• Public Affairs

  • ACOEM Supports Better Care, Lower Cost Act

    February 26, 2014

    The Honorable Ron Wyden
    U.S. Senate
    Washington, DC 20510


    The Honorable Erik Paulsen
    U.S. House of Representatives
    Washington, DC 20515

    The Honorable Johnny Isakson
    U.S. Senate
    Washington, DC 20510


    The Honorable Peter Welch
    U.S. House of Representatives
    Washington, DC 20515

    Dear Sirs:

    On behalf of the American College of Occupational and Environmental Medicine (ACOEM), I am writing to express the College’s support for the Better Care, Lower Cost Act (S. 1932/H.R. 3890). This legislation is an important part of a much-needed national strategy to address the growing burden of chronic health conditions in our society.

    The U.S. Center for Disease Control and Prevention estimates that as many as 1 out of every 2 Americans may now be dealing with a chronic disease — a trend that is adding major costs to the health care system, including Medicare, while negatively impacting our economy. The only sustainable way to relieve the economic pressures of rising health care costs is to “drain” some of the manageable health risk and illness burden out of the population — and that means addressing chronic health conditions and their precursor risk factors more aggressively.

    As an organization of physicians and other health care providers with expertise in workplace health and wellness, ACOEM strongly believes that the workplace can play a unique role in helping move forward a national effort to address chronic health conditions. Specifically, we believe that by striving to keep workers healthier from the moment they enter the workforce to the time they retire, we can dramatically increase the probability that they will “graduate” into entitlement programs such as Medicare in a much healthier condition.

    Evidence is mounting that effective workplace health and wellness programs, when properly managed and sustained, can help reduce the incidence and burden of chronic conditions such as hypertension, obesity, and diabetes, which are driving up the costs of Medicare. Helping workers avoid these chronic conditions while they are still employed lessens the chance that they will enter the Medicare system burdened with illness. The net effect is a likely reduction in costs to Medicare in the long term.

    In fact, 30 years of research on the science of the “compression of morbidity” has produced credible evidence linking prevention, exercise, and healthy lifestyles to increased longevity and a compression of morbidity and disability into a shorter period at the end of life. In essence, the compression of morbidity has demonstrated that by making proper choices about our health and lifestyle, we can live longer, with a better quality of life and die more suddenly with significantly lower health care costs.

    Furthermore, compelling new research shows that health risk factors can be reduced even in older age groups. For example, a study of 15 employers that included workers over age 60 found significant reductions in risk factors, including cholesterol levels, blood pressure, and BMI, after participating in their personal prevention plan for just two years. [Loeppke R, Edington D, Bender J, et al. The Association of Technology in a Workplace Wellness Program with Health Risk Factor Reduction. Journal of Occupational and Environmental Medicine. March 2013;55(3):259-64.]

    Such an approach presents a win-win-win paradigm: Employers benefit from a healthier more productive workforce and lower health care costs; employees are rewarded with a longer and improved quality of life; and government’s long-term health care costs are reduced. It makes sense that a healthier retiree who ‘graduates’ into Medicare is going to ultimately have lower costs than one who enters the system already debilitated by chronic disease.

    As your congressional colleagues discuss S. 1932/H.R. 389, I offer the following for your consideration:

    • Encourage agencies such as the Centers for Medicare and Medicaid Services (CMS) to support research and to implement policies that link the value of employee health with reducing the cost of programs such as Medicare. ACOEM and others are engaged in research to help advance this link  but a more robust federal commitment is needed to move the effort forward.
    • Expand the Graduate Medical Education (GME) program to include residency programs in occupational medicine and preventive medicine. These are the physicians with the specific training and skills to advance the concepts of workforce wellness, prevention and population health management. More of them are needed in the workplace, but they currently are not part of the GME system.

    Again, thank you for your leadership. Please do not hesitate to contact me at 847-818-1800 or Pat O’Connor, ACOEM’s Director of Government Affairs, at 202-223-6222, should you have any questions or if we can be of help in supporting your legislation.


    Ronald R. Loeppke, MD, MPH, FACOEM