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• The Prepared Patient
• Facts of Life

Contents

Introduction

In recent years we have witnessed an unprecedented increase in healthcare costs in the United States. By 2004 estimates, per capita healthcare costs had risen to $6,280, representing 16% of Gross Domestic Product (1). Several factors have influenced these increases including: new medical technology, increasing malpractice and drug costs, and an aging population. Currently, employers bear a large portion of the burden of healthcare costs. The average employer spends $2000-$5000 per employee on healthcare each year (3). Healthcare cost increases leave employers few options in the balance between providing a necessary benefit to employees and remaining profitable.

However, cost-saving improvements can be made both by decreasing the demand for medical services and increasing their appropriate use. Estimates show that 25% of all doctor visits and 55% of emergency room visits are not necessary (4,5,6). Based on 2003 estimates, this translates to $13.6 billion spent on unnecessary doctor visits and $24 billion spent on unnecessary emergency room use (6). Why are medical services used inappropriately? Current estimates show that 90 million American adults have low “health literacy” (7). Health literacy is the ability to obtain, process, understand, and act on health information (8). Low health literacy presents challenges to the consumer at many levels of interaction with the healthcare system, including:

• Patient-health provider communication
• Understanding of :
• Medical instructions and medical compliance
• Health information publications and other resources
• Informed consent
• Drug labels
• Treatment options
• Ability to:
• Locate health information
• Evaluate health information for credibility and quality
• Respond to medical and health insurance forms
• Give a patient history
• Self-manage chronic disease
• Seek acute or preventive care

Healthcare consumers with low health literacy are twice as likely to be hospitalized (9), more likely to visit the emergency room (10), use less preventative services (11), and accrue annual healthcare costs that are 4 times higher than consumers with higher health literacy (12). In fact, estimates show that employers may be footing as much as 17% of the estimated $73 billion in annual healthcare costs attributed to low health literacy (7). That's at least $12 billion annually!

Without the information and skills necessary to successfully navigate the healthcare system, employees are likely to make healthcare choices based on immediate need without strategies for appropriate usage. Inappropriate use, in turn, impacts the healthcare costs for everyone.

In Tennessee, employers have ample reason to prioritize and incorporate health promotion education. A recent study conducted by the United Health Foundation ranked Tennessee 48th out of the 50 states for overall health status (13). Do you feel that your employees are prepared to make wise medical decisions? Could this be affecting your healthcare expenditures? What if you could improve the way that employees use medical services by helping them to become active, informed, and wise healthcare consumers?

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Are Employee Wellness Programs Really Cost Effective?

How do I get buy-in from my Employees?

Research shows that most employees are open to their employers helping them become more informed healthcare consumers. A recent survey of employees by Towers Perrin found that (29):

• 79% of employees think that their employer should encourage them to be healthy.
• 76% of employees would be interested in a health plan that offered financial incentives for healthy behavior.
• 64% of employees would be willing to participate in a confidential health risk assessment.

Why use a UT Extension Employee Wellness Program?

The field of health education is in constant change. UT Extension educators are trained to motivate and guide people to improve their health literacy and health practices by using research-based programs. All materials are up-to-date and peer reviewed. UT Extension educators participate in in-service training conducted by faculty in the University of Tennessee Department of Family & Consumer Sciences. These faculty have terminal degrees in their field and specialize in specific health education areas and are available for UT Extension educators to answer questions that arise. Partners from outside health organizations and the UT College of Pharmacy also contribute to in-service training programs and mentor specific UT Extension educators.

How informed are your employees to make the following decisions:

• When and when not to see a physician?
• When and when not to use the emergency room?
• How to choose appropriate diagnostic tests?
• How to select a primary care physician?
• When and how to question a physician’s recommendations?
• How to take over-the-counter and prescribed medications appropriately?
• What preventative services are available through their healthcare insurance?

Give your employees the tools to save you money!!

"Navigating Your Healthcare System"

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Program Goal

The goal of this program is to produce wise healthcare consumers who practice healthy behaviors, take advantage of preventive care, and use medical services appropriately and cost effectively, resulting in a reduction in the economic burden of healthcare costs to Tennessee employers and employees.

Program Objective

• Develop a cadre of UT Extension educators who are trained to deliver this program to Tennessee employees.
• Work with employers to improve the health literacy of Tennessee's workforce.
• Partner with other Tennessee organizations to impact the health literacy of Tennessee's workforce.
• Contribute to protecting, supporting and enhancing one of Tennessee's greatest natural resources - a healthy and productive workforce.
• Contribute to reducing healthcare costs in Tennessee.

Learner Objectives

Upon completion of this program, participants will have increased awareness and knowledge of the following:

• Healthy lifestyle choices concerning diet, weight, and physical activity.
• Behaviors and attitudes that lead to increased stress.
• The importance of preventative care such as medical screenings and immunizations.
• Practical chronic disease management.
• The different types of medication and how they are labeled.

Participants will also have the tools necessary to:

• Reduce and manage stress.
• Practice everyday safety measures.
• Practice self-care to handle minor health problems at home.
• Keep an accurate record of current medications.
• Locate and evaluate credible health information.
• Evaluate and choose an appropriate health insurance plan.
• Find an appropriate doctor.
• Form a partnership with their doctor and other members of the healthcare team.
• Evaluate the necessity and timeliness of suggested medical procedures.

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The Program

Navigating Your Healthcare System consists of seven modules:

	Module 1 – Health Begins with You
	Module 2 – Protecting Your Health
	Module 3 – Self-Care Check Points
	Module 4 – Managing Your Medications
	Module 5 – Making Medical Decisions
	Module 6 – Paying for Your Healthcare
	Module 7 – Working with Your Healthcare System

Module sequence and inclusion is optional and can be tailored to specific workgroups or community settings.

Program Components

Each module contains several 30-minute sessions that expand on specific issues related to the module topic. Each session contains the following components:

• An Instructor Information Sheet
• A MS PowerPoint teaching presentation
• A Summary Sheet handout for participants
• An Activity Sheet for participants
• Coordinating publications (brochures, books, handouts, etc.), resources, and promotional items (magnets, bookmarks, etc.) to reinforce the session message.

Because employee dependents represent a substantial portion of healthcare costs to the employee and employer, handouts have been designed to be shared with family members that may also benefit from the message.

Additional Educational Programs Addressing High-Risk Employees

In some cases, it may be financially beneficial to target specific high-risk groups within your employee population. For these groups, we also offer several programs geared to address specific health concerns:

• Dining with Diabetes
• Choices for Better Bone Health (osteoporosis)
• Arthritis Foundation Exercise Program
• Arthritis Self-Help Program
• Tai-Chi for People with Arthritis
• Get the Flu Shot, Not the Flu
• Tennessee Shapes Up (weight-loss)
• Walk Across Tennessee (encouraging physical activity)
• Living Well from the American Cancer Society (cancer)
• Body and Soul (heart disease)

Availability of the Program

This program is currently offered by your county UT-Extension educators.  The program is offered for both worksite and community education settings.

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Contact Information

Barbara (Bobbi) Clarke, PhD, RD
Professor & Extension Health Specialist,
Co-Director UT Center for Community-based Health Initiatives
University of Tennessee Extension
Family & Consumer Sciences
119 Morgan Hall
Knoxville, TN 37996-4501
Telephone: (865) 974-8197
Fax: (865) 974-5370
E-mail: bclarke@utk.edu

For more information about the UT Extension Health & Safety programs, please contact your local County Extension FCS Agent .