D Adam Long | PubMed Health

PubMed2006

Care management program evaluation: constituents, conflicts, and moves toward standardization.

Care management program evaluations bring together constituents from finance, medicine, and social sciences. The differing assumptions and scientific philosophies that these constituents bring to the task often lead to frustrations and even contentions. Given the forms and variations of care management programs, the difficulty associated with program outcomes measurement should not be surprising. It is no wonder then that methods for clinical and economic evaluations of program efficacy continue to be debated and have yet to be standardized. We describe these somewhat hidden processes, examine where the industry stands, and provide recommendations for steps to standardize evaluation methodology.

Actuarial Analysis↗

PubMed2006

The cost of lifestyle health risks: obesity.

OBJECTIVE: The objective of this study was to provide employers interested in lifestyle health initiatives a resource for estimating their members' obesity-related costs stratified by demographics and business sector. METHOD: Claims-level medical costs attributable to obesity are estimated. Data come from 61 U.S. employers' health plan members' claims experienced between January 2000 and December 2004. RESULTS: Diagnosed, nondrug medical expenses attributable to obesity account for 21.3% of lifestyle and 2.8% of all medical costs for those aged 19 to 64 years. Obesity costs for children under 19 years are negligible. Up to age 64 years, females' obesity costs markedly exceed males'. At particular risk for high obesity costs are women, those aged 55 to 64 years, and healthcare sector members. CONCLUSIONS: Obesity is a costly lifestyle health risk and self-insured employers should take action with or without policy aid such as the HeLP Act S2558.

Adult↗