1 gaston regional chamber healthcare summit leading edge wellness strategies for your organization...
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Gaston Regional Chamber HealthcareSummit
Leading edge wellness strategies for your organization
00.25.910.1 (4/08)
Are you ready for the future of wellness?
Wellness matters
70 – 90 percent of health care costs are due to unhealthy choices and preventable risks 1
In 2008, employers are projected to spend 46% more for health care costs than in 2003, an average of $9,312 per employee 2
Chronic diseases cost businesses more than $1 trillion in lost productivity 3
U.S. companies lose nearly $63 billion in lost work and productivity each year due to employee injuries and illnesses 4
1 Health Care Statistics, Prevent Disease.com, 20062 2008 Towers Perrin Health Care Cost Survey3 “An Unhealthy America: The Economic Burden of Chronic Disease,” The Milken Institute, October 20074 Journal of Occupational and Environmental Medicine, July 2007
Wellness programs may save organizations $900/person/year in direct medical costs 1
Most employers can expect a $3 to $1 return on investment for preventive services and health promotion 2
Employers can save $1.65 in health care expenses for every dollar spent on a comprehensive health care program 3
Wellness programs save money through: Lower health care costs Greater productivity Reduced absenteeism 4
Wellness works
1 Wellness Councils of America (WELCOA) Absolute Advantage: ROI Bullseye; Building a First ClassWorkforce by David R. Anderson, 20032 Healthcare Cost Trends for 2008, PricewaterhouseCoopers, 20083 Journal of Occupational and Environmental Medicine, February 2008 4 Purdue University, February 2007
Gather information to understand needs and develop strategies
Solutions that drive meaningful change and make your vision a reality
Celebrate your successes and refine your strategies for the future
The plan sponsor’s journey to wellness…embracing change and developing a supportive culture
Assess your workplace culture, environment, business and benefit strategies
Review claim information to understand utilization and health risks Understand your employees, preferences, health status and behaviors Identify the behaviors you want to change Determine how wellness programs will contribute to your benefit strategy Define how you will measure and determine success
Review current plan designs; align with defined goals and objectives Choose wellness programs and incentives that will meet your needs Identify other workplace changes, cafeteria food, smoke-free environment
Ensure leadership commitment and support Create a detailed implementation plan and timeline Develop a comprehensive communications plan
Measure outcomes against goals and objectives Gather feedback about how well your strategy is working Celebrate successes and refine your strategy
Gather and analyze information
The plan sponsor’s journey to wellness…Five steps to creating an effective wellness strategy
Design wellness strategy
Evaluate outcomes and refine strategy
Define goals and objectives
Develop implementation plan
Supporting members with wellness solutions that span the continuum of care
Provide structured programs to support return to health and productivity
Manage medical care
Manage disability
Stay well (mind and body) Identify and manage health risks to prevent disease and disability
Reduce absenteeism and on-the-job productivity loss
Manage/mitigate disease impact
Identify and manage those most at risk for disability
Access to Quality Care
Health/low risk
At risk fordisease/injury Managing
a chronicdisease Major health
events
Aetna Health ConnectionsSM
The suite of programs & services that enables wellness solutions
* Availability may vary by location, product, group size
StayingHealthy
ChangingLifestyles
ManagingConditions
Simple Steps To A Healthier Life® Health Assessment
Personal Health Record
MedQueryHealth Fairs and On-site Screenings *
Lifestyle Coaching *
Tools and Informational Resources
Discount Programs, Natural Products and Services
Advocacy Programs *
Integrated Solutions
Worksite Clinic Services *
Well Visits & Screenings
Informed Health Line
Disease Management
Case Management
Aetna Healthy ActionsSM Incentives Capabilities
Communications Campaigns and Toolkits
MajorHealth Events
A plan sponsor’s multi-year wellness strategy
Simple Steps To A Healthier Life®
Disease Management
Incentives
Simple Steps To A Healthier Life®
Disease Management
Incentives
More health assessments
Lower absenteeism
Increase in physical activity
Reduction in medical costs
Increase in productivity
Reduction in medical costs
YEAR 1 YEAR 2 YEAR 3
(Illustrative only)
Fitness and weight management programs
Simple Steps To A Healthier Life®
Incentives
Lifestyle coaching or wellness counseling
Inte
gra
ted
Hea
lth
S
olu
tio
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Disease Management
Overall trends in Aetna employee population
The Aetna Experience
MedicalTrend
Engagement(chronically ill)
Results ofSimple Steps
Healthy LifestylesProgram
Participation
IllnessBurden
(chronically ill)
2007 trend is 3.3%A compared to 5.9% as of 11/06 and 15.9% as of 11/05
Engaged and Engageable population increased from 64.3% in 2005 to 72.7% in 2006
Participation in Healthy Living Programs climbed 111% from 2005 to 2007
Participation increased from 10,939 in 2006 to 17.085 employees in 2007, a 56% increase
Retrospective Risk Score shows chronically ill population became less sick over last 2-1/2 years
Please note: Trend is the result of plan design, medical management and wellness interventions. Today we are talking about wellness interventions, but all interventions should be used to get the trend in line.
Illness burden measures the breadth and intensity of diseases in a population. A Dec 2007 12 month rolling trend Aetna Confidential
may not be copied or reproduced without prior written approval
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Your employees and their families are fully engaged in their health and take responsibility for health care decisions
The benefits experience they receive is personalized to meet their needs, based on experienced clinical knowledge and analysis
All benefits seamlessly work together to enhance your bottom line and the well-being of your employees
We’re creating a future where…
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Your employees and their families are fully engaged in their health and take responsibility for health care decisions
The benefits experience they receive is personalized to meet their needs, based on experienced clinical knowledge and analysis
All benefits seamlessly work together to enhance your bottom line and the well-being of your employees
Seamless Linking HRA to PHR to Wellness Programs
We’re creating a future where…
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The journey to optimal health starts with the health assessment…
Simple Steps to a Healthier Life
Know your:Numbers
Health statusModifiable risks
Wellness resources
… and continues with the right programs and services
Preventive Screenings
Well Visits
Improve Nutrition
Increase Physical ActivityMedical Adherence
Care Plan
Care Management
Managed Disability
Managing ConditionsStaying Healthy Lifestyle Changes Major Health Events
Our industry-leading PHR is really like a personal health assistant
All patient information in one place
A dynamic system for interactivity based on our patented CareEngine® technology
Integrated patient and health care information to support higher quality, cost-effective care
A unique decision aid for health care providers, providing up-to-the-minute information on the patient
Aetna Personal Health Record goes well beyond a static claim history
Your employees and their families are fully engaged in their health and take responsibility for health care decisions
The benefits experience they receive is personalized to meet their needs, based on experienced clinical knowledge and analysisValue Based Benefits - Rx/DM incentive: Copay relief for medication adherence for specific drug classes
All benefits seamlessly work together to enhance your bottom line and the well-being of your employees
Seamless Linking HRA to PHR to Wellness Programs
We’re creating a future where…
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Evidence-based strategies are built into our:
Improving care for members at all stages of health
Evidence-BasedCare
Effective application of evidence-based care is key to improving outcomes
Evidence-based care relies on research evidence to enhance patient care
Strategies for collaborating with members and physicians to improve health
Clinical coverage decisions Strategies to identify care improvement
opportunities Overall medical care management
approach
22% of U.S. patients take less of the medication than is prescribed
American Heart Association: Statistics you need to know. http://www.americanheart.org/presenter.jhtml?identifier=107Accessed November 21, 2007.
Aetna Pharmacy Management
Medication adherence
Aetna Pharmacy Management
Why adherence matters
Results of failure to adhere to prescribed medications: Increased hospitalization Poor health outcomes Increased costs Decreased quality of life Patient death
Benner JS, Glynn RJ, Mogun H, Neumann PJ, Weinstein MC, Avorn J. Long-term persistence in use of statin therapy in elderly patients. JAMA 2002;288:455-461
“Of all medication-related hospital admissions in the United States, 33 to 69 percent are due to poor medication adherence, with a resultant cost of approximately $100 billion a year.”
The Logical Next Step
Several sources of data:
1. Surveys of self-reported underuse and pill-splitting
2. Comparisons of people with less and more generous drug insurance
3. Longitudinal studies of the introduction of payment caps
Reducing or eliminating cost-sharing (at least for some
conditions or for some levels of risk) may increase
adherence to efficacious medications
In fact, the cost of paying for increased drug costs may be (more than) offset by the cost-savings from averted clinical events
Aetna Pharmacy Management
Overcoming barriers to adherence
Health plan pays member copay Reduces member out-of pocket costs Emphasizes the importance of continuing therapy
Education and outreach Explains the need for medication therapy Breaks down complex therapies into manageable parts Offers strategies for coping with side effects
Benner JS, Glynn RJ, Mogun H, Neumann PJ, Weinstein MC, Avorn J. Long-term persistence in use of statin therapy in elderly patients. JAMA 2002;288:455-461
Aetna Pharmacy Management
Investment in medication adherence can lead to dramatic reductions in overall cost of care
Sokol M et al. Impact of Medication Adherence on Hospitalization Risk and Healthcare Cost. Medical Care. Volume 43, Number 6, June 2005
Outcome is significantly higher than outcome for 80-100% adherence group (P<0.05). Differences were tested for medical cost and hospitalization risk.
RxRx $$
Medical $Medical $
$8,812
$6,959$6,237 $5,887
$3,808
$55
$165$285 $404
$763
$0
$2,000
$4,000
$6,000
$8,000
$10,000
1-19% 20-39% 40-59% 60-79% 80-100%
Diabetes Medication Level of Adherence (% days supply/year)
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Sensitivity Analysis: Time Horizon
Health Affairs 2007; 26: 186
Benefit Design Research Study
Aetna / Harvard Proposal
• Aetna to participate with Harvard in a study to formally test the hypothesis that by removing financial barriers (co-pay, co-insurance and deductibles) for certain conditions we would:– Increase medication adherence– Improve clinical quality– Decrease medical costs
Your employees and their families are fully engaged in their health and take responsibility for health care decisions
Work Site Clinics: Brings wellness to the worksite
The benefits experience they receive is personalized to meet their needs, based on experienced clinical knowledge and analysisValue Based Benefits - Rx/DM incentive: Copay relief for medication adherence for specific drug classes
All benefits seamlessly work together to enhance your bottom line and the well-being of your employees
Seamless Linking HRA to PHR to Wellness Programs
We’re creating a future where…
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What is engagement?
Engagement is an individual’s ownership of and active participation in his or her journey to optimal health and wellness
JOIN US
Engagement matters
• Up to 50% of health care costs are due to unhealthy choices and preventable risks1
• In 2008, employers are projected to spend 46% more for health care costs than in 2003, an average of $9,312 per employee2
• Chronic diseases cost businesses more than $1 trillion in lost productivity3
• U.S. companies lose nearly $63 billion in lost work and productivity each year due to employee injuries and illnesses4
1 NAHU’s Healthy Access Briefing Report: Constraining Medical Costs, 2006, https://www.nahu.org/legislative/healthyaccess/Report-ConstrainingMedicalCosts.pdf 2 2008 Towers Perrin Health Care Cost Survey3 “An Unhealthy America: The Economic Burden of Chronic Disease,” The Milken Institute, October 20074 Journal of Occupational and Environmental Medicine, July 2007
Your organization may already be paying
Increased productivity has been noted as a
key reason plan sponsors adopt an onsite health center*
Onsite programs using face-to-face coaching and motivational
interviewing techniques result in higher engagement levels than telephonic only delivery
of programs
Worksite health services create and support an effective wellness
strategy by helping to create and maintain a culture of wellness
©2007 Aetna Inc.
* Watson Wyatt “Realizing the Potential of Onsite Health Centers” 2008 Study
Lost productivity and a lack of focus on wellness can cost your organization
We know…
Our worksite health solution:
• Expands and extends our Aetna Health Connections overall health and wellness solutions portfolio
• Initial offering includes onsite delivery of:
– Selected Aetna Health Connections programs already delivered telephonically
– Biometric screenings
.
Aetna Health Connections Direct2you
Our future vision of Direct2you solutions:
Part-time clinical staff
Community-based centers
Remote outreach and engagement
Aetna Health Connections
The program includes face-to-face delivery of any combination of these programs:
Disease Management
Wellness Counseling
Behavioral Health (BH) Assessment and Counseling
Employee Assistance Program (EAP) Assessment and Counseling
Biometric Screenings available through Summit Health or Quest Diagnostics
Available beginning 1/1/2009
Direct2you
Your employees and their families are fully engaged in their health and take responsibility for health care decisions
Work Site Clinics: Brings wellness to the worksite
The benefits experience they receive is personalized to meet their needs, based on experienced clinical knowledge and analysisValue Based Benefits - Rx/DM incentive: Copay relief for medication adherence for specific drug classes
All benefits seamlessly work together to enhance your bottom line and the well-being of your employees
Seamless Linking HRA to PHR to Wellness Programs
We’re creating a future where…
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