One in three first-time participants in a company-sponsored, lab-based wellness program were not aware that they were at high risk for a serious medical condition, The study by Quest Diagnostics, a provider of diagnostic testing services, found that 36 percent of first-time participants in lab-based wellness programs had evidence in diagnostic testing of at least one newly identified common chronic condition.
In addition, 89 percent of those found to be at high risk for chronic kidney disease, 59 percent of those found to be at high risk for high cholesterol and 28 percent of those found to be at high risk for diabetes first learned of the health concern through their employer-sponsored lab-based wellness program. The remaining participants who were at high risk were aware of having those conditions.
The study, called “Value of Laboratory Tests in Employer-Sponsored Health Risk Assessments for Newly Identifying Health Conditions,” examined the role that laboratory-based employer wellness programs play in identifying high risk for common chronic disease. It was limited to a cross-sectional analysis of health risk assessment laboratory results of 52,270 first-time wellness plan participants (adult employees and their eligible spouses or domestic partners) conducted between 2003 and 2010.
Nearly all of the participants in the study were insured, meaning that health care access did not guarantee detection of high risk for common chronic health conditions—and suggesting that lab-based employee wellness programs are playing an important role in filling the gap.
The analysis focused on three common health conditions—high cholesterol, diabetes and chronic kidney disease—because of their high prevalence and related costs in the United States and the benefit of effective intervention associated with early detection.
“This is exciting research that documents the importance of using health risk data with actual lab results, not just relying on self-reports,” commented Helen Darling, president and CEO of the not-for-profit National Business Group on Health. “Most employers know that helping employees and dependents understand and reduce their risk factors will improve health and quality of life while avoiding serious and costly medical problems down the road."
But getting individuals to focus on the seriousness of these issues and the need to act sooner rather than later remains a challenge for employers, Darling noted, adding, "These data are compelling because they show that lab-based wellness programs provide medical evidence of serious health risk that individuals really can’t ignore.”
Age, Gender, and Education Level
The rate of newly identified disease increased progressively with age, ranging from 24.4 percent among 20- to 29-year-olds to 41.7 percent among 50- to 60-year-olds.
Among 20- to 29-year-olds, high cholesterol risk was especially elevated at 29.2 percent, while diabetes risk presented at 1.7 percent and chronic kidney disease risk at 1 percent.
Men (39 percent) were slightly more likely than women (33 percent) to have at least one newly identified condition. Education level provided little benefit in the early awareness of the three conditions described.
Risks and Costs of Chronic Disease
“The growing obesity epidemic poses serious health risks to Americans, including dangers associated with heart disease, diabetes and chronic kidney disease,” said Harvey W. Kaufman, M.D., senior corporate medical director at Quest Diagnostics and study author along with Fred R. Williams, the company’s director of health management Strategies, and Mouneer A. Odeh, director of informatics and analytics.
“Lab-based wellness programs empower individuals with the data they need to face their health risks, change their behaviors and improve their health—and in some cases, dramatically change their prospects,” Kaufman added.
According to the Centers for Disease Control and Prevention (CDC), high cholesterol can lead to heart disease and stroke, the first and third leading causes of death for men and women in the U.S. In 2010, the total cost of cardiovascular diseases in the U.S. was estimated to be $444 billion.
Treatment of these diseases accounts for about $1 of every $6 spent on health care in the U.S. The direct medical costs in 2007 for diabetes were $116 billion, while indirect costs (disability, work loss, premature death) in 2007 were $58 billion. On average medical costs for a person with diagnosed diabetes are more than twice as much as the expense of a person without diabetes.
The CDC estimates that by 2050, one in three people will have diabetes.
Awareness of chronic kidney disease is low, even though the prevalence (26.3 million in the U.S.) is similar to diabetes (25.8 million). According to the National Institute of Diabetes and Digestive and Kidney Diseases, end-stage renal disease in 2008 cost $39.46 billion in public and private spending. Early detection and treatment can slow or halt the progression of chronic kidney disease and associated co-morbidities.
Avoiding the Chronic Disease Cost Avalanche, SHRM Online Benefits Discipline, September 2011
Educate Employees to Control Out-of-Pocket Lab Costs, SHRM Online Benefits Discipline, July 2011
Uncommon Knowledge: The Value of Health Assessment Data, SHRM Online Benefits Discipline, July 2011
SHRM Online Benefits Discipline
SHRM Online Health Care Reform Resource Page