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Workers and Chronic Conditions
As presented to the Washington Business Group on Health

Overview

41.4% of the working age adults (20-65) have at least one chronic condition. The most common chronic conditions in working age adults are:

  • Hypertension
  • Depression
  • Diabetes
  • Asthma

Costs

67.5% of all medical costs in working age adults are for people with one or more chronic conditions.

Average Total Medical Expenditures in Working Age Adults

No Chronic Conditions: $998 / person

One or More Chronic Conditions: $2929 / person

Indirect Costs

A recent study shows that during one month almost one quarter of workers between the ages of 25 and 54 has at least one day of work loss or work cutback due to a chronic condition this equates to 2.5 billion impaired workdays (Kessler et al, 2001)

Fortune 100 Companies: Health Benefits Coverage Survey

Sample Frame: 100 companies with the highest revenues in 1999

  • Summary Health Plans, which were distributed to employees obtained and confirmed by Employee Benefit Managers
  • Response rate of 76%
  • Survey conducted in Spring-Summer 2000

Benefits Provided By 100 Percent of Fortune 100 Companies

  • Prescription Drugs
  • Mental Health Outpatient Services
  • Home Health Care
  • Physical Therapy
  • Durable Medical Equipment
  • Occupational Therapy
  • Speech Therapy
  • Skilled Nursing Facilities
  • Chiropractor

Benefits Important For People With Chronic Conditions Covered By Less Than 50% of Firms

  • Dietitian
  • Nutritionist
  • Medical Social Worker
  • Family Counseling

Benefits Important For People With Chronic Conditions Not Covered By Any Firm

  • Home Modifications
  • Non-emergency Transportation
  • Personal Care
  • Respite Care

Benefits where more than 50% of the firms require coinsurance

  • Durable medical equipment
  • Mental health services (outpatient and inpatient)
  • Skilled Nursing Facilities

Benefits where more than 50% of the firms impose restrictions

  • Mental Health Outpatient
  • Mental Health Inpatient
  • Home Health Care
  • Chiropractor

Frequent coverage restrictions are

  • Limits on the number of inpatient days
  • Formularies
  • Limits on outpatient visits
  • Medical Necessity Provisions



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