The Pulse of Duke’s Workforce
Arthritis, diabetes and hypertension are among the top health issues for employees
Last year, Duke's health insurance plans covered about 62,000 staff, faculty, dependents and retirees. Together, costs ranged from $2.9 million for mental health assistance to $12.6 million for preventative care.
That's part of $163.2 million in total payments Duke provided in 2012 to cover anything from annual check-ups to $6,000-a-month cancer drugs.
"I'm so impressed by all the health resources Duke provides employees," said Pamela Edwards, chief associate nursing officer for Duke University Health System. She uses Duke’s health benefits to treat her hypertension. "It provides tremendous support toward achieving our health goals."
According to the Society for Human Resource Management, workers in the U.S. will face higher insurance premium costs in coming years, with annual prices rising an average $114 from 2011 to 2012. At Duke, however, costs have increased at a slower pace and are met with increased effort to offer employees ways to stay healthy.
In 2014, Duke health plan premiums will increase between $1 to $7 per month for individual coverage and $7 to $27 per month for family coverage.
Faculty and staff can evaluate health care needs and sign up or make changes to their benefits during Open Enrollment from Oct. 28 to Nov. 8. It's also a good time to identify Duke's preventive health programs like DukeWell and LIVE FOR LIFE, Duke’s employee wellness program.
"We want employees and their families to achieve wellness goals, from diet and fitness to managing chronic illness in order to lead enriching lives," said Joyce Williams, assistant vice president for Benefits. "Duke's investment in wellness also assists in containing health care costs, benefiting individuals and Duke by moderating premiums and contributing to work place productivity."
Not everyone can stay in perfect health, however. Several of last year's most expensive health issues among employees included medicine and treatment for cancer, arthritis, diabetes and hypertension.
As faculty and staff consider options for health care coverage in 2014, several Duke employees share how they successfully manage their health with Duke's help. Scroll down to read each story or click the links below to jump to each.
- 'Duke's help is what got me through'
- Hidden Dangers of Diabetes
- Taking Control of a Silent Killer
- Getting 'Back' in Shape
'Duke's help is what got me through'
One of the costliest annual health conditions for Duke coverage is arthritis. Last year, Duke provided $6.2 million in payments to help cover chronic joint disease that lingers with employees and their dependents.
It's something Peggy Lyde understands since she deals with arthritis pain in her knees. At its worst, her pain prevented her from climbing stairs or walking far from her work desk. She started treatment for arthritis in 2011 and received discounted medication through DukeWell, a care management program offered to employees covered by Duke Select and Duke Basic, Duke's most popular health plans.
"Duke covered 80 percent of the cost for cortisone shots, about $30 for ongoing medication and I started walking every day and changed my diet," said Lyde, a nursing care assistant at Duke Hospital. "If all my costs had to come out of my pocket, I never would've gotten the treatment I needed. Duke's help is what got me through."
Jane Walbrun, associate director of benefits at Duke, said Lyde's case has become common in recent years. Instead of taking aspirin, employees with arthritis now receive prescriptions for cortisone or anti-inflammatory drugs for joint pain like naproxen, she said.
"New drugs or treatments make dealing with these issues easier, but Duke also offers ways for employees to change their lifestyle," Walbrun said. "We have a lot of resources for chronic illnesses beyond medicine."
With LIVE FOR LIFE, Duke's employee wellness program, Lyde received a free, hour-long fitness consultation about weight-loss tips. She also partnered with a care manager from DukeWell to plan a low-carb diet. Instead of cereal or bread each morning, she eats eggs and turkey bacon. She also walks about 45 minutes each day.
Lyde has dropped 50 pounds since the start of 2011, and her knees are feeling better than ever.
"I know there are a lot of folks in my condition and they should take advantage of what Duke has to offer," she said. "You just have to get motivated enough to help yourself."
Loretta Alford unzipped a small cloth wallet and pulled out a KwikPen, a device that looks like a pen but is loaded with insulin. She snapped on a disposable needle and pressed it through her slacks and into her abdomen.
Like some diabetics, Alford injects herself with insulin four times daily to help her body turn sugar into energy.
"My doctor told me I had to give myself injections or I'd die," said Alford, 62, a medical assistant in Duke's OB-GYN clinic.
When Alford was diagnosed with diabetes in 1996, she hated needles so much she skipped shots or asked her nurse colleagues to administer them for her. She didn’t understand the hidden danger diabetes posed for her body.
"When glucose builds up in the blood, it can cause devastating complications including kidney failure, amputation, blindness and heart disease," said Susan Spratt, a Duke physician specializing in diabetes. "The good news is we can prevent these complications by controlling glucose levels, blood pressure and cholesterol."
Last year, Duke's health plans paid $6.1 million for insulin and other diabetes treatments. Diabetes was the third costliest health condition among Duke's workforce.
After her diagnosis, Alford started insulin injections, but she didn't take other steps to improve her health. She ate out frequently and resisted pricking her finger to check blood sugar levels.
By 2010, she weighed nearly 200 pounds. Then in 2011 and 2012, tragedy struck. Her two brothers died from diabetes complications.
"That got me thinking I needed to change my ways," Alford said.
Last year, she enrolled in DukeWell, Duke's care management program, which provides a care manager for monthly phone calls to set health goals. Armed with information and support, Alford stopped eating fast food and tested her blood three times daily.
This summer, her doctor had good news: she had lost 21 pounds and her blood sugar levels were dropping.
"I'm feeling more energetic now," Alford said. "It just took having someone check up on me who sounded like they cared."
Taking Control of a Silent Killer
Three days a week, Pamela Edwards walks on a treadmill for 45 minutes to keep her weight and blood pressure in check.
For 25 years, she has cycled on and off medications to control her blood pressure as her weight fluctuated by as much as 25 pounds.
"I have a family history of hypertension," said Edwards, 57, chief associate nursing officer for Duke University Health System. "Last year, I decided to take control of my health to reduce that risk."
Edwards was among 4,604 Duke health plan participants treated for high blood pressure, the fifth most costly condition last year. Treatments cost $3.9 million but helped prevent other health problems.
"We call hypertension the 'silent killer,' because it has no symptoms but increases the risk of heart attack, stroke and other cardiovascular problems," said Laura Svetkey, director of the Duke Hypertension Center. "Lowering blood pressure, even slightly, reduces those risks."
A busy family schedule and 45-minute commute often derailed Edwards' efforts to eat well and exercise. This year, though, she connected with a mix of Duke resources to get on track.
Edwards joined the Duke Health and Fitness Center for $37 a month with a Duke Fitness Club discount. Through her Duke health plan, she consulted with a nutritionist. And she enrolled in DukeWell, a free care management program to help participants make lifestyle changes.
Claudia LeBarron, a DukeWell care manager, coached Edwards each month. She encouraged Edwards to exercise, reduce her daily soda intake from four sodas to one and monitor blood pressure each day to stay motivated.
"My job is to help people figure out what their barriers are to good health, and share ideas on how to tackle them, one small step at a time," LeBarron said.
Edwards has lost 15 pounds since January, and she's kept her blood pressure below the danger zone of 140/90.
"I'm so impressed by all the health resources Duke provides employees," Edwards said. "It provides tremendous support toward achieving our health goals."
It was early June when Thomas Koinis' lower back started feeling sore and stiff, making weekly runs and prolonged sitting difficult during the workday. After a month dealing with pain and a decreasing range of motion, he got proactive.
Koinis now eases pain by lying on his stomach and pushing his torso upward - a McKenzie stretch also known as a "cobra pose" in yoga. However, most relief has come from standing up.
"I could tell my posture was really poor when I sat down at my computer," said Koinis, 60, a physician at Duke Primary Care in Oxford. "When I stand up, things aren't too bad."
For help, Koinis enlisted Duke's Ergonomics Division to get setup with a stand-up desk. Instead of awkwardly sitting on a stool for two or three hours a day, Koinis now stands at a hallway workstation where he inputs patient information. He has a chair with adjustable height and back support, which keeps his posture ideal.
Koinis' problems aren't uncommon among faculty, staff and their covered family members. In 2012, Duke paid $3.1 million in health costs for spinal or lower back issues, spending $1,039 per patient.
Tamara James, director of the Ergonomics Division, said something Duke employees can do to avoid back pain is simply not sit too much.
"Think about how much we sit - in the car, at work and then after we get home at night," James said. "Easy ways to avoid pain include stretching, making sure your chair has good lower back support and getting up and moving."
With alleviated back pain, Koinis returned to running 12 to 15 miles a week in addition to biking and swimming. He also accesses tips and diagrams for back health on the Ergonomics Division website at safety.duke.edu/ergonomics.
"I'm appreciative of the fact Duke listens to my problem, and I can use resources to fix it," Koinis said. "It’s a good feeling to see action being taken so I can get back to normal."