From One Public Sector Benefits Leader To Another: Why Heart Disease Prevention Can’t Wait

When I talk about heart disease with benefits leaders in the public sector, I don’t think about statistics first.

I think about my dad.

After he had a stroke in his early sixties, he went back to work. Not because he wanted to, and certainly not because the job was easy. He became a correctional officer for the state of Texas, and worked 12-hour night shifts in a high-stress facility.

He did that until he was 73 because he needed health insurance. As a farmer, he couldn’t afford a plan on his own so he took the job that would give him coverage.

At the time, I was overseeing benefits for state agencies in Texas. Which means that, in a very real way, I was helping manage my own dad’s health plan.

That perspective changes how you see this work.

When we talk about heart disease as a “cost driver,” we’re really talking about people who are doing hard, essential jobs. These are corrections officers, state troopers, janitors in rural communities, cafeteria workers, teachers, construction workers—many of whom are there because the benefits make it possible to support their families.

And that’s why this year’s Public Sector Heart Health Matters findings resonate so deeply with me.

The Problem Isn’t Awareness. It’s What To Do Next.

The data shows that 95% of public sector leaders say heart disease-related costs are a top concern. Yet only 35% rank heart disease prevention as a top priority.

From working in this space, I know this gap isn’t coming from indifference or apathy. 

Public sector leaders want to do something about heart disease. But many don’t know what will actually move the needle—and they cannot afford to get it wrong.  Healthcare is consuming such a large share of their budgets that most teams are focused on stabilizing costs, not experimenting with new approaches.

In government organizations, every decision is layered with scrutiny. Programs are taxpayer-funded and reviewed publicly. You can’t “try something and see if it works.” If it fails, you own that failure.

There’s also a very real fatigue in this space. A lot of leaders have been burned by point solutions that promised engagement and delivered very little. So when someone says, “We can save you money,” the instinct is skepticism.

I’ve been there, and know that disbelief isn’t unreasonable. It’s earned.

And I also want to acknowledge that our survey found public sector organizations are not behind on prevention—they’re ahead. Eighty-eight percent already offer health and wellness programs, and 64% offer digital health solutions, which is higher than the private sector.

The commitment is there. The opportunity now is to direct that energy toward the conditions driving the most cost.

Heart Disease Is Expensive and Prevalent

When I was leading well-being initiatives for a large state entity in Texas, what struck me wasn’t just cost. It was overlap. The most prevalent conditions — hypertension, heart disease, diabetes — were also among our top cost drivers. When something is both common and expensive, you don’t have the luxury of ignoring it.

In corrections especially, we saw higher rates of diabetes, hypertension, and heart disease than almost anywhere else. These are demanding, stressful jobs, and many employees are there because the benefits make it possible to support their families. 

When someone isn’t well in those roles, it shows up in absenteeism and presenteeism. Ninety percent of public sector leaders say the indirect costs of unmanaged heart health may exceed direct claims costs. Which makes sense, because this isn’t just about medical spend. It’s about keeping the workforce stable and capable.

Medication Adherence Is Not A “Wellness” Issue. It’s A Cost Issue.

One of the clearest opportunities in this year’s Heart Health Matters report is medication adherence.

Three in four adults treated for hypertension are not on the right medication or dose. Forty-four percent don’t take medications as prescribed. That translates into roughly $3,900 per person per year in avoidable costs tied to preventable hospitalizations.

We can talk about lifestyle—and we should. But as we age, risk increases. That’s biology. Medications play a critical role in prevention and management, and many of these prescriptions are inexpensive and proven.

That’s why 96% of public sector leaders say they want better medication management tools, and 92% say they would adopt or renew programs with proven outcomes.

The will is there. Leaders just need confidence that a solution will truly engage members and keep people out of the ER.

“My Population Is Different.”

I hear this often when I talk to public sector leaders, and when I first looked at Hello Heart as a client, I felt the same way. I remember thinking, there’s no way you’re going to engage 15 to 20% of our population.

And then we did.

In public sector populations, we’ve seen enrollment reach approximately 20%, with about 65% of members remaining engaged after the first year. Notably, men—who have historically been more difficult to engage in wellness programs—are participating at rates comparable to women, and in some public sector groups, at even higher levels.

This is particularly meaningful in the public sector, where many employees work in rural and low-income communities with more limited access to healthcare. 

Our latest research shows enrollment rates are 11% higher in low-income communities, along with increased primary care provider (PCP) utilization among our members in those areas—helping close gaps in access and care.

That tells me something important: when people can see their own data—when they can track it, compete with themselves, understand it—behavior shifts.

Digital health is allowing care to happen between doctor visits, in people’s homes, especially in rural communities where access is limited. That’s new, and it matters.

ROI Is Non-Negotiable and It Can Be Measured

I understand the pressure to prove ROI. It’s the top consideration for new digital health programs in the public sector.

When I was working for the state of Texas, I wasn’t chasing ROI in isolation. I wanted to empower members. But I also knew we were spending enormous amounts—hundreds of millions—on medications that weren’t necessarily changing behavior.

If we could invest a few hundred dollars to put a device and support program into someone’s home that actually helped them manage their blood pressure, that felt like a responsible investment.

One misconception I hear often is that savings won’t show up until years down the road. But when you’re preventing ER visits and hospitalizations and guiding members back to their PCPs—which is where we want them—financial impact can happen sooner than expected.

Today’s the Day to Act

If I were advising a public sector leader building their 2026 strategy, I would say this: start with your data.

If heart disease is one of your top cost drivers—and for most public sector organizations it is—prioritize solutions that measurably impact those conditions. Prevention is not a soft strategy. It’s fiscal stewardship.

Public sector employees are doing incredibly hard work. Many are there because they need the benefits. If we can support them in managing their heart health, we’re not just protecting budgets. We’re protecting the people who keep our states running, and we really can move the needle on heart disease. I’ve seen it.

Explore the full findings in our 2026 Public Sector Heart Health Matters Report and take the next step toward protecting both your workforce and your budget.