Healthy Returns: How Investing In Employee Health Pays Dividends
In March, a federal judge struck down an essential Affordable Care Act policy that mandated private insurers fully cover certain preventive care services, including screenings for cancer, diabetes, depression, and more. The ruling potentially affects all Americans who get their health coverage through their jobs — roughly 150 million people.
With rates of obesity, diabetes, heart disease, and depression exploding, why are we snuffing out efforts to stop this crisis from spiraling even more? Instead, we should be sounding the alarm. Those preventable conditions are the leading drivers of our country’s $4 trillion in annual healthcare costs.
Already, the U.S. spends twice as much per person on healthcare as the EU and three to four times more than South Korea and Japan — largely because we don’t invest enough in preventive care. Healthcare costs (primarily made up of hospital care and clinical services) amount to nearly 20% of US GDP and are crippling our economy.
Preventive care saves lives — and healthcare costs in the long run. But, without a mandate, some employers may be tempted to cut back on preventive services. That would be a mistake.
Every year, chronic diseases and injuries cost U.S. employers $575 billion in lost productivity and workers’ compensation. What’s more, studies show that obesity makes workplace injuries significantly more likely. If the current trajectory of cardiometabolic disease persists, we’re looking at many more billions of dollars lost.
Employers would do better to invest in programs and therapies that treat obesity and other cardiometabolic conditions. The sooner employers can stop the progression of those diseases, the more they stand to gain. Whereas many private and public insurers only have patients in their plans for one to two years, most employers retain their workers for over four years. Employers have time to see real returns on their preventive care investments.
Some employers are catching on and covering new weight loss drugs like GLP-1s that have impressive weight loss outcomes up to 17% of body weight. There’s no question people want help losing weight and offering access and coverage for these drugs may prove to be a way to attract and retain talent.
But employers don’t need to rely on expensive drug therapies alone to prevent expensive downstream effects from chronic diseases. They can invest in more lifestyle interventions like medical nutritional counseling and health coaching, too. And they’re often more economical — especially when delivered virtually.
More than twenty years ago, the Diabetes Prevention Program study showed that treatment of diabetes in high-risk individuals led to a return of $3.34 for every $1 spent. With over 3,000 participants, the study found that those who received lifestyle interventions had the lowest incidence of diabetes — and that those lifestyle interventions were more cost-effective than medication (like metformin) alone.
Ten years later, a follow-up study showed that participants were still one-third less likely to develop diabetes a decade later than people who took a placebo. Since then, more than 600,000 people at risk of type 2 diabetes have participated in the National DPP lifestyle change program.
Preventive care is a worthwhile investment. The more we can encourage people to participate in their own self-care, the healthier and more productive they’ll be. Nutritional counseling, health coaching, and prescribing medications when needed can help people not only manage complicated conditions like diabetes but also prevent them from developing in the first place.
That prevention is key because diabetes is effectively irreversible according to the American Diabetes Association. While people may be able to achieve remission through healthy eating and exercising, the underlying physiology of the disease can’t be reversed. It’s really a lifelong condition to watch and manage — even for those who live a healthy lifestyle. And there are untold costs for those who don’t stay on top of the condition.
Poorly managed diabetes can quickly snowball into heart disease, chronic kidney disease, nerve damage, vision loss, feet problems, and worse. The costs are nearly never-ending. We must encourage the prevention of diabetes as much as possible to bend the cost curve of the disease. Especially since more than one in three Americans are at risk of developing it.
Employers can easily encourage preventive screenings and care by partnering with virtual cardiometabolic care companies that cover the full spectrum of those conditions from obesity to diabetes, hypertension, heart disease, and more. Some even cover treatment for mental health conditions like depression and anxiety that so often underlie diabetes and obesity.
Historically, mental health care has been too often overlooked as an essential service in our healthcare system. But it can play a large role in preventing not only serious mental illness but serious physical conditions, too. Integrating mental health services into preventive care programs can help ease depression and anxiety, and thereby, prevent chronic conditions like diabetes and heart disease from developing. That investment may cost more upfront, but it’ll save in the long run.
The best way to promote a healthy, growing U.S. economy is by ensuring its workforce remains healthy too. This is no time to be cutting back on worthwhile screenings and preventive interventions. Instead, let’s invest in our future by investing in the health of our people.