Conference Presentation, Panel
Wellness and Prevention: Creating Healthier Lives and a Healthier Economy
Milken InstituteEric Schatzker, Steve Bird, Lynn Goldman, Kyuri, Bernard Tyson, LaDawn Mantegi, Daryl Difty
- Approximately 50% of causes of death are preventable, yet the U.S. faces an uncontrolled rise in healthcare expenditures driven by a failure to implement known preventative measures regarding tobacco, hypertension, physical activity, and diet.
- Current spending allocations are skewed, with only 3% to 5% dedicated to actual disease prevention and approximately 5% to total primary care and early disease detection, despite behavioral factors driving roughly 70% of all healthcare costs.
- A shift in focus from tertiary treatment to primary prevention is projected to yield significant financial returns, including a $16 billion return on a $10 per person annual investment over five years, while avoiding a projected 65% rise in national spending from 2015 to 2023.
- Incentive-based health improvement programs are expected to lower workforce biological age by four years within five to eight years, cut healthcare costs by half over eight years, and achieve a compound annual cost decline of 9% in 2013 and 2014.
- Specific biometric targets over a two-year period following implementation include 73% of employees failing blood pressure standards passing, 45% failing elevated glucose standards passing, and 43% failing cholesterol standards passing.
- Programs initiated in 2005 with 28% obesity rates are expected to reduce obesity rates by 21% within two years, with 70% of participants maintaining a BMI below 30 long-term.
- Approximately 30% of companies currently utilize biometric screening, but fewer than five link these screenings to outcome-based rewards; 85% of Safeway volunteers are expected to be measured annually to achieve financial checks for a 10% obesity reduction.
- Data integration via electronic health records and cloud services is expected to connect structured and unstructured sources, including wearables, to personalize interventions, track population trends, and enable 30 million e-visits in the current year.
- Large-scale data efforts, such as IBM's aggregated employee data revealing an average of 8,800 steps per day, support the projection that healthcare institutions will be measured on upstream metrics like smoking prevalence and medication adherence rather than just tertiary outcomes.
- Structural and socioeconomic barriers, including lack of grocery stores, unsafe environments, and taxpayer subsidies for sugar production over fruits and vegetables, are expected to continue impacting health outcomes and slowing progress.
- New initiatives include establishing 65 farmer markets in underserved communities, creating "social groups" for weekly goal monitoring, and deploying apps like "Text for Baby" to facilitate prenatal care in remote locations.
- Organizational strategies involve quarterly health earnings reports, "walking meetings," and executive pacing during phone calls to increase physical activity, alongside potential policy debates on sugar or salt taxes.
- Risks include the continued socioeconomic divide preventing low-income individuals from affording healthy food or exercising safely, the possibility that only "fit" people will adopt health tracking devices without plan design changes, and the potential for 30% of healthcare spend to be wasted without primary prevention focus.
- The "total health system" approach is expected to reintegrate mental health by addressing stress, while personal accountability for metrics like BMI and blood pressure is projected to influence individual healthcare spending and 911 call volumes.