My Focus on Chronic Illness

Why I am a health coach and how the focus of that work will look like over the coming weeks, months and years. God Willing!

I have decided to focus my health & wellness coaching on supporting individuals who are facing chronic illness in their own life, or members of their family. There are several good reasons for this, but here are my top three.

1. I am personally facing a chronic illness for the first time in my own life
2. Chronic illness is a major contributor to rising health insurance costs – a specialty of mine.
3. Once you begin to study Wellness & Health, it is like drinking from a firehose. I can help more by focusing on one core topic.

Now with that said upfront, I can move on to defining chronic illness (or disease if your prefer). During my years as a health plan manager, our plan broke down claim data into Accidents & Injuries, Chronic Illness and Non-Chronic Illness. The difference between Illness and Injuries is fairly straight forward. Accidents happen and safety is important part of prevention, but it is not my speciality.

What is Chronic Illness

Illness, specifically chronic is different than say, pregnancy. Chronic illness can be related to genetics, or better epi-genetics events. However, the definition of chronic illness that is linked to lifestyle is where I will be focusing. Here is a definition I found that fits quite well…

“Chronic disease: A disease that persists for a long time. … The leading chronic diseases in developed countries include (in alphabetical order) arthritis, cardiovascular disease such as heart attacks and stroke, cancer such as breast and colon cancer, diabetes, epilepsy and seizures, obesity, and oral health problems.” Definition of Chronic disease – MedicineNet

Chronic Illness in the United States

Like I said earlier, lifestyle plays a significant part of chronic illness in the U.S.Here are the Top 9 Most Expensive Chronic Diseases – in the U.S. 2015 CMS

1. Cardiovascular Diseases – $317 billion per year
2. Smoking Related Health Issues – $300 billion per year
3. Alcohol Related Health Issues – $249 billion per year
4. Diabetes – $245 billion per year
5. Alzheimer’s Disease – $223.1 million per year
6. Cancer – $171 billion per year
7. Obesity – $147 billion per year
8. Arthritis – $128 billion per year
9. Asthma – $56 billion per year

Quite the list and unfortunately this data is as of 2015 and is only rising. Chronic illness is typically long term and very expensive to treat per the healthcare payer data. It should also be noted that healthcare payers (typically the insurance company) pay almost nothing, or very little out on prevention and/or alternative treatment &prevention programs.

More Prevention Thru Wellness Programs is Needed

The fact is prevention costs continue to fall on the patient, or individual, although there is a trend showing increased spending on wellness programs, like health coaches, wellness education, etc. much more is needed to slow the high cost of chronic illness in the U.S.

CMS reported in 2015, total healthcare spending had reached $3.2 trillion and expected it to grow by 5.5% per year until the year 2025. (“If man is still alive” as the 60’s song lyric goes.)

I have reviewed this topic of total spending per chronic disease before, and so again it should be noted that Diabetes almost always ends in Cardiovascular disease, so one could combine them into one topic.

Wellness Program Impact

Do I think a “good wellness program” can save most people and the nation on healthcare costs? Yes I do and would not have switch my work from health plan consulting to Health & Wellness Coaching if I didn’t.  For me, a good wellness program is really a good Wellcare Plan that works with your Sickcare plan (a.k.a. health insurance).My plan is called the Core4-Plus Wellcare Plan and I share how it works here.

However, no matter what I believe, you can find several estimates published online. This would is as good as any….

“According to the Rand Wellness Programs Study, the disease management component to the studied wellness program was responsible for 86 percent of the hard health care cost savings, generating $136 in savings per member, per month, and a 30 percent reduction in hospital admissions.” March 2019.

If you search the question, “Do Wellness Programs Save Money” all you get is YES, Companies report they save a little over $3 for every dollar spent. Get, what does the individual save? That is hard to find. You could assume that maybe 20% of the savings is split with the employee since many employers share health plan costs on an 80/20 basis with the company paying the larger share.

Unfortunately, from my experience Payers talk the language of Prevention, however they have not yet proved to be the solution. Consider the learning objectives of this recent webcast on, “How Payers Support a Culture of Prevention and Well-being”. I have listened to this pitch.

• Identifying risk factors using health risk assessments and data collection tools,
• Developing targeted wellness activities with the highest potential for success, and
• Guiding shared decision-making about prevention services and healthcare, for over 20 years and it has not changed into real action. 

It’s always about gathering data on employees, who don’t trust their plans or employers, with screenings, and questionnaires. In my experience we need to education all individuals on how to operate their body in a healthy lifestyle way, with an understanding that if they fail to maintain good health they will have to pay much more for healthcare in the future. This requires much more knowledge than just eat your food in accordance with the MYPLATE guidelines. We need to make staying fit more than a spring training session to be reading for the beach body, or to play some extreme sport. We must end the 24/7, 365 work life, so we get the rest we need to complete the real marathon called life.

All this said and I have barely touched the real expensive part, chronic illness. Remember that…to be honest I believe most people with a chronic illness just want the quality of their life back, but all they get is more pills, more bills, office visits and very little results. If that is you. Then consider joining my “inspiring Healthy Lifestyle” eNewsletter subscription list (don’t worry… its FREE) so we can find a way to communicate together and work on that challenge, we both face, and get your quality of life back.

Sources and Inspiration

“Top 10 Most Expensive Chronic Diseases for Healthcare Payers”, Thomas Beaton, 2017.

“Webcast: How Payers Support a Culture of Prevention and Well-being”, Wellsource. 2019.

“Where Wellness & Prevention Fit In A Value-based World”, Monica Oss, 2019.

“Do Wellness Programs Save Companies Money?”, Bravo Well, 2019.

“Workplace Wellness Programs Study”, 2013.

Disclaimer: In fact, before starting any exercise, diet or wellness program, be sure you consult your doctor and be sure to learn the proper techniques for that diet before starting a new wellness program.That would defeat the whole purpose of the activity and your injury may even increase your health insurance cost not reduce them. This post and site is intended to be for educational & entertainment purposes only and is not intended to be considered medical advice. Readers should understand the links to products may or may not pay commissions to the author of the post to defray website costs or the time of the writer and/or coach’s time. Linked products are not endorsements of the product unless specifically so designated.