healthcare costs

A recent white paper by the Health Action Council and UnitedHealthcare finds companies that build deliberate strategies around their employees’ most common chronic health conditions may improve overall employee health and achieve cost savings over the long term.

The findings are based on a study of five chronic health conditions — hypertension, diabetes, back disorders, mental health and substance use, and asthma — across more than 280,000 HAC members insured with UnitedHealthcare. Many of us will suffer at least one of these conditions during our lifetime, with a real impact on health care costs. The study also revealed a number of important disparities in care, which can be improved through a combination of lifestyle modifications and targeted wellness programs.


Among HAC members, African Americans are 63 percent more likely to have hypertension than other races or ethnicities. Also, the study found women are sub-optimally treated across all age groups versus men, who were typically given more prescription drug treatments.

Men over 50 years of age in lower income groups have the highest prevalence of diabetes, while those of Asian ethnicity have a 43 percent higher-than-average prevalence of the condition, largely driven by genetics and diet.

Typically, employees with back disorders skew older and are in lower income brackets, with factory work identified as one of the top jobs linked to back pain. Despite a strong case that physical therapy or chiropractic care helps reduce reliance on muscle relaxants and other drugs, our study found six out of 10 obese employees with a back disorder are foregoing or not being offered physical therapy or chiropractic care.

Those with mental health and substance use challenges tend to be female, younger and in lower-income Caucasian groups. Rural areas are often unable to meet mental health care needs due to inadequate services, leading to a higher than average number of emergency room visits and hospitalizations.

African Americans have a 20 percent higher prevalence of asthma than other races and are more likely to experience a flare-up that requires treatment, yet they are less likely to have been prescribed asthma steroids.


To address care disparities and ensure all employees have access to proper care, we recommend employers consider their population’s demographic and geographic profile and then create simple, targeted wellness programs to address the most prevalent common conditions.

Here are several suggestions:

• Evaluate your current benefit plan design for opportunities to implement a care program that evolves with the patient over time — for example, making physical therapy or chiropractic care mandatory for back disorders before moving to more aggressive treatments.

• Cover medications as preventive care for specific chronic conditions or promote the use of patient assistance programs for specific types of medications. The latter may require exclusion of some medicines from your benefit plan design.

• Institute an exercise, stretch or meditation program at the beginning of work shifts to improve safety and decrease injuries. These types of practices are preventive and may decrease the severity of an injury if one occurs.

• Create targeted communications for specific regions and demographics. Consider sharing success stories or appointing a program champion from the target audience. Understand and reflect on cultural differences when developing each communication.

• Promote virtual care to improve access to treatment for specific conditions — for example, mental health support in rural areas.

• Work with your third-party administrator or medical experts to identify opportunities for provider outreach and education on best-in-class approaches.

You can reach and help those who may be at greatest risk of these common conditions and yet least likely to take action on their own. To learn more, see the full white paper: “Finding the uncommon: revealing disparities in care and prescribing for common conditions.”

Patty Starr is president and CEO of Health Action Council, a not-for-profit organization working with employers to enhance human and economic health, and Craig Kurtzweil is VP at UnitedHealthcare Center for Advanced Analytics, which helps simplify the health care experience.