Dr. Amy Cheng, MD, MBA, is an emergency medicine physician and member of Cleveland Clinic Canada’s Medical Director Program.
Dr. Paige Bauer, PhD, is the Director of Global Corporate Advisory at Cleveland Clinic Canada.
Chronic disease has traditionally been associated with people in their 50s and 60s, often emerging as careers begin to wind down. This is no longer the case. Today, chronic conditions are increasingly affecting younger Canadians, just as they are advancing in their professional lives. As a result, chronic disease is escalating corporate healthcare costs and reshaping workforce benefits across all age groups.
Between 2019 and 2023, the fastest growth in corporate healthcare claims for conditions such as asthma, diabetes, high blood pressure and high cholesterol occurred among people aged 30 and under. Chronic disease-related drug claims in this age group are rising two to three times faster than in older cohorts. These trends point to a growing long-term cost burden for employers, as chronic disease emerging earlier in life often requires decades of treatment and is associated with a higher risk of comorbidities and disability over time.
The Canadian companies we work with as medical advisors are seeing these impacts firsthand, with younger workers driving increased healthcare costs and sick leave at a time when chronic disease is already the leading cause of short- and long-term disability claims in Canada.
Many companies are responding to these challenges by redesigning their benefits, policies and programs to better manage costs. In our view, a prevention-focused approach to chronic disease will best ensure corporate Canada improves health outcomes while bending the long-term cost curve.
Prioritizing education and empowerment
Canadian employers can support employees across three levels of disease prevention:
- primary, prior to disease onset
- secondary, in the earlier stages of disease
- tertiary, post-diagnosis to manage progression and prevent complications
Historically, most organizations have focused their benefits on the tertiary stage, post-diagnosis. However, forward-thinking companies are increasingly investing in the primary and secondary stages, where there is greater opportunity to influence long-term health outcomes and manage costs more effectively. At these stages, goals include educating and empowering employees while reducing barriers to testing, screening and early disease diagnosis.
Education sessions, led by outside health experts and in-house HR staff, may focus on:
- Increasing awareness of healthcare risks
- Offering evidence-based guidance to support sustainable lifestyle and behaviour change
- Teaching employees to access and proactively use their benefits
In addition, employers can offer workplace testing for conditions such as high blood pressure, cholesterol and blood glucose, all of which are risk factors for chronic disease. Some organizations work with healthcare experts to help employees understand their individual risk factors and when and where to get screened for chronic disease, enabling earlier detection and more timely intervention.
In the tertiary stage, organizations strive to effectively manage disease to help employees remain healthy and productive and prevent complications, comorbidities or disability. Peer support groups, chronic disease management programs and one-to-one health coaching are examples of tertiary stage interventions that help employees manage symptoms, adhere to treatment plans and sustain necessary lifestyle changes. Mental health and financial counselling supports are also important, as chronic disease can create significant mental health challenges and financial uncertainty for patients and their families.
Banking on a better approach
As the corporate medical director for BMO Financial Group, headquartered in Toronto with more than 50,000 employees globally, Cleveland Clinic Canada advises on how to reduce risks and improve the health of employees. The bank recently launched chronic disease programs through its benefits partners to align with its ‘healthy outcomes’ benefits principle, which requires that healthcare investments are evaluated on access, affordability and their ability to drive prevention, early intervention and sustainable employee health.
At the primary and secondary levels, BMO’s preventive health campaigns – such as Wellness Week and their Foundations of Wellness Conference – are focused on education, engagement and care navigation. This includes targeted, proactive outreach to employees, clinician-led education sessions and employees sharing their personal health journeys and how they’ve been supported by the company.
While still in the early stages, these initiatives have seen positive participation in education sessions, highlighting a clear area of interest among employees. Among U.S. employees, they have driven higher use of primary care and “well-child” care services, and a 6.1-per-cent increase in age-related cancer screenings.
At the tertiary level, BMO leverages drug spend and utilization analytics to identify priority chronic conditions and design targeted programs to better support disease management. In Canada, BMO has introduced a targeted diabetes management program through Sun Life, alongside coverage for costly medications, to help employees best manage their blood sugar and weight post-diagnosis. Employees have access to one-to-one and virtual consultations, which provide personalized support to reduce the risk of complications, comorbidities and long-term disability, which is costly over the long term. Similar support through targeted programs is provided for chronic respiratory conditions and smoking cessation.
Today, many businesses are in the initial innings of enhancing their approach to chronic disease. The stakes are high. Sedentary lifestyles, poor diet and rising stress levels are just a few factors driving higher rates of chronic disease in younger populations. These trends, combined with an aging population, are contributing to an expected doubling in chronic disease between 2020 and 2040. In the face of this surging epidemic, a stronger focus on prevention is critical to managing corporate healthcare costs, sustaining productivity and protecting workforce health.
This column is part of Globe Careers’ Leadership Lab series, where executives and experts share their views and advice about the world of work. Find all Leadership Lab stories at tgam.ca/leadershiplab and guidelines for how to contribute to the column here.