The Complete Health Improvement Program. Healthnetwork Foundation Webinar November 2013 Amy Mechley, M.D. The Christ Hospital Health Network

Transcription

1 The Complete Health Improvement Program Healthnetwork Foundation Webinar November 2013 Amy Mechley, M.D. The Christ Hospital Health Network

2 Current State Of Affairs

3 Health Care Costs Chronic Diseases Absenteeism Presenteeism Productivity Optimal Health

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5 Why Is It So?... or how did we get here?!

6 Obesity Overweight 32%, obese 34%, morbidly obese 6% SO ONLY 1/3 OF OUR POPULATION IS OF NORMAL WEIGHT Obese men 5.9 more sick days, women 9.4 Very obese lose 1 month of productive work per annum Obese men $1152 in extra medical costs, women $3613 Source: Reuters, April 30, 2012

7 Obesity Obesity (BMI >40) increases the risk of: Diabetes 7x, escalating at 5% per year High Blood Pressure 6x Heart Disease 5x Arthritis 4x Asthma 3x Sleep Apnea 6x Cancer of the Breast, Prostate, Colon, Cervix Source: Reuters, April 30, 2012

8 What We Eat Fruits, Vegetables, Grains and Legumes 7% 42% Dairy & Animal Foods 51% Refined, Processed Foods USDA Agriculture Fact Book

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11 U.S. Sugar Consumption Teaspoons of sugar per person per day

12 Food Refining = 1 Tablespoon of oil

13 Diabetes Trends (US ) 25% % of people with diabetes by age 20% 15% age % 10% 5% age

14 Heart Disease.. Less than 100 Years Ago You can expect one heart attack/year in an average hospital in an average sized town Prevalence of Coronary Heart Disease in North America, 1928 Medical Textbook by Sir William Osler, MD Today the number of heart attacks in the U.S a year!

15 Heart Disease Today Bypass Surgery 400,000/year averaging $60,000+ each 37-46% of vein grafts failed (75% narrowing) within 12 to 18 months NEJM 2009, 361 (3) 235 Angioplasties & Stents 1,000,000/year averaging $35,000 each

16 Prescription Drugs 180,000* fatal Adverse Drug Reactions 7.5% of all US deaths *Properly or improperly prescribed (cdc.gov/datastatisticsdrugenquirer.com)

17 US Medical Cost Trends Medical Spending (in $ Billions) 75% on Chronic Diseases % 5,010 in % of GDP ,359 2,

18 Why target lifestyle behavior? Lifestyle accounts for 75% of national medical costs 1 and associated chronic diseases. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 91% 82% 71% 70% Cancers Stroke Heart Disease Diabetes 1. Centers for Disease Control,2006 Sources: Stampfer, 2000; Platz, 2000; Hu, 2001

19 Causes of Premature Death and Major Illness in the U.S. Lifestyles Heredity Environment Lack of Med Rx

20 HEALTH 75% Lifestyle 10% Medical Care 10% Environment 5 % Genetics

21 Influence of Behavior-Related Risk Factors on Medical Costs

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25 Etiology of Chronic Inflammation Examples: Stress : Cortisol Obesity Hypertension Animal products, saturated fats, refined carbohydrates ("carbs"), and sugars, and trans fats (the type so prevalent in processed foods). Tobacco

26 In the Sept. 15, 2010 issue of the American Journal of Cardiology, Cleveland Clinic surgeon Caldwell Esselstyn, Jr., MD... Stents and bypass surgeries may have their place, but for the vast majority of patients they are not as effective as a low fat, plant-based diet.

27 The Solution: Lifestyle Intervention

28 Diseases Influenced by Lifestyle: Type 2 Diabetes High Blood Pressure Overweight and Obesity Depression Cancer High Cholesterol Coronary Disease Arthritis

29 The Complete Health Improvement Program (CHIP) CHIP was designed to: educate, motivate, and inspire individuals to make wiser lifestyle decisions to facilitate the prevention & reversibility of many of our chronic diseases.

30 Complete Health Improvement Program 2013 Lifestyle intervention program Corporate mins, group setting Community mins, group setting Practical Experience, Reinforcement, Behavior Change Focus Whole of Health approach biometric pre/post data capture to prove results

31 VIDEO: 900%

32 Does CHIP work?

33 Peer Reviewed Journal articles on lifestyle medicine : nutrition therapy effective for chronic disease management Over 1170 peer-reviewed journal articles in med line Ornish Esselstyne Barnard Collins Diehl

34 CHIP Results 50,000+ graduates CHIP clinical results published over 20 peer reviewed journals American Journal of Cardiology The Journal of the American Dietetic Association Preventive Medicine Journal of Occupational & Environmental Medicine significant ROI

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36 Rankin et al. Am J Cardiol. In press.

37 Return on Investment (ROI) Year 1 ROI Diabetic savings *Elevated Risk savings Program cost per member $600 $ $ ROI 5.9:1 2.3:1 Year 2 ROI Diabetic savings *Elevated Risk savings **$ $ ROI over 2 years (no additional cost) 11.2:1 5.9:1 *elevated risk members included both high risk and diabetic members **2 year savings were calculated by doubling year 1 savings for this group Additional Notes: - Based on 2 formal analyses of healthcare costs - ROI is calculated as investment divided by savings and is expressed as a ratio - Savings are the actual claims dollars difference between the participants in the CHIP intervention and the nonparticipants that were in the study with similar risks (the control group) - Program cost (investment) is $600; the retail tuition price per participant for corporate programs

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39 Quick 5 takeaways to start 1. Be intentional about your food, make sure it is food, consider giving up processed foods. 2. More plants, less meat and dairy. (veggies, fruits, beans whole grains and legumes..lowers inflammation) 3. Move more every day by integrating activity into your daily schedule ( stand-up or walking meetings, 10 flights daily, get and use a pedometer.) 4. Seek silence in your day. 5. Invest in your health.

40 RESOURCES The China Study by Colin Campbell 900% Forks Over Knives, Documentary...free on HULU or on netflix The Spectrum, by Dean Ornish

41 Amy Mechley, M.D.