Gut Check: Tackling the Rise of Digestive Health Challenges

Explore the hidden costs and impact of digestive health challenges. Discover how an integrated approach can lead to better health outcomes.

May 28, 2024


Gastrointestinal (GI) and digestive issues rank in the top five chronic conditions driving medical and pharmacy expenditures. Increasingly, costs from these conditions are a focus for employer-sponsored health plans, highlighted by the 2024 Large Employer Health Care Strategy Survey.1Patients with GI conditions require coordinated and integrated care that involves lifestyle changes and medical treatment. Determining the impact of digestive health on employees and implementing targeted strategies to support those with digestive issues is a good first step in building a healthier and more productive workforce and offers an avenue for controlling health care expenses.

Why Digestive Health Matters

The Challenge of Diagnosis and the Chronic Nature of Gastrointestinal Symptoms

Patients affected by GI issues often endure a lengthy and frustrating diagnostic journey. Their symptoms are often normalized or sometimes deeply interwoven with comorbid conditions, leading to misdiagnosis or no diagnosis at all. Diagnostic tools used are predominately invasive scans, which, along with conventional treatments, often fail to provide answers or relief for many patients, underscoring the need for a whole-person approach to diagnosis and treatment. Such an approach also assesses the impact of diet and undiagnosed food allergies on gut health.8

Broader Impacts of Gastrointestinal Health

Imbalances in the gut microbiome can cause cardiovascular issues such as high blood pressure and heart disease. This happens because those imbalances affect cholesterol levels and the integrity of blood vessels.11 There is a connection between GI health and mental health, known as the gut-brain connection. Imbalances in the gut microbiome are associated with mental health conditions like depression and anxiety.12 The gut microbiome significantly impacts obesity by influencing metabolism and fat storage.13 Chronic inflammation is strongly linked to disruptions in gut health, which can contribute to a range of systemic issues. 14 Anti-inflammatory drugs account for a significant portion of pharmacy costs.15

Supporting Employees with Digestive Issues

Improving an understanding of gut health, addressing the stigma associated with GI issues and reducing barriers to care involve raising awareness about these conditions and emphasizing that they are common and on the rise, but manageable.15 This approach encourages early diagnosis, making it easier for individuals to access the care they need.

The following strategies can be employed to further support this approach:

  • Request data on all GI diagnosis codes from health plans and relevant vendor partners to understand the true cost impact.
  • Improve access to dietitians and non-invasive treatments to create a healthier workplace and improve outcomes.15
  • Navigate members toward programs that promote good nutrition and a whole-body approach to care.
  • Offer coaching and utilize resources on GI disorders to enhance employee support and promote awareness of digestive health issues, enabling earlier detection and management.
  • Provide on-site allergen-free food options to promote inclusivity and support employees with dietary restrictions.
  • Establish connections through on-site clinics to facilitate convenient access to medical advice and treatment, essential for managing acute GI symptoms.

Digital Health Innovations in Gastrointestinal Care

Numerous companies within employer-sponsored health networks have launched virtual clinics that provide comprehensive care for conditions such as Crohn’s disease, ulcerative colitis, irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD). These platforms offer access to an integrated care team of specialists, including gastroenterologists, dietitians and behavioral health professionals, who can offer comprehensive care aided by technology.16

Effectiveness of Whole-person Approach in GI Care

Integrated, whole-person care in treating GI conditions is especially important because symptoms can be confusing, diagnosis is difficult and conditions may be chronic, impacting many aspects of life. Therefore, digestive health patients often require a multidisciplinary approach for effective management. Providing patients with continuous access to a variety of care providers and personalized treatment plans enhances patient engagement, satisfaction and outcomes.16

The care process should be:

A study of one digital GI solution showed that its virtual multidisciplinary care model resulted in high levels of patient satisfaction and significant medical cost savings, underscoring the potential of these platforms to transform GI care delivery while prioritizing patient-reported outcomes.

Strategic Considerations for Employers

Employers aiming to address digestive health issues should consider a holistic approach that ensures properly identifying the scope of the problem, supporting preventive measures and lifestyle changes and providing access to specialists that focus on whole-person health in diagnosing and treating digestive health issues.

The following considerations should be addressed by employers to ensure that they are meeting their employees' needs and contributing to long-term health and productivity for the entire organization:

Comprehensive GI coverage: Ensure that your health plans cover a range of services supporting the full spectrum of GI conditions, from common issues like IBS and GERD to more complex diseases like Crohn’s and ulcerative colitis. Additionally, facilitate access to a multidisciplinary team both in-person and virtually, including GI specialists, dietitians and mental health support.

Data-driven measurement: Adapt health data analytics to better understand digestive health trends within your workforce. Implement programs that are informed by this data to address the most prevalent conditions.

Proven outcomes and support: Consider vendors with proven outcomes demonstrated through case studies or pilot programs, showing evidence of cost savings, symptom improvement and high patient satisfaction. To ensure that the solution is seamlessly integrated into existing benefit offerings and is utilized effectively, look for vendors who offer comprehensive support, including initial education, awareness campaigns and targeted outreach.

Medication management: For patients taking high-cost biologics for inflammatory and digestive conditions, determine what support is recommended, mandated or provided by your pharmacy benefit manager if the drug type is changed (including a switch to a biosimilar).

Preventive health measures: Implement workplace well-being initiatives that include preventive measures such as nutritional counseling, stress management and regular health screenings that check for common digestive health symptoms. These steps can help identify or manage digestive health issues before they become severe.

Education and awareness: Check with your health plan about what resources they have and how to best guide members toward those resources. Educate employees about digestive health through workshops and seminars to increase awareness, reduce stigma and encourage early treatment of GI conditions.

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