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Sunday, 20 January 2013 22:17

Prevention pays

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WEST MICHIGAN — Data tucked into an annual Grand Valley State University glimpse at the health care system in West Michigan supports a simple notion for better controlling costs: prevention works.

An analysis of medical claims data from Priority Health and Blue Cross Blue Shield of Michigan by GVSU professors found that diabetics who undergo three basic diagnostic tests annually cost more than 10 percent less to treat than those who did not have the tests done for whatever reason.

That difference of $1,100 per patient equates to about $77.3 million in annual savings in a four-county region of West Michigan, even with the costs of the tests figured into the equation.

“That’s real money,” said Paul Isely, a business professor at GVSU’s Seidman College of Business who co-authored the annual Health Check report.

The data supports the need for increased investment in prevention and wellness and that paying a little more up front and getting people tested can generate longer term savings, Isely said. It’s an obvious conclusion, but one that doesn’t always resonate with employers when they craft employee health benefits or to people who are at risk for chronic medical conditions.

“That is a major cost savings. It’s telling us here in West Michigan that doing the preventative tests is well worth the cost structure – by quite substantially, by the numbers we’re seeing,” Isely said. “We know there is the ability of wellness programs to change the incidence of these (conditions).”

GVSU’s 2013 Health Check report that analyzes health care trends in West Michigan pegs the average cost to care for a diabetic at $9,485 annually across a market that includes Kent, Ottawa, Muskegon and Allegan counties. With an incidence rate of 6.4 percent, that equates to $773.5 million in expenditures in the four counties to treat diabetes.

And diabetes is just one chronic high-cost medical condition that drives up costs.

Treating hyperlipidemia, or high cholesterol, costs $777.7 million, or an average of $6,811 per patient per year. Coronary artery disease costs $17,799 per person, or $527.9 million annually across the region. Asthma is a $652.6 million disease in West Michigan each year, or $7,123 per patient.

In many instances, chronic medical conditions such as diabetes are preventable and linked to personal behavior and lifestyle.

“Ninety percent of what we have is what we see in the mirror each day,” said Jeff Connolly, West Michigan president for Blue Cross Blue Shield of Michigan. “The statistics are alarming.”

Speaking at a health care outlook sponsored by GVSU and the Alliance for Health, Connolly made the case for employers to embrace workplace wellness to a greater degree. Blue Cross Blue Shield’s Health Blue Living wellness-based HMO introduced five years ago now has more than 100,000 members and has generated promising results.

“You can see results,” Connolly said of the wellness-based health coverage that employers have been increasingly adopting for a number of years. “I’m not saying it is without strife, but the reality is that if you want to change it, you can change your behavior and improve your health.”

Among the positives in the report for West Michigan is that costs on the region to treat people with five of six high-cost conditions is lower in the region than in the Detroit area. Only coronary artery disease costs more to treat in West Michigan and that’s only by a marginal amount.

Read 46206 times Last modified on Friday, 18 January 2013 11:14
Mark Sanchez

Senior Writer

msanchez@mibiz.com

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