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October 30, 2018

Are Scary Halloween Diagnoses Impacting Your Benefits Spending?

Artemis Health

The spookiest time of year is upon us once again. You’re probably perfecting homemade costumes, buying bulk candy, and carving pumpkins for the porch. This holiday also has a darker side. We’re not talking about haunted houses or teenagers who still trick-or-treat. We’re talking seriously scary diagnoses that could affect your employee’s health and your healthcare spending.

The Artemis Platform is perfect for analyzing the dark, hidden corners of your benefits data. Sure, you can look at standard reports like actionable overspending, program utilization, and high cost claimants. That’s the useful info you need to make great benefit decisions. However, we think it’s fun and interesting to explore the nitty-gritty diagnoses and costs in your population. In celebration of Halloween, we’re looking at three diagnoses that evoke the spirit of the holiday.

First Diagnosis: Zombie Apocalypse

Technically, there isn’t an ICD-10 code for “zombie apocalypse.” So we went with the next best thing: necrotizing fasciitis, commonly known as flesh-eating bacteria. This rare infection causes the body’s soft tissue to die suddenly. Common symptoms include red or purple skin, fever, severe pain, and open sores that do not heal. That’s pretty terrifying, if you ask us.

We looked at sample data from a 24-month period to find some basic info about necrotizing fasciitis and how it might impact benefits spending. Here’s what we found.

We found just 5 members in this data set ready to join the zombie hordes, costing a total of $78,399 in employer spend. Most were female, and all were over the age of 40. While our sample size is too small to make any firm conclusions, it’s worth noting that the average spend on necrotizing fasciitis is roughly $15,600. I think most sufferers and their loves ones would spend whatever it takes to avoid joining the cast of “The Walking Dead.”

Second Diagnosis: Sugar Rush

Halloween is the beginning of a three-month sugar rush for many of us. It starts with the candy we give to trick-or-treaters and doesn’t end until we eat the last of the Christmas goodies. For diabetics, it’s gotta be tough to avoid swiping a little of that Halloween candy haul. Normal blood sugar levels for a non-diabetic adult usually falls between 70 (fasting) and 140 (2 hours after eating).

Poorly controlled diabetes can cause what’s known as a “diabetic coma” whether their blood sugar is too high (600) or too low (under 70). Symptoms include confusion, difficulty speaking, extreme fatigue, and loss of consciousness. Our analysis of diabetic coma doesn’t necessarily take into account the intake of Halloween candy, but it does give a sense for the scope of the problem.

This 24-month analysis found 97 members who had been treated for diabetic coma. Since this diagnosis is most common for type II diabetes, it’s no surprise that we see a spike in the 50-59 and 60-69 age groups. The risk of developing type II diabetes goes up after age 45.

Total spend for this condition in our sample data was $154,572, but that doesn’t account for other treatments, equipment, drugs, or doctor’s visits needed to successfully manage diabetes. Forbes recently reported that spending on a single diabetes patient reached roughly $15,000 annually. Many employers are tackling this problem with case management services that help diabetes sufferers learn techniques and lifestyle changes to better manage their illness.

Third Diagnosis: Chainsaw Massacres

What’s a haunted house without a chainsaw-wielding murderer jumping out from the dark? This trope looms large in the hearts and minds of all horror movie fans thanks to the 1974 film and 2003 reboot, “The Texas Chainsaw Massacre.” Details from the film and the character Leatherface were inspired by a real serial killer, so being massacred with a chainsaw is a definite possibility. Especially this time of year.

As you can probably imagine, it’s difficult to find data on the prevalence, demographics and costs associated with chainsaw massacres since they are relatively rare outside the realm of Hollywood. So we went with the next best thing: chainsaw-related injuries. These are most likely accidents. Here’s what we found.

13 members in this sample data had suffered at the hands of a chainsaw, and majority were male. The highest risk appears to be in the 50-59 age group, and total spend was a whopping $796,857 for employer health plans. If we were working with real customer data for this analysis, we’d likely want to look for comorbid conditions like heart disease or stroke. Perhaps chainsaw-related injuries can be explained by another health condition that flares up during the intense exercise of cutting down trees and brush. Depending on the employer’s industry, we might also compare against Worker’s Comp, short-term disability, and long-term disability claims to make sure these accidents weren’t occurring on the job.


A disclaimer: we used small sets of sample data for all these analyses, and they are just for your entertainment. However, we can draw a few conclusions based on our results.

  1. Avoid women between the ages of 40 and 59 if you don’t want to develop an insatiable craving for brains.
  2. Don’t dip into your kids’ Halloween candy supply. Choose a nice dark chocolate with less sugar if you just can’t resist sweet treats during the holidays.
  3. Try not to stay at any remote roadside hotels, especially if the hotel manager is likely to own a chainsaw.
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