Healthier Employees Do Wonders for Bottom Line

Mel Blackwood knows a thing or two about heart disease, and it’s not just because he is the Northwest Arkansas regional executive for Arkansas Blue Cross and Blue Shield.

The Harrison native said his father, Leon Blackwood, suffered his first heart attack when he was 51. That was followed by a second attack at age 61, a third at 65 and a coronary stent implant at 75 before elder Blackwood, by then 77, passed away in July of 2002.

Mel Blackwood turned 50 last year. Although his father’s longevity still prompts a smile, the combination of reaching middle age and his family medical history has been gnawing at the insurance executive.

It’s made the business of fighting one of health care’s costliest problems — and easily the largest cost-driver on company health care premiums — down right personal. Blackwood said at least 25 percent of all claims ABCBS pays out are related to cardiovascular disease and stroke.

“Pretty well everyone on my father’s side died of heart disease,” Blackwood said. “When I see that it’s the No. 1 killer of Americans in general, and being in this business I have a pretty good understanding of what puts cost pressures on the health care system, it’s hard not to get motivated when we know that through diet, exercise and smoking cessation, CVD is a problem we can do something about.”

CVD and stroke killed 1,088 people in Benton, Washington, Madison and Carroll counties combined in 2000, up 7.3 percent from just two years previous, according to the Arkansas Department of Health. Statewide in 2000, the most recent year for which ADH statistics are available, 11,133 Arkansans died from the diseases.

Arkansas hospital discharge reports show, the ADH said, that total charges related to CVD from 1997 to 2000 totaled $3.5 billion statewide. In 2000 alone, that figure was more than $1 billion.

The risk of heart disease more than doubles between the ages of 34 and 45, and for professionals in high-stress jobs or those who are overweight, the news is even worse.

All of those factors have led ABCBS and Blackwood, who’s nine-county region includes 120,000 insured members, to shift focus from promoting managed care during the early 1990s to a new series of wellness initiatives. The idea is to educate and motivate people to live healthier lives so that in addition to feeling better, the customers can also help themselves and their employers save money on the front end.

ABCBS sends Dr. Ray Bredfeldt, the firm’s Northwest Arkansas regional medical director, out to about 40 companies and organizations per year armed with a Georgetown University medical degree and a Microsoft PowerPoint presentation on health care drivers and costs.

Blackwood said numerous reports say health care costs are rising 12 to 15 percent annually. Although burgeoning technologies and utilization affect that figure, it makes sense that if people make better decisions that improve their health, the result should be fewer major medical incidents. In turn, Blackwood said, utilization will be reduced, and insurers won’t have to raise premiums as much because they’ll be shelling out less dollars.

“More CEOs have become aware of the lifestyle factors that drive their companies’ health care costs,” Blackwood said. “We’re seeing employers change the process of how they structure their health care programs. They’re putting more accountability on employees and providing more education. But ultimately, it comes down to each individual.”

The cost of CVDs and stroke nationally is expected to be $368.4 billion in 2004, according to the American Heart Association (AHA) and the National Heart, Lung and Blood Institute. The figure, up 12.8 percent from an estimated $326.6 billion in 2000, includes both direct and indirect costs from lost productivity to actual medical treatment.

Firms that Get It

Bredfeldt said local executives are seeing that higher stress jobs put people at greater risk for heart disease and hypertension.

They also see the less tangible benefits of a healthier workforce, such as improved morale and loyalty. One of the most proactive companies Bredfeldt immediately points to is J.B. Hunt Transport Services Inc. of Lowell.

The doctor said Mark Greenway, J.B. Hunt’s vice president of human resources, and the truckload carrier is doing an excellent job of giving workers tools to improve their health.

Greenway said the firm had always been concerned about employee wellness. But a presentation by Bredfeldt made the company more aware what a direct impact obesity and heart disease were having on its health care costs.

J.B. Hunt was one of the first major companies, Greenway said, to adopt a consumer-driven health plan. It comes with higher deductibles but gives employees spending accounts with annual rollovers that offer motivation to use their coverage wisely. The policy is coupled with a wellness program presented to employees through a partnership with TrestleTree Inc. of Fayetteville — a health care manager that uses Webcam conferencing to connect at-risk patients with “personal health coaches.”

“Our health care cost trend is significantly below the national average,” Greenway said. “If the national average annual increase is 10 to 14 percent, we’re half that. When you can start saving that much off your trend, it’s more than just a financial savings. Employees see how much it’s positively impacting their lives, and they’re happier.”

Greenway said his company’s voluntary program primarily promotes proper nutrition, exercise and tobacco cessation.

Dennis Smiley, president of Arvest Bank-Springdale, said that exposure was only part of the motivation for Arvest Bank Group Inc. to become the presenting sponsor of the AHA’s 2004 Northwest Arkansas Heart Walk. The April 3 event at Fayetteville’s Walton Arena is expected to draw about 40 corporate teams and thousands of individual participants.

“Our company is self-insured, so the health of our people drives up or down the cost of our premiums that we have to pay into our pool,” Smiley said.

Sally Langsner, human resources manager at Pratt & Whitney PSD Inc. in Springdale, said she got interested in starting a corporate team when her 47-year-old husband had a sudden triple-bypass surgery. Coworkers rallied behind her, and the firm expects to field a Heart Walk team of about 30 people.

Stephen Langsner, a professor of recreational and leisure studies at the University of Arkansas, has recovered well since the 2001 incident and is participating on a UA Heart Walk team. He’s focused on exercise and a good diet.

“I have become aware that nearly everyone has been affected in some way by heart disease,” Sally Langsner said. “I have started asking people, ‘Do you know what your cholesterol is?'”

War on Carbs, Calories

About every other television commercial, it seems, is trying to cash in on America’s low carbohydrate craze. Tyson Foods Inc. in Springdale announced in January that it would begin removing artery-clogging trans-fat ingredients from some of its packaged foods due to growing consumer concerns about health problems such as obesity and diabetes.

Although many people see obesity as merely a cosmetic problem, Bredfeldt said, statistics show it leads to both CVD and cancer — the two leading cause of death.

On average, being 30 pounds overweight at age 40 takes about 6.5 years off your life, according to the Annals of Internal Medicine. A smoker at age 40 cuts off seven years, and a combination of the two shortens life, the journal said, by 13.5 years.

Males 30 pounds overweight are 9 percent more likely to develop cancer, according to the New England Journal of Medicine, and females in the same group are 23 percent more likely. The risks are similar for heart disease.

“Roughly, it’s estimated that smoking and obesity increase a company’s insurance premiums by 20 percent if not more,” Bredfeldt said. “One thing we can all really watch is portion sizes. Restaurant portions have increased and according to Fat Land, a health industry journal, since 1980 the amount of sugar-based sweetener consumed has increased by 32.1 pounds per person per year.”

Bredfeldt said what ABCBS is trying to tell people is they can do a lot more for themselves than a doctor can. With a national obesity epidemic and an aging workforce, Bredfeldt said, health care costs are going to continue to explode if the population does not become healthier.

“The thing to remember is that two thirds of us are overweight,” Bredfeldt said. “The last couple of years I got it under control, but I’ve struggled with my weight all of my life. Just a little more exercise would help most people. If you could just walk 1.5 miles for a half hour five times a week, that would burn 150 calories each time and you’d lose a pound without changing your diet.

“When we pay twice as much for health care in America as any other country, what we have to realize is just financially it’s going to catch up with us and the choices we’re making will have a dramatic impact not just on our lives but our children’s future and our economy.”

(Editor’s note: Jeffrey Wood is a Heart Association volunteer.)

Close to Home
The following are the most recent available statistics on deaths related to cardiovascular disease in Northwest Arkansas and the state:

County — 2000 — 1999 — 1998 — Two-year % Change

Benton — 563 — 537 — 528 — 6.6%
Washington — 375 — 344 — 362 — 3.6%
Madison — 54 — 76 — 45 — 20.0%
Carroll — 96 — 110 — 79 — 21.5%
Local Totals — 1,088 — 1,067 — 1,014 — 7.3%
Statewide — 11,133 — 11,331 — 11,059 — 0.7%

Source: Arkansas Department of Health, Center for Health Statistics and Division of Vital Records