Cost/Benefit of Health Action Plans Tips

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9. Engage Others In Your Success

You can plan to succeed, or you can ignore the signs that you are wasting your dollars and causing future health care expenses. Share some of your thinking with a reliable friend, family member, or consultant who can support you in your health behavior change. Here are some questions that you may want to answer in order to have a meaningful discussion with your advisors:
What have you learned about the behaviors you are doing and their effect on your health?

Name 3 behaviors that are improving your everyday health:
Why do you do these?

Name 3 behaviors that are derailing your health:
How will you change the behaviors right away?
How will this improve your health, and over what time period?

With whom will you share this information? When?
Why?

   

8. Get Some Advice On Evaluating Your Efforts

If you are not sure about how you have applied the scoring methods to the health risks you are taking, revisit your worksheets. If you have created an excel spreadsheet, you can move some numbers and consider the impact on the equations.
At the end of the day, it's your money, it's your health, and it's your life. Friends and family, clinical consultants and insurers, can provide some advice. But only you know what's really important. Look again at your personal health mission statement. How will you achieve your mission if you continue to do behaviors that knock you off course? How will you achieve your 10-year goal if you don't change your course of action?
Look around you. Are you living the life you want? Do you have the energy and stamina to make improvements? If not, develop the plan to make the change: 1/ what's the targeted change? 2/ what's the investment you'll make to succeed? 3/ what's the measure you'll use to know if you are achieving your goal? 4/ when will you revise/refine your target to stay on your mission?

   

7. Another Way To Look At The Value Of Your Efforts

Why is using this equation a valid measure? First, because it builds on a common economic equation for value, which is V=Q/C (value equals quality divided by cost). But, because there are few personal standards in quality measures across conditions and diseases just yet, you are being asked to insert a personal measure of quality: what is the improvement in your quality of life if you make the change?
Second, you are pushing the “cost” concept to make it more real to you: you are linking the risk of continuing the current behavior times the reward for change and dividing this over time [a rudimentary cost/benefit analysis]. These numbers, when applied evenly across your concern for conditions or habits, can help you compare urgency of condition modification. The pressure is on for you to make a lifestyle change that will improve your overall health and wealth.
To state it again, take care of the most pressing problems: if you have a lump in your breast, get to the doctor. If you are not taking your blood pressure medication as prescribed, get back on track. If you need some help, ask…there are resources in the community who can and want to help you.

   

6. Adding An Equation To Your Valuation

Your sense is that, by doing a few of the above behaviors (exercise, get clinical exam, and eat more healthfully) you can change several indicators. But the value equation helps you apply real numbers to the efforts.

On a level of 1-5, you will assign values to the behavior; these values will allow you, personally and subjectively (after all, you are the CEO, so you bring both quantitative and personal experiences to the board room), to evaluate how to spend your health resources to achieve better outcomes.

Return to the idea of “BMI is too high.” You have decided to consider “getting more exercise, eating more healthfully, and get clinical exam” as your investments in your health improvements.

In this exercise, there are 5 “dimensions” for you consider. These are Quality, Risk, Reward, and Time, and, by following the equation, you will see how much they are really worth in effort and resources.

For Quality of improvement, rate the impact of the behavior change (the investment) by scoring: 1= low change in quality of life; 3= medium change; 5= substantial change
As an example, for “eating better” you might score this as “3” for a medium change in quality of life

For Price, consider the cost of making the behavior change. Again, score it on a scale of 1= low cost to achieve goal; 3= medium cost; 5= high cost.
Example: eating better is a “3” as it's a bit more expensive, but not cost-prohibitive

For Risk, consider the total risk to your health if you don't make the change. 1= low risk, 3= med risk, 5= high risk on future health and health costs
Example: if you don't change your eating patterns, will this be a low, medium, or high risk to your health and future health costs? You might decide to score this as a “5.”

For Reward, consider how much the change will improve more than one health indicator, or be increased over the years because you made the change early. 1= low reward or impact; 3= medium reward or impact; 5= high reward including quality of life, impact on future health
Example: you may decide that changing your eating patterns has a high reward on future health costs “5.”

Finally, consider the Time it will take for you to make the change. Actually, you can start eating better right now; no need to wait for Monday, as many folks do! 1= less than 30 days to achieve goal; 2= less than 90 days to achieve goal; 3= 6 months to goal; 4= 9 months to goal; 5= 1 year or lifetime commitment (such as taking a prescription for life)
Example: the change is made easily, but sustaining over time may take more effort, so you might rate this as a “2.”

Now apply the equation
V= (Q/P) x (Risk x Reward)/Time
Entering the values you've assigned above, you get the following valuation of you effort in changing eating behaviors to reduce BMI
V= (3/3) x (5 x 5) / 2= 1x 25/ 2= 12.5
Now then, if you use this equation to value your other potential behavior changes, you'll be able to get a prioritized look at where your dollars/time/efforts will deliver the best return on your investments. REMEMBER: this is one way, but not the only way, to consider your intended investments. Always consider your clinician's advice, your other conditions, and your ability to follow through; set yourself up to win both short-term and long-term advances!

   

5. The Value Of Losing Weight

You are looking for investment advice for your health-wealth portfolio. You may be considering the fact that you are overweight. Using this example, you can begin to use the value of health formula for deciding how you want to proceed.

If your waist, BMI or weight is in a negative category
The result can be: higher rates of hypertension, high cholesterol, some cancers, joint pain
Ignoring your high blood pressure
The result can be: damage to heart muscle, arteries and veins, brain, internal organs
Ignoring your high cholesterol levels
The result can be damage to cardiovascular system (heart, arteries, veins), brain, internal organs
Not enough fruits and vegetables in your diet
The result can be decreased heart and organ health, thicker layer of fat, poor influence on mood and energy, potential muscle or joint pain, increase free radicals which cause cell damage
Not enough exercise
The result can be decreased heart and organ health, thicker layer of fat, poor influence on mood and energy, potential muscle or joint pain, increase free radicals which cause cell damage
Overdue for tetanus
The result can be that a simple cut can cause serious joint pain, fever, even death
Overdue for flu shot
The result can be an increased risk of flu, pneumonia, upper respiratory diseases, asthma
Overdue for clinical exam (physical, etc.)
The result can be Acute or Chronic illnesses that may go undiscovered, putting your overall health at serious risk and causing higher health costs
Overdue for breast, PAP or prostate exam
The result can be Acute or Chronic illness (especially cancer) may go undiscovered, putting your overall health at serious risk and causing higher health costs
Eating too many fats or drinking more than 1-2 servings of alcohol daily
The result can be decreased heart and organ health, thicker layer of fat, poor influence on mood and energy, potential muscle or joint pain, increase free radicals which cause cell damage
Ignoring a daily exercise program
The result can be decreased heart and organ health, thicker layer of fat, poor influence on mood and energy, potential muscle or joint pain, increase free radicals which cause cell damage

So, which behaviors can not only help you achieve lower BMI, lower weight, and lower waist measures? Look at the list again. If you do these, you know that there is a good chance the results will be that health is improved, outlook is improved, stress management and health management can significantly improve health outcomes.

   

4. Understanding The Value Of Investing In Your Health

The reason you answer the high-level screener provided is to use it as a simple screening tool to provide input on where to put your resources for short-term and long-term achievement of goals. You may already know how you want to proceed, but this lets you compare across potential health outcomes, using a simplified formula. Again, fill out the worksheet on the next page with your answers on a scale of 1-5 (instructions are shown).
The value-based equation provides a quantifiable way to consider that changes that deliver value for our health. Value is defined as quality divided by price times risk times reward, and divided by time to goal. The actual formula looks like this:
V= (Q/P) x (Risk x Reward)/Time
If you have a computer, this is a good time to open an excel spreadsheet. If you are doing this by hand, get your calculator now. While this formula may look complicated on first glance, when you work with it, you will find that it gives you some very concrete information upon which to base behavior change decisions that will affect your health-wealth portfolio.

   

3. Improve Your Health And Cost Savings

When you assign a value to your positive and negative health readings/behaviors/scores, you begin to see data that guide you to the best paths for improvement. If you are not getting regular checkups, haven't had your flu shot (unless you shouldn't have one due to a medical reason), or are not keeping up with your fruits and vegetables, you can immediately see the “aha” moment by assigning numbers--+5 means you are doing what is expected, -5 means you are not “measuring up.” Look at the negative numbers and see if there is a pattern.
Some folks do not score well because of current finances; you may not have the resources to get all the care you need. In this case, the CEO looks for other community resources: community clinics, support groups (weight loss, exercise, etc.) or friends and neighbors who will be your support. On the other hand, you may be one of those folks who say, “If it isn't broke, don't fix it.” The problem is, these “normal” measures are standardized by the medical literature. That means that you need to pay attention, because the scientific studies show that managing these behaviors forestalls medical emergencies or unintended consequences.
Remember, emergencies and unintended consequences deplete your financial resources. You want to do everything you can minimize these events.

   

2. Heads Up! Is Your Health Worse?

The question “Is your health work, the same, or better than last year?” is an indicator for higher costs of care in this year. It means that you know, or you suspect, that your health has declined. You may have some indicators that your health is not as good as last year; you may have had a diagnosis of disease, or you may have re-injured a joint that you injured many years ago. You may have recently gained a large amount of weight, or you may not be taking your medications as prescribed. No matter the reason, it's time to take more focused action: get the joint examined, take your medications as prescribed, get to the doctor for a full check-up, and get to it now. You, as CEO of your health, have consultants ready to help you; your doctor, your pharmacist, your local health club, your insurance company, all want you to get healthy and be healthy.
The question “Do you feel confident to manage your health or make health changes?” is an indicator that you may be setting yourself up for failure. Can you scale back your goals for improvement and still feel successful? Can you enlist some additional help—again, through the clinical consultants or the insurance/employer assistance programs—to achieve your goals? Is there an on-line community or self-help group that can assist you in your movement to improve?
Don't waste time…get some help now.

   

1. Health Affects Activity, Mind, Money

You know what it takes for getting healthy and keeping good health:
1. Genetics that provide the basis for long and illness-free life.
2. Healthful eating and regular, vigorous exercise to maintain a lean body weight and reduce joint involvement, chronic disease, and rapid mood swings.
3. Following doctors' orders on self-care and treatment plans for both acute and chronic conditions.
4. Preventive care that includes regularly-scheduled tests, screenings, and inoculations.
5. Money saved up for the unforeseen accidents, disease developments, and crises.
The question now is, are you perfect? Like many people, the answer is probably “no.” Many people do their best to get regular exercise and eat healthfully; and they check in with their health advisors, maintain adequate insurance, and wear seatbelts. But, like you, they get sick, they have accidents, and life does not always recognize that they are behaving as “perfectly” as they can.
The goal in this chapter is to provide you some numbers, or values, for risks, behaviors, and lifestyles that you can change. The values are measured by actions, so they do not considering genetic risk, although it does play a role in lifelong health. Instead, the focus is to provide a measurable way for you to understand the impact of poor choices on your health, and, ultimately, on the achievement of your mission and vision.

   
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Carma Spence-Pothitt
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