Post-Offer Employment Testing and Its Impact on Health Care Costs for Employers.

OBJECTIVE: To quantify the cost benefits associated with Post-Offer Employment Testing (POET). METHODS: Cross-sectional analysis of 5 million individuals/480 million medical, prescription, absence, short- and long-term disability, property and casualty and workers' compensation claims. Individuals who received POET were statistically matched by company, position, age, and gender to candidates who did not. RESULTS: Significant injury reduction rates and integrated benefits cost savings were found in the cohort screened by POET. CONCLUSION: POET is an effective tool for the employer to manage health, disability, motor vehicle crash, at-work injury costs, and reduce turnover.

The role of comprehensive eye exams in the early detection of diabetes and other chronic diseases in an employed population.

The main objective of this study is to assess the cost benefit associated with comprehensive eye exams as a tool for the early detection of diabetes, hypertension, and high cholesterol. A retrospective, claims-based analysis was performed using U.S.-based employees and spouses from a large, national database. Individuals who received first notification of disease as a result of an eye exam were compared to individuals who did not receive early detection and presumably learned of their condition after further disease progression. Total health plan costs, lost time costs, and termination rates were calculated for the 12-month period after the index date. A sizable population first learned of their chronic condition through eye exams as no other claims-based evidence was found to suggest prior knowledge of the condition. All three disease cohorts with early detection during an eye exam had lower first-year health plan costs, missed fewer work days, and were less likely to terminate employment than the respective comparison groups. As employers strive to better manage health and business outcomes, comprehensive eye health exams can provide an opportunity for early disease detection and associated cost savings through referral to primary care providers and condition management programs.

The long-term health plan and disability cost benefit of obstructive sleep apnea treatment in a commercial motor vehicle driver population.

OBJECTIVE: To assess the impact on health plan and disability costs associated with continuous positive airway pressure or bi-level positive airway pressure treatment of obstructive sleep apnea in a commercial motor vehicle driver population. METHODS: A retrospective, pre/post claims-based comparison analysis was performed. Health plan and disability costs, in addition to disability claimant rates and missed workdays were compared for the 12 months before treatment to the 24 months after treatment. RESULTS: Health plan costs were significantly lower in both the first and second years after treatment. Short-term disability metrics also exhibited favorable results, with approximately half as many using the benefit, lower costs, and fewer missed workdays in the postperiod. CONCLUSIONS: Effective treatment of obstructive sleep apnea in drivers is associated with lower health care and disability costs and fewer missed workdays.

The association of insulin medication possession ratio, use of insulin glargine, and health benefit costs in employees and spouses with type 2 diabetes.

OBJECTIVE: Measure the impact of insulin utilization on health costs and absenteeism. Compare outcomes between users of insulin glargine and other insulin. METHODS: Using a large retrospective database, this regression analysis examined annual health costs and absenteeism among employees and spouses with type 2 diabetes who used insulin. The analysis studied impacts of medication possession ratio (MPR) and glargine use, controlling for demographic factors, salary, and prior health care. RESULTS: Higher MPR was associated with significantly lower health costs for patients with high prior costs. Glargine users' MPR was higher than other insulin users' MPR (66% vs 54%, P < 0.0001). Among all insulin users, those using glargine had significantly lower total ($6771 vs $7969, P = 0.0046) and circulatory-specific ($312 vs $636, P < 0.0001) costs. CONCLUSIONS: Insulin MPR and the use of insulin glargine were associated with lower health care costs.

Health care expenditures in ulcerative colitis: the perspective of a self-insured employer.

OBJECTIVE: This study was designed to investigate the incidence, prevalence, treatment patterns, disease severity, and direct costs associated with ulcerative colitis (UC) for claimants in health plans offered by a large self-insured employer in the United States. METHODS: Retrospective analysis of medical claims with and without UC identified from a population of approximately 500,000 employees, retirees, and dependents. RESULTS: Costs for UC claimants were more than twice those for the comparator group ($14,486 vs $6158; P < 0.005). Total health care costs for the severe disease cohort were double those of the mild or moderate cohorts ($26,875 vs $12,154 and $12,731), as were inpatient costs ($13,516 vs $3235 and $2244). The annual incremental cost of treating severe disease was $6812 (P < 0.005) compared with mild UC. CONCLUSION: UC is a significant predictor of increased medical costs with severe disease, driven mainly by inpatient costs.