The National Impact of Chronic Conditions

While practically everyone has heard the words "health plan," how many people think about what that phrase actually means? Probably just the ones who unexpectedly find themselves in need of health care services. At that point, they get to see just how their policy's i's are dotted and ti's are crossed.

But,

Chronic conditions: impacting business and society

According to the U.S. Department of Health and Human Services (DHHS), the prevalence of chronic disease is reaching alarming levels. In the United States, about 125 million people live with at least - one chronic condition-a health problem that has a long course of illness, generally doesn't improve spontaneously, and is rarely completely cured by medication.

Five chronic diseases-heart disease, cancer, stroke, lower respiratory disease, and diabetes-account for more than two-thirds of all deaths in the United States. Health care for people with chronic diseases accounts for 75 percent of the nation's total health care costs, and proper management of chronic conditions in their early stages can help control these costs.

* Cardiovascular disease

America's leading cause of death is cardiovascular disease, which accounts for about 930,000 deaths in the United States. Although age and family history are factors, there's a direct correlation between lifestyle and cardiovascular disease. For example, smoking has been directly linked to a higher risk of heart disease.

* Asthma

Pulmonary disease has a huge impact on our communities. Asthma is responsible for 11.8 million missed days of work and 14.7 million missed days of school per year. Studies show that 24 percent of children and 15 percent of adults with asthma are unable to perform daily, normal activities because of their condition.

* Diabetes

More than 18 million people in the United States have diabetes, a condition that interferes with the production or use of insulin. Complications can include vision impairment, amputations, stroke, heart disease, and kidney failure. Diabetes has led to 24.2 million days of hospitalization and 14 million disability days per year. People with diabetes who follow a routine of diet and exercise can often maintain a healthy lifestyle and avoid medical crises.

The plan for wellness

Whether employees are chronically III or disease-free, they can still live fuller lives. One health care organization that is squarely focused on this concept is Kaiser Permanente. Kaiser Permanente offers a range of proactive care management programs and tools that help keep you healthy and fit. While health care is certainly important, health is measured by our ability to achieve goals, enjoy relationships, and savor life. Kaiser Permanente's strategies include:

* Managing chronic conditions so that members can lead richer lives;

* Offering preventive services to all members to avoid or delay the onset of chronic conditions;

* Providing members and their families with healthy living tools;

* Identifying members who are at risk for developing chronic conditions and begin early preventive strategies.

Kaiser Permanente has a carefully planned approach to managing chronic conditions. Care management programs help members better control symptoms and conditions, often before they become serious.

Kaiser Permanente's care management programs have produced encouraging results. Here are three success stories.

* Cardiovascular disease

In the United States, heart disease is the leading cause of death, but among Kaiser Permanente members in Northern California, this trend is not followed. Our members have benefited from the right medications, weight loss, stress reduction, and smoking cessation. Kaiser Permanente members in Northern California are 30 percent less likely to die from heart disease than non?Kaiser Permanente members in the state.

* Obesity

Kaiser Permanente's Care Management Institute (CMI) has taken a leadership role in dealing with the national issue of obesity. A study was conducted on 210 patients participating in obesity management programs from four facilities in Southern California. Patients took part in a six-month behavioral and nutritional program.* Among two groups who participated in the study for six months, the average weight loss in the first group was 26 lb., and in the second group, 37 lb. An important conclusion of the study was that obesity will be one of the most challenging and costly diseases to be treated. To prevent and treat obesity will take awareness of this condition by all health care personnel.

* Asthma

Better control through medication and appropriate primary care has meant fewer emergencies for Kaiser Permanente members. Between 2002 and 2003, children had 17 percent fewer asthma-related Emergency Department visits and adults had 8 percent fewer visits. Similarly, within Kaiser Permanente between 2002 and 2003, asthma-related hospital admissions and hospital observation stays have declined 9 percent among children and 3 percent among adults, suggesting better day-to-day control of asthma problems.

Get out and get active

Proactive care management-prevention-is a key part of Kaiser Permanente's identity. For 60 years, Kaiser Permanente has emphasized prevention as part of high-quality care. Members can be proactive by taking charge of their health.

Kaiser Permanente offers many opportunities for members to participate in their own health through a wide range of health classes and programs that are held in medical facilities. Resistance training, nutrition classes, and weight management programs are available, and many courses are open to the public. (Some fees may apply.)

Members can participate in health-related services and programs at discounted rates. For instance, with the 10,000 Steps?* online program, Kaiser Permanente members receive a discounted rate on a pedometer. Participants use their personal Web log to track the number of steps they take each day. Those who need a little extra motivation can look forward to daily e-mails with encouraging health tips.

If you need to drop a few pounds, Kaiser Permanente and Weight Watchers?[dagger] have teamed up to bring members new weight-management options at a discount. With a sensible program of healthy eating, physical activity, support, and maintenance tips, Weight Watchers makes it easier for members to adopt a healthier lifestyle. Discounts ranging between 12 and 23 percent are offered on meeting fees, at-home kits, and the Weight Watchers online subscription.

Online support for healthy living

When it comes to healthy lifestyle changes, the first step can often be the most difficult. Online tools can help you maintain healthy habits.

The Web site kaiserpermanente.org provides many health-enhancing options that members can take advantage of, such as the healthy lifestyle programs. These options include the following:

* HealthMedia Succeed?, a total health assessment

* HealthMedia Balance?, a weight management and fitness program

* HealthMedia Relax?, a stress-reduction program

* HealthMedia Nourish?, a nutrition program

* HealthMedia Breathe?, a smoking cessation program

As of September 2005, more than 100,000 members had completed at least one of these programs. Almost 9 out of 10 participants were satisfied with their program.?

Planning for health and taking steps early on to reduce the effects of chronic conditions is good for business. Proactive health care can lead to healthier, more productive employees who spend more days on the job and can enjoy life more fully.

For more information, please contact your local Kaiser Permanente sales representative or visit kaiserpermanente.org.

* 10,000 Steps? is a registered trademark of HealthPartners, Inc.

[dagger] These products and services are provided by entities other than Kaiser Permanente. Kaiser Permanente disclaims any liability for these discounted products and services. Should a problem arise, members may take advantage of the Kaiser Permanente grievance process by calling the Member Service Call Center at 1-800-464-4000.

? Summary of HealthMedia Results to Date, June Forkner-Dunn, PhD, RN, Internet Services Group, Kaiser Permanente, August 15, 2005.