Let this sink in for a moment: Half of your employees live with an unmanaged chronic illness. And depending on the industry and job type, it’s likely much higher.

A sobering study from the Centers for Disease Control and Prevention (CDC) and the National Health Interview Survey (NHIS) shows over half of U.S. adults live with at least one chronic health condition, while more than a quarter suffer from multiple chronic conditions, which the CDC defines as “conditions that last one year or more and require ongoing medical attention, or limit activities of daily living or both.” 

Common chronic illnesses, including high blood pressure, Type 2 diabetes, asthma, obesity and high cholesterol, are not only the leading causes of death in the U.S., they account for 90% of the nation’s $3.8 trillion in annual healthcare expenditures. The prevalence of chronic illnesses has only become worse over the last decade, yet health plan costs continue to grow year over year.

What makes these figures so hard to swallow is the fact that many of these diseases result from lifestyle choices, like smoking, excessive drinking, poor diet and a lack of physical activity. Yet, few employer-sponsored healthcare models address the root cause of unhealthy behaviors, opting for transaction-based care that favors the status quo.

To truly improve your employees’ chronic illnesses — and simultaneously lower health plan costs — employers need to radically rethink their approach to chronic condition management.

Helping Employees Manage Chronic Illness Starts with Better Provider Relationships

Think back to the definition mentioned above: Chronic conditions last a year or more, and require ongoing attention. Yet our current healthcare climate favors quick transactions and prescribing medication, versus understanding the root cause of the condition — often a behavior or lifestyle choice. And because every patient requires different needs and responds to different motivations, there’s no one-size-fits-all solution.

Jeff Terrill, Chief Commercial Officer at Marathon Health, says effective chronic condition management begins by allowing providers to spend quality time with each and every patient, so they can build deep relationships.

“Fundamentally, we believe healthcare professionals and doctors are best-suited to impact change at an individual level,” Terrill says. “We’re going to engage with you at a relational level. You’re not a transaction. You’re not an encounter.” 

At Marathon Health, Terrill says these relationships span across the employee’s entire care team, from the provider and health coach to behavioral health specialists and dietitians. “We’re going to make it a point to have a relationship that’s deep with you and with us as a team, and we’re going to peel back layers of the onion to understand what drives your motivation to deliver outcomes that matter to you as an individual,” Terrill explains.

Behavior Modification Improves Chronic Illness in Employees

Understanding the real motivation behind the desired lifestyle change helps employees connect their values with their behaviors, which increases engagement with health coaching programs. 

“We’re trying to understand the gap between where they are today and where they want to go,” says Lisa Murphy, RN, MBA, Vice President of Organizational Development at Marathon Health.

A key part of the Marathon Health approach involves using motivational interviewing to unlock their motivations, and then crafting a personalized solution to address behavior change — because three different people might give three different reasons for wanting to lose weight, or improve their A1c.

“We help them to see how their behaviors don’t align with their own values, and that’s much more motivating to people,” says Tamara Golden, RN, Health Coach, and Leadership Development Specialist at Marathon Health. “It’s very effective because it’s so patient-centered. It’s all about what’s important to them, and as a result they’re more likely to follow through.”

Once the health coach and employee align on the “why,” they can begin a goal-oriented plan to improve or eliminate the condition completely, instead of maintaining it long-term through medication.

“Let’s reverse-engineer disease progression, because disease generation is a process that’s driven by the food you eat, the level of physical activity or lack thereof, and the stress load you carry with you,” Terrill says.

Personalizing the experience also means meeting with the employee on their terms. For employees with mobility issues or facing pandemic restrictions, you need to provide a virtual care offering, utilizing remote Bluetooth monitoring for conditions like diabetes, high blood pressure and high cholesterol.

Employers Can Use Health Data to Manage Employee Chronic Health Conditions

Rather than waiting for conditions to become problematic, employers need to analyze population health to identify and target high-risk and emerging-risk employees. “Upstream care obviates the need for downstream care,” Terrill says.

This could include analyzing data to identify member cohorts, such as patients with unmanaged diabetes or high blood pressure, and connecting them with medications, regular health coaching and other behavior modification services to improve health outcomes. 

“The key is to align the interventions provided with the level of patient need,” says Michael Gonzales, Executive Vice President of Growth and Strategy at Marathon Health. “You want to keep the chronic population out of the hospital, so you want to get them on remote patient monitoring devices, connect them with behavioral health counselors and start them on chronic condition management programs. 

“Whereas, the at-risk population, you’ll want to ensure they don’t develop chronic conditions. Perhaps they don’t have a primary care physician, it’s important to get them in a primary care program, starting with an annual assessment that includes a health risk assessment, biometric labs and a comprehensive health review with a provider,” Gonzales adds.

Transforming Employee Health Through Effective Chronic Illness Management

To reverse course on chronic conditions, employers need to reimagine their healthcare offerings, and partner with a provider who prioritizes building long-term relationships with each employee to understand their true motivations and uses data to drive behavior change. 

Chronic condition management is a marathon, not a sprint, and employees need a partner in their journey for lasting behavior change.

About the Author: Allison Eckstein

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