With obesity numbers continually rising, employers need to be aware of the cost implications associated with metabolic syndrome.
With this in mind, we asked Captive Resources’ Brian Gagne and Maddison Bezdicek to discuss metabolic syndrome and share strategies employers can implement to control their healthcare costs while improving employees’ lives in our recent Health Risk Management webinar.
Continue reading for a recap of their presentation.
What is Metabolic Syndrome?
Central obesity is the primary contributor to metabolic syndrome, with the most common prognoses being heart disease, liver and kidney disease, sleep apnea, and cancer.
To be diagnosed with metabolic syndrome, three of the following conditions must be present:
- Elevated Blood Pressure: >130 millimeters of mercury (mmHg) systolic pressure or >85mmHg diastolic pressure or diagnosed hypertension requiring treatment
- Elevated Blood Sugars
- Waist Size: >40 inches for males and >35 inches for females
- Low High-density Lipoprotein Cholesterol: <40 milligrams per deciliter (mg/dL)
- Elevated Triglycerides: >149mg/dL
Financial Effects of Metabolic Syndrome
Historically, individuals with metabolic syndrome have higher healthcare utilization and costs compared to those without metabolic syndrome. Consider the following statistics presented by Gagne:
- Average annual costs are 1.6 times higher for those with metabolic syndrome.
- On average, there is a 24% increase in costs for each additional metabolic syndrome risk factor.
- The American Heart Association estimates that costs associated with hypertension, obesity, and diabetes will triple by 2050.
While these numbers may seem daunting, employers can use many tactics to reduce the costs associated with metabolic syndrome. We’ll dive into these tactics below.
Cost Containment Strategies
According to Bezdicek, there are many strategies employers can implement to better control costs associated with metabolic syndrome.
Data Review
Employers can utilize their claims data or data analytics platforms to assess their needs and begin identifying the appropriate solution.
We want to note that fully-funded employers often have limited access to their plan data compared to employers that self-fund.
Data review can involve:
- Reviewing the prevalence of chronic condition claims.
- Identifying gaps in care.
- Identifying cost drivers in prescription claims.
Education
Employers can get creative with educating employees and fostering health-mindedness. Here are a few ideas for companies to consider:
- Bring in an engaging speaker with expertise on health topics.
- Ask the local hospital and grocery store to host a healthy shopping tour of the store for employees and their families.
- Start a podcast, book, or cooking club focused on healthy lifestyles.
Onsite Services
Employers can host screenings or offer services onsite for easy access. Consider the following ideas:
- Check with the local hospital to see if a registered nurse or a physical therapist can spend a few hours a week onsite.
- Provide an onsite annual screening option.
- Install an automatic blood pressure machine.
Benefit Plan Design
Employers can design their plans to create better access to care for their employees. Consider the following options:
- Evaluate and re-design the company’s current incentive structure.
- Make it as easy as possible for employees to see a clinician at least once a year in addition to making other preventative care services accessible.
- Consider offering direct primary care or virtual primary care access.
Physical Environment
Employers can reduce barriers to well-being and healthy choices. Consider the following ideas:
- Provide complimentary healthy food, lunch, snacks, or drinks.
- Provide a clean, relaxing break area for stress reduction.
- Provide walking and standing desks.
Work Structure/Job Design
Employers can reduce barriers to well-being within job design and work structure. Consider the following tactics:
- Train managers to support and model work-life harmony.
- Conduct workload and staffing audits to provide time for employees to prioritize their health.
- Normalize walking meetings or time for physical activity during the workday.
Rx Solutions
Employers can support medication access and adherence. Consider the following solutions:
- Develop the company’s approach to glucagon-like peptide-1 (GLP-1) medications, including prior authorization steps to ensure correct medication approvals.
- Reduce or eliminate copayment maintenance medications associated with metabolic syndrome.
External Partners and Resources
Employers can identify solutions to both prevent and manage metabolic syndrome factors.
- Investigate the effectiveness of your disease management services.
- Consider external digital health solutions for weight management, diabetes management, and mental health support.
About the Webinar
This presentation was part of Captive Resources’ Medical Stop Loss Webinar Series — regular installments of webinars to educate medical stop loss group captive members. The thoughts and opinions expressed in these webinars are those of the presenters and do not necessarily reflect Captive Resources’ positions on any of the above topics.
