Proactive Care Strategy Today

This article addresses a pressing issue within today’s U.S. healthcare marketplace. Consumerism can be effective when benefits leaders, acting without bias or conflicts of interest, help members access high-value care. However, cost, quality, and value are not the only drivers of decision-making. Marketing campaigns, social pressures, and misinformation increasingly influence both patients and providers. GLP-1 receptor agonists are one of several treatment options for type 2

Hypertension is one of the leading causes of cardiovascular (heart attack), neurovascular (stroke), and chronic kidney disease. It is also one of the largest contributors to inpatient utilization and total medical plan cost for most self-insured employers. The challenge is that hypertension is treatable, which means a significant amount of inpatient utilization and health plan cost is preventable, yet it causes few, if any, early symptoms. Benefits leaders must move beyond ed

Having a unified, holistic behavioral health strategy is essential to improving outcomes across all clinical categories. Behavioral health is deeply interconnected with physical health, especially in populations managing chronic disease. Emerging research shows that Black and Latino patients with inflammatory bowel disease (IBD) are significantly more likely to experience post-traumatic stress related to their condition, with rates of PTSD diagnosis and symptom severity subst

Helping women maintain a healthy body weight is an investment that produces positive outcomes in both the near and long terms. Healthy weight is closely linked to metabolic health, including insulin regulation, which plays a critical role in long-term wellbeing. Emerging research shows that women with higher insulin levels in midlife are more likely to experience menopause symptoms, such as hot flashes and night sweats, at a younger age, and these symptoms tend to last longer

When assessing the return on investment of any medical intervention, including GLP-1 medications, it is critical to evaluate the total cost of care, including both medical and pharmacy spend, compared with a matched cohort. Focusing only on pharmacy cost provides an incomplete and often misleading picture. The broader clinical impact must be considered, especially for populations with cardiometabolic disease. Emerging evidence shows that GLP-1 receptor agonists may provide me

Providing dietary advice and guidance for any large population can be daunting. Each person is a unique, interconnected individual with different needs. Yet, common threads have emerged as nutrition research has improved. The best strategy is to provide a trusted source of truth where the population can receive clear, general guidance built around three key concepts. First, focus on dietary choices aligned with the Mediterranean diet, which has been associated with significan

Want to start shifting rising medical and pharmacy benefit cost trends? Employers must move benefits strategy from reactive, high-cost care to PROACTIVE CARE that reduces downstream utilization, including inpatient services. There is an easily identifiable cohort most likely to become future high-cost claimants: individuals with cardiometabolic disease, including obesity, type 2 diabetes, hypertension, and high cholesterol. Removing barriers to care for these common chronic

Women are physically and physiologically different from men, yet most benefits strategies fail to reflect the populations they serve. Optimizing health, quality of life, and productivity starts with recognizing each person as whole and designing distinct care journeys for women and men. The current system is clinically appropriate for men and was largely built that way. Women need a different journey, tailored to their unique needs across adolescence, reproductive years, midl

There is no way to reverse the upward trend in total cost of care without a PROACTIVE CARE strategy. Financial tactics alone, such as negotiating rates or frequently switching administrators and vendors, do not address the root cause: the growing demand for costly medical and pharmaceutical services driven by rising chronic conditions. Nearly six in ten commercially insured Americans had at least one chronic condition in 2024, and many had multiple co-occurring conditions, s

Vaccination for Respiratory syncytial virus (RSV) has received significant attention recently, which can increase anxiety around confirming immunization status for those at highest risk. Clear, evidence-based education remains essential, as current RSV vaccination recommendations do not always align with the breadth of risk across the adult population. Recent research found that more than one-quarter of U.S. adults have at least one diagnosed risk factor for severe RSV diseas

Finding ways to provide ongoing, high-quality, evidence-based information on the definitions and benefits of a healthy lifestyle is a foundational strategy for any benefits team. Continued efforts to improve education and drive engagement are worthwhile and support stronger long-term outcomes. Recent evidence reinforces this approach. A 2026 systematic review and meta-analysis found that adherence to the Mediterranean diet was consistently associated with lower rates of major

This is a strong study with findings that should be considered in any population health or substance use disorder (SUD) strategy. While some patients report benefit from cannabis, clinical experience also shows meaningful behavioral health complications, with negative outcomes often outweighing positives. The evidence base supports this caution. A large review of 15 years of research found that the health benefits of medical cannabis are frequently weak or inconclusive, and n

We continue to follow the research on smoking cessation and vaping. It remains unclear whether vaping is an optimal long-term solution for quitting smoking, as results from high-quality studies have been mixed. That said, current evidence suggests vaping may be preferable to continued cigarette use. Research indicates that smokers who both vape and smoke are more likely to eventually quit smoking and reduce overall cigarette consumption compared with those who only smoke, whi

The rising incidence and prevalence of type 2 diabetes is driven by a combination of total caloric intake and food choices. One effective way to address this growing risk is to gradually educate individuals on higher-quality food choices and how to purchase them. Creating a clear and tangible link between specific foods and disease helps make risk more real and actionable. Research supports this approach, showing that diets with higher inflammatory or hyperinsulinemic potenti

When developing an obesity strategy, it is critical to accurately identify the population most at risk for downstream morbidity and cost. BMI is useful, but it is increasingly clear that more precise metrics are needed. The weight-adjusted waist index (WWI) offers a stronger way to identify high-risk individuals by better reflecting central adiposity and fat distribution. Recent research shows that WWI outperforms BMI and other obesity indices in predicting cardiovascular dis

Here’s some total cost of care math for a Monday. Biologics for psoriasis average roughly $20,000–$40,000 per year. GLP-1 receptor agonists average $12,000–$16,000 per year. If improved weight control from GLP-1 RAs reduces psoriasis severity and allows some members to avoid or delay biologic therapy, employers could see meaningful net savings. Depending on drug prices, that difference can range from approximately $4,000 to $28,000 per member per year. Evidence supports this

Should self-insured employers and other large groups that bear healthcare risk during midlife adopt strategies to mitigate risk in later years, especially when the average employee stays only three to five years? Obesity offers a clear case study. While employers often question whether investing in obesity treatment today delivers a return decades later, a broader, whole-person and whole-life perspective changes the answer. Today’s employees will eventually retire, while futu

It is urgent to change the revenue cycle and payment model for primary care and other relational care providers because the current reimbursement structure works against what all stakeholders want. Providers enter medicine to connect with and serve people. Patients come seeking connection and personalized, whole-person care. When payment models do not allow reimbursement for the time required to build that connection, they undermine what ultimately drives healing: a trusting

Optimizing mental health across the lifespan should be both proactive and reactive, with meaningful downstream benefits. We can intervene at any stage of a chronic condition, not just after decline begins. This requires a shift in how we view populations. They are not collections of diseases to be treated, but people to be served. When we focus on the person, our thinking becomes more proactive and centered on continuous optimization. A disease may have occurred, but a person

Nicotine use is important to consider in any population health or wellness strategy. It increases member risk and should be factored into benefit design, including the potential for increased member cost share. While there is often debate about whether vaping or nicotine pouches are safer than cigarettes, evidence shows that nicotine itself is harmful regardless of delivery method. Research demonstrates consistent increases in blood pressure, vascular damage, and higher cardi