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The Wisdom of Early Care

Integrity Health believes in the wisdom of early care. We are strong advocates for preventive measures. We want members to treat ailments before they become later stage diseases. This approach keeps members well, and it holds down the high cost of health care-for employers and employees alike. That's the wisdom of providing early care.

Some health insurance plans think they save money when a claim is denied, a doctor visit delayed, or a lab test not done. This miscalculation only pushes treatment to later stages of illness, when it is more expensive. It promotes the use of emergency room-style medical care. It drives the cost of health care up-and the quality of care down. Consider the evidence:

According to health organizations such as the American
Cancer Society, the American Heart Association, the American Academy of Pediatrics, and the Center for Disease Control, for any sizable group of employees, expected rates of disease, whether it is diabetes, heart disease or cancer, is known. The chart below, for example, shows the expected, actual, and undiagnosed rates of different cancers in a real group of 75,000 plan members. Note the large number of undiagnosed cases:

Now consider the difference in the cost of treating early stage vs. late stage cancers:

    Expected Actual Undiagnosed
Cervical
Cancer
40-59, F 34 13 21
60-79, F 6 2 4
Breast
Cancer
40-59, F 463 179 284
60-79, F 166 86 80
Prostate
Cancer
40-59, M 299 90 209
60-79, M 490 111 379
Colon
Cancer
40-59, M 113 97 16
60-79, M 137 40 97
40-59, F 74 58 16
60-79, F 65 25 40
Population
Totals
  1,847 701 1,146
For 75,000 members:

(The expected number is based on the national probability of specific cancers, according to the American Cancer Society, Surveillance Research 2006 and the demographic distribution of the referenced health plan.)

The difference is staggering. Every time we are able to find a problem at an early stage, we improve an employee's health, reduce health care costs, and ultimately save money for the employer and employee.

Cervical
Cancer
Breast
Cancer
Prostate
Cancer
Colon
Cancer
Early Stage Per Month $1,350 $1,327 $1,100 $1,032
Late Stage Per Month $6,816 $9,352 $4,500 $10,610
Difference $65,594 $96,306 $40,800 $114,936

Diabetes now accounts for about 20% of all health care costs in America. Complications from this disease-hypertension, neurological disease, renal disease, stroke, angina, congestive heart failure-are devastating, and all are expensive to treat. Consequently, the health and financial consequences of undiagnosed or untreated diabetes among the employees in the studied group is equally stunning:

  • 13 out of 150 stroke patients were not diagnosed with hypertension before stroke,
  • 50 out of 150 stroke patients were diagnosed with hypertension before stroke, however, they did not taken ACE inhibitors before stroke,
  • 87 of 150 stroke patients were diagnosed with hypertension before stroke and took ACE inhibitors. However, 37 of them did not take the prescribed hypertension drugs within180 days before their stroke.