Population Health Management

To paraphrase Pogo, "We've seen the enemy, and it is us".

Chronic diseases are on the rise in the United States, and the cost to employers is enormous. But many of these diseases can be properly controlled and treated.

Did you know that over 70% of medical claims are due to lifestyle-related factors?

It is also important to remember that over 65% of claims are generated by dependents, so new communication strategies must find a way to effectively reach them.

Did you know that individuals with chronic conditions account for nearly 80% of inpatient hospital visits, and almost 85% of prescription drug use?*

More employers today are willing to invest in disease management and other health improvement strategies. The payoff can be a lowering of the medical cost 'trend line', which can have dramatic impact on the bottom line.

There is a dramatic link between chronic conditions and high claim cost. For example, a claimant classified as 'mildly obese' generates over $1,500 more in annual claims than an average claimant.

The dramatic pace of increase in the percentage of obese Americans is showing itself in our children as well.

C.M. Smith can help employers design strategies to address chronic diseases such as diabetes, heart disease, and asthma. These strategies are one way to address the 10% of your covered population who account for over 70% of your claim cost.

We are Partnering with Employers to Enhance Health and Productivity:

  • Perform Population Health Management (PHM) needs analysis
  • Recommend PHM strategy, goals, objectives and programs
  • Review of all PHM contracts (i.e. wellness, disease management, case management, EAP, disability, workers’ compensation)
  • Facilitate vendor negotiations
  • Oversight of all vendors, measure performance and monitor performance guarantees
  • Recommend intelligent benefit designs based on data and health strategies
  • Development of PHM scorecards

The business case for 'better health' is compelling. We urge employers to become familiar with the case studies and tools provided through the Partnership for Prevention www.prevent.org.

C.M. Smith also strongly endorses the goals of the Healthy Workforce 2020 initiative http://health.gov/healthypeople.
* - Hewitt Associates, 2003