Most large employers self-fund their health plans for employees. One of their biggest expenses is preterm births.
Currently, 1 in 10 births are preterm – less than 37 weeks gestation. Each preterm birth increases medical costs over a normal birth by $50,000 through the first year after birth.
These costs could be reduced significantly by lowering the number of preterm births. Many trials have found that taking just 5,000 IU of Vitamin D daily reduces the risk of preterm birth in half, to just 1 in 20 pregnant women.
I propose that employers could incentivize women in their health plans to take Vitamin D during pregnancy by paying them and their doctors to do so. This practice is well established and very effective in getting women to stop smoking during pregnancy, a much more difficult intervention than taking Vitamin D.
The total cost of the incentives plus education, distribution, etc., should amount to approximately $890 per woman, for a cost savings to the company of $50,000 minus 20 x $890, or $32,200, for every 20 pregnancies. $350 would cover the costs of testing, education, distribution, and payment system. The remaining $540 would be the incentive to the mother and doctor, perhaps split equally - about $1/day of pregnancy.
Summary: I suggest that incentivizing women and doctors to add Vitamin D during pregnancy would be a win-win situation for the employer, the women, and their infants, and a very practical way to introduce the benefits of Vitamin D to the health community.
Henry Lahore, Dec 6, 2017
References - Preterm births, Employers
- Preterm birth rate reduced 57 percent by Vitamin D – Nov 2015
- Preterm birth rate reduced by 43 percent with adequate Vitamin D supplementation – meta-analysis Feb 2017
- Preterm birth has become the leading cause of infant mortality – JAMA June 2016
- Even giving a single dose of vitamin D during pregnancy gave a return on investment of 300 X
- A clinical trial in hospital is giving ALL pregnant women vitamin D to substantially reduce premature births
- Employer alliance is trying to reduce the cost of health care – Aug 2017
- WalMart, Amazon, Boeing, Intel, FedEx are examples of self-insured companies:
- 94% of US large employers health insurance are really self-insured (self-funded)
- thus the healthier the families of the employer, the lower are the employer health-care costs
- Preterm births are VERY costly – Feb 2017 $50,000 - Employers pay 12 times as much in health care costs for premature/low birthweight
- Preterm cost for employers approximately 50,000 dollars – Oct 2017
References - Financial Incentives
- Pay people to stop smoking? It works, especially in vulnerable groups Review of 77 controlled trials involving 29,000 women. - average 24 percent increase in cessation rates compared to control groups, along with improvements in birth outcomes.
- Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes - A Randomized Clinical Trial Dec 2017: 2X increased self-monitoring in those given financial incentives
- Do financial incentives improve health? Harvard Health June 2016
80% of large employer now offer financial incentives to motivate healthy lifestyles
"$800 to quit smoking were three times more likely to quit than employees encouraged to quit but not given money for doing so."
- 65% of doctors are getting cash “kickbacks” from big pharma March 2017 - paying doctors works
- Blue Cross Blue Shield pays your doctor a $40,000 bonus for fully vaccinating 100 patients under the age of 2
$400/fully vaccinated child - incentives to doctors appear to be needed and work
- Economic interventions to improve health – review 2016
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