More than 15 million Americans have now been diagnosed with chronic obstructive pulmonary disease (COPD), a progressive lung disease that is the third leading cause of death and the second leading cause of disability in the U.S. Evidence shows that approximately 12 million Americans living with COPD remain undiagnosed. What’s more, this disease affects individuals at the peak of their earning and spending power and triples employers’ health costs compared to employees without COPD.
In 2010 the U.S. spent $29.5 billion on direct health care, with additional costs not captured in claims because of under-diagnosis and misdiagnosis. For a misdiagnosed employee, what begins as an occasional sick day caused by frequent colds and respiratory infections may evolve into weeks of dealing with greater disability and long-term chronic illness, leading to reduced productivity and higher medical costs.
These facts about COPD should trigger alarm among employers and prompt them to take action against this growing public-health crisis. To begin the battle, companies should consider these eight steps:
Get educated about COPD by accessing tools to better understand the full impact and implications of the disease in the workplace. The nonprofit COPD Foundation has an employer toolkit with a calculator that organizations can use to estimate how much COPD costs them and the potential savings that could result from better management.
Disease education can inform workers with COPD about how to prevent or lessen the frequency and severity of acute exacerbations (a flare-up), thereby decreasing their need for sick days and increasing their productivity at work. Individuals who experience flare-ups and don’t seek treatment from their primary care physicians are more likely to be admitted to the hospital. Also, incomplete recovery from flare-ups may be one of the main reasons for faster lung function decline, which may speed up the pace of declining productivity and lead to premature retirement.
Establish a benefit plan with employee incentives, such as a lower-cost premium share and lower out-of-pocket costs for tests, treatments and prescriptions in exchange for following COPD preventive care and taking medication as indicated. Make sure, too, that the employee health plan includes coverage for COPD-related care, such as pulmonary rehabilitation services, spirometry (the measuring of breath) and disease management programs. Spirometry is important for avoiding a misdiagnosis and understanding the severity of the disease.
Employers should design benefits based on health plan data that pinpoint gaps in care, as well as establish goals for improving the plan’s existing support services, including its ability to identify members who would benefit from coaching or self-management tools. In addition, plans should adopt and test strategies that improve uptake and effectiveness, such as communicating via social media.
Determining which employees are at risk for COPD is an important step in managing health care costs. Employees can answer five easy questions online to see if they are more likely to get the disease. More than 2.7 million Americans have assessed their risk for COPD this way. Companies also can host an onsite COPD screening day featuring peak breath flow and spirometry screening.
Support workers by providing information about this disease and how to manage the symptoms. For example, provide a COPD Information Line postcard to connect employees to support and education resources, and observe COPD Awareness Month every November, using resources such as those developed by the COPD Foundation and the National Heart Lung and Blood Institute.
Many adults who have COPD are misdiagnosed with asthma; thus, it is critical that sufferers get the right diagnosis and the appropriate treatment. Businesses can play a key role in encouraging employees to identify COPD symptoms and seek the medical care they need.
Employers should offer a smoking-cessation program—the only proven method that slows the rapid rate of lung-function decline. Asking participants in a such a program if they have COPD provides counselors with information they can use to individualize their methods.
To relieve COPD’s drag on the bottom line, employers should turn to resources and expertise. This is critical for analyzing the status of wellness programs relative to COPD outcomes, making it easier to integrate tailored screening and education strategies, and helping define measurable health outcome goals to increase productivity and lower costs.
Fortunately, when diagnosed, COPD is treatable, and individuals with this disease can lead full and productive lives. Wellness programs that encourage early screening help bring out earlier diagnosis. Education and health management can lessen the frequency and severity of COPD flare-ups, lead to fewer missed workdays, reduce hospital claims and increase worker productivity.
John W. Walsh, who was diagnosed with Alpha-1-related genetic COPD in 1989, is the president and co-founder of the COPD Foundation, a nonprofit organization dedicated to developing and supporting programs that improve the quality of life through research, education, early diagnosis and enhanced therapy for persons whose lives are affected by chronic obstructive pulmonary disease (COPD). He is also the co-founder of the Alpha-1 Foundation (a research organization) and AlphaNet Inc. (a unique nonprofit disease management services company run by and for patients).
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