half, 58%, have implemented health promotion, improvement or disease management programs in the last 5 years. Most programs, 84%, were focussed on prevention and healthy lifestyles and less than half, 47%, were focussed on chronic disease management. Programs that moved beyond education and awareness were:
- Virtual mental health programs (68%)
- Wellness apps (58%)
- Health coaching (39%)
- Measurement and evaluation need to improve. Program measurement took place in just 32% of wellness/health promotion programs and 29% of absence/disability management programs. Ways of measuring included:
- Participation (53%)
- Engagement (47%)
- Absenteeism (29%)
- Satisfaction (24%)
- Improvement in mental health metrics (21%)
Measuring participation is a great way to start but measuring more can provide valuable information about the impact of programming.
Here are some takeaways from our presenters:
- The burden of chronic disease is growing and is bigger than most plan sponsors estimate.
- According to the 2021 Benefits Canada Healthcare Survey, 60% of plan members have been diagnosed with at least one chronic condition, but plan sponsors estimate that just 34% of their workforce has a chronic condition.
This lack of understanding may be why plan sponsors fail to adequately recognize and address the importance of wellbeing programs, and chronic disease prevention and management programs and services.
- According to the 2021 Benefits Canada Healthcare Survey, 60% of plan members have been diagnosed with at least one chronic condition, but plan sponsors estimate that just 34% of their workforce has a chronic condition.
- Chronic disease management is critical to avoid wasting medication, avoiding complications, co-morbidities, and improving health outcomes.
- Using asthma as one example, over 3.8 million Canadians are diagnosed with asthma. Notably, there are 250 preventable deaths per year, and over 70,000 emergency room visits from uncontrolled asthma. 75% of patients with asthma report having health-related anxiety and experience absence from school or work because of their condition. Some of these costs are impacting benefit plans over and above drug costs to control asthma, which is one of the highest categories in most benefit plans. Direct and indirect cost estimates are likely to double in the next decade reaching $4 billion in 2030. Asthma is an ideal area for plan sponsors to invest their resources:
According to Asthma Canada, patients report a lack of information/education on managing asthma, difficulty in location of asthma/respiratory educators and inadequate air quality regulations are all real issues in preventing the care, support and treatments asthma patients need.
Asthma and other manageable chronic diseases should be on the radar of plan sponsors and other healthcare stakeholders.
- There are new innovations that can be completely life altering for serious, complex, and often rare diseases such as cystic fibrosis, but too often these are kept out of reach of patients because of the expense of treatment. Denying access can fail to recognize the entirety of costs borne by both the public and private sectors. New funding solutions need to be explored to ensure access to patients.
Scientists announced a new therapy that seems likely to benefit 90 percent of people who now have cystic fibrosis. Washington Post, December 17, 2019
- There are opportunities for employers, benefit consultants, and insurers to use prevention, early detection, and disease management tools more frequently and effectively to prevent escalating drug and disability costs.
Canadians do not realize how inactive they were according to results shared by Dr. Steven Grover from the Pan Canadian Healthy Living Strategy. While 54% of adults reported they are moderately active at least 150 min/week, this dropped to 5-15% (depending on age) when objectively measured with a digital tracker. “The proposed Healthy Living targets seek to obtain a 20% increase in the proportion of Canadians who are physically active, eat healthy and are at healthy body weights. These targets can be achieved through collaborative action.”
“When those with a chronic condition do become disabled, workplace oriented, multi-disciplinary programs are most effective,” according to Liz Scott, PhD. “Chronic disease management techniques can assist in the prevention and management of disability and return to work.”
There is a long way to go before our industry is successful at delivering a benefits plan model(s) that integrates tools and services to optimize employee health outcomes, and that will also positively impact the financial sustainability of benefit plans. Any model(s) that are created must also allow easy customization and ensure plan sponsors can integrate solutions based on the unique needs of their population. For them to be successful, plan sponsors will need help with effective communications to educate and engage employees. They also need access to programs and service options that allow them to move beyond education initiatives and include appropriate program evaluation and measurements to demonstrate results.
Thank you to all those who joined us and their high level of engagement and participation! We look forward to welcoming you to our upcoming virtual BBC session on May 19th, After COVID: Making Plans More Resilient by Identifying and Filling Gaps. Save the date for our June 16th season finale: Drug Trends and the Shifting Oncology Treatment Model.