Healthcare Costs

Improve Health and Lower Costs with Workplace Mindfulness

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By John M. de Castro, Ph.D.

 

“Mindfulness is, above all, about being aware and awake rather than operating unconsciously. When you’re consciously present at work, you’re aware of two aspects of your moment-to-moment experience—what’s going on around you and what’s going on within you.” –  Shamash Alidina

 

A healthcare system is only as good as the propensity of people to utilize it. For a number of reasons including procrastination, denial, fear, etc. people often do not go to the doctor even when needed. This can have negative health consequences. On the other hand, using the health care system in a timely manner promotes health by preventing disease or increasing early diagnosis which can reduce the duration and severity of disease. So, counterintuitively, using the healthcare system can actually reduce costs. Hence finding methods to promote the timely and appropriate use of the healthcare system is in everyone’s interest.

 

In the U.S., the majority of health insurance is provided by employers who are responsible for the costs. So, it is in the best interest of employers to promote the health of their employees to reduce costs and improve their bottom line. This is a win-win situation where health promotion in the workplace is good both for the employer and the employee. There have been a number of programs implemented in the workplace that have been tried to improve employee health. A common program is one that promotes a healthy diet and exercise. Less common, but growing in popularity are programs that employ mindfulness training. But, to date there has not been a direct comparison of the two.

 

In today’s Research News article “A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1412011575489431/?type=3&theater

or see summary: Klatt and colleagues recruited faculty and staff who participated in the university’s health care plan which also tracked costs. They were randomly assigned to receive either a diet and exercise education program or a mindfulness training program, or to a no-treatment matched control group. They measured health care costs for the nine months prior to the trainings and for five years after. The mindfulness training was a group based training in mindfulness meditation while the diet and exercise education program worked to improve awareness of health behaviors.

 

They found that both training groups, in comparison to controls, had increased use of the healthcare system as evidenced by an increase in prescription medications but a decreased use of primary care, fewer hospital admissions, and overall lower healthcare costs. The overall savings averaged $4,000 per employee per year. Hence, both mindfulness and diet and exercise training programs resulted in substantially lower healthcare costs that were maintained over a 5-year period. To have such a long-term follow-up is extremely rare but very valuable as it demonstrates that the training programs have enduring consequences.

 

The authors “hypothesize that the results of this study reflect that both of the original interventions raised health awareness, so that participants were more proactive and involved in their health.” It is likely that they did so in different ways. Diet and exercise education did so directly by stressing engaging in health behaviors while mindfulness training did so by raising the individual’s awareness of their body and physical state. If this is true it suggests that combining the two interventions may have an even greater impact on health and healthcare costs.

 

So, improve health and lower costs with workplace mindfulness.

 

“Once you learn mindfulness skills, you can practice them at almost any moment of the day—sitting at your computer, stuck in traffic, even eating. In fact, there has been a . . . growing interest in using the practice of mindfulness in the workplace to provide a buffer against stress.” – Jason Marsh

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Klatt MD, Sieck C, Gascon G, Malarkey W, Huerta T. A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention. Complement Ther Med. 2016 Aug;27:139-44. doi: 10.1016/j.ctim.2016.05.008.

 

Abstract

Objective: To compare healthcare costs and utilization among participants in a study of two active lifestyle interventions implemented in the workplace and designed to foster awareness of and attention to health with a propensity score matched control group.

Design and setting: We retrospectively compared changes in healthcare (HC) utilization among participants in the mindfulness intervention (n = 84) and the diet/exercise intervention (n = 86) to a retrospectively matched control group (n = 258) drawn for this study. The control group was matched from the non-participant population on age, gender, relative risk score, and HC expenditures in the 9 month preceding the study.

Main outcome measures: Measures included number of primary care visits, number and cost of pharmacy prescriptions, number of hospital admissions, and overall healthcare costs tracked for 5 years after the intervention.

Results: Significantly fewer primary care visits (p < .001) for both intervention groups as compared to controls, with a non-significant trend towards lower overall HC utilization (4,300.00 actual dollar differences) and hospital admissions for the intervention groups after five years. Pharmacy costs and number of prescriptions were significantly higher for the two intervention groups compared to controls over the five years (p < 0.05), yet still resulted in less HC utilization costs, potentially indicating greater self-management of care.

Conclusion: This study provides valuable information as to the cost savings and value of providing workplace lifestyle interventions that focus on awareness of one’s body and health. Health economic studies validate the scale of personal and organization health cost savings that such programs can generate.

Reduce Healthcare Costs with Mindfulness

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“If we want to lower the costs of healthcare, we need to reduce the demand for healthcare services – not increase supply.” – Charles A. Francis

 

“Mindfulness is now more relevant than ever as an effective and dependable counterbalance to strengthen our health and well-being, and perhaps our very sanity.”  ― Jon Kabat-Zinn

 

In the United States the costs of healthcare are out of control. We pay more per capita by far than any other country in the world and yet our healthcare outcomes are mediocre at best. Healthcare spending per person in the U.S. is over $10,000 per year, 17% of the Gross Domestic Product, over $3 Trillion. Increasingly, Americans are having problems paying for care — 26 percent report they or a family member had problems paying medical bills in the past year. Fifty-eight percent of Americans reported foregoing or delaying medical care in the past year. Many patients stop taking medications or never fill prescriptions due to unaffordability.

 

Costs are putting a strain on the finances of individuals and the entire country. Obviously there is a need to somehow control costs while improving the quality of healthcare services. One strategy is to attempt to reduce the costs of providing care. This, however, has proved to be extremely challenging. Another tactic is to work toward reducing the need for services. This can include methods to prevent illness and shorten or dampen illnesses when they do occur. Mindfulness practices have been shown to do just that, preventing illness, decreasing symptoms, and improving recovery as a stand-alone treatment or as an adjunct to conventional treatments (see http://contemplative-studies.org/wp/index.php/category/research-news/health/ and http://contemplative-studies.org/wp/index.php/category/research-news/well-being/).

 

In today’s Research News article “The low risk and high return of integrative health services”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1170859096271348/?type=3&theater

Russo and colleagues review the studies of the effects of alternative treatments including mindfulness practices on costs for healthcare services. They found that the use of mindfulness techniques reduced overall hospital costs. This occurred due to reduced length of stay in the hospital prior to and immediately following surgery, decreased use of prescription drugs which in turn further reduced length of stay, post-operative co-morbidities, and drug dependence, while increasing patient self-care. The use of mindfulness practices also decreased anxiety, pain, and narcotic use and improve patient satisfaction.

 

The exact amount of money saved depends upon many complex factors such as the interventions used, the practices used, the structure of the program, and facilities used. But, some examples can highlight the magnitude of the savings. The application of yoga training to cancer treatment resulted in cost savings of $156 per day, nearly $300,000 annually. Application of mindfulness techniques to diabetes care resulted in estimated savings of $31,000 per person per year. These savings were calculated after all of the costs associated with running the programs were subtracted. Obviously, considerable savings can be obtained by hospitals with the use of mindfulness techniques.

 

To my knowledge, there have not been any estimates of the savings produced by mindfulness practices with outpatient and non-hospital healthcare cost reductions and by disease prevention. So, the actual impact of the use of mindfulness techniques on healthcare costs is unknown but logic suggests that the savings are huge.

 

These are important findings and underscore the economic consequences of the application of mindfulness techniques to healthcare. Unfortunately, in the American healthcare system there is no incentives to reduce the number of treatments employed as the providers are paid according to the number of services provided rather than value and effectiveness of the services. The move toward outcomes-based payments may help in this regard. But, clearly there is a need to change the incentives in the system to promote wellness and reduced costs. Mindfulness practices have been proven to do just that.

 

Regardless, it is clear that we can reduce healthcare costs with mindfulness.

 

“People don’t actually want to think about their own health and don’t take action until they are sick. Yet employers are very motivated to get their employees healthy, since they bear most of the burden of their health care costs.” – Clayton Christensen

 

CMCS – Center for Mindfulness and Contemplative Studies