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Preventative Health Care Drives Down Costs
Hospitals Adjust to the Demand for Preventative Medicine

From the growing popularity of wellness initiatives to DNA testing to technology that detects the first stages of disease, medical practice is shifting from treatment to prevention. Find out what’s next for preventative medicine in hospitals.

By Valerie Van Kooten

When company officials at Vermeer Corporation in Pella, Iowa, began seeing employees' health insurance claims rise dramatically in 2005, they took a second look at what was going on. It turned out the bulk of the claims were from five to 10 percent of employees and were related largely to lifestyle choices that had to do with obesity, stress and depression.

"We decided right there we needed to be more proactive on-site and get a wellness program going," says Julie Tabatabai, director of wellness for Vermeer, a manufacturer and distributor of industrial and agricultural equipment worldwide. As a result, health care costs for the company remained flat in 2006 and 2007, and Vermeer has revved up efforts to educate and mentor its 2,000 employees, thus ensuring fewer claims in the future.

As more American companies look at the bottom dollar on health care claims, officials in those companies are turning to the expertise and advice of U.S. hospitals, and are forming partnerships that result in a win-win situation for everyone.

Chronic Diseases Drive the Effort
Preventing disease before it happens is becoming the norm for hospitals across the nation. Chronic diseases account for seven out of 10 deaths in the United States, according to the Centers for Disease Control and Prevention (CDC). In addition, they are the primary driver of health costs — nearly 75 percent of yearly health care spending in the U.S.

"As we see our employees age and we see more chronic illness, if we don't get a handle on it, it's going to do us under," Tabatabai says.

And yet there was a time when prevention was seen as a "far-out" approach to health care. "The foundation of all health care is, in large measure, prevention," says Susan Pisano, vice president of communications for America's Health Insurance Plans in Washington, D.C. "That's been the approach in our community for decades, even during those times when prevention as a major tool was being scoffed at."

Pisano says prevention breaks down into two areas: primary preventative care, like immunizations, and secondary preventative care, such as mammograms, which do not prevent cancer but do help detect it in early stages. "We can also see prevention in chronic conditions, like diabetes," she says. "You may already have it, but let's make sure you have an annual eye and foot exam. By doing these things, we can virtually eliminate diabetic blindness."

America's hospitals have long understood that taking preventative care to the public will help everyone win; that’s why so many hospitals offer screenings and immunizations at workplaces and schools, as well as free clinics for high-need areas. In addition, hospitals and their related clinics offer educational outreach in areas ranging from weight loss to childbirth preparation to smoking cessation. Every year, hospitals make hundreds-of-millions-of-dollars worth of investments in communities, says Dan Royer, director of advocacy development for the Iowa Hospital Association.

Health Education at a Distance
Employees at hospitals in the Pacific Northwest can have lunch while they view presentations about preparing fresh produce, preventing cancer through diet and exercise, or avoiding holiday weight gain. The unique part about this is that the presenter is often not on-site — he or she might be hundreds of miles away. The employees are part of a teleconference lunch and learn.

The program was developed by Inland Northwest Health Services in Spokane, Wash., in 2004, and now has 55 urban and rural hospitals across the region participating in preventative health efforts, reaching more than 1,000 employees.

Inland Northwest Chief Operating Officer Nancy Vorhees says preventing illness and injury is a key way to reduce health care costs. "Businesses that offer preventative education to employees help address these issues, as well as absenteeism and productivity, that affect business operations," she says. "Telehealth technology is one way businesses can provide added benefit to their employees in a cost-effective and efficient way."

In addition to telehealth services, Inland’s health@work program can provide on-site evaluations of the workplace and then put together a customized plan for that company that will offer confidential biometric health screenings, smoking cessation programs and diabetes education.

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