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1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organizatio n 00.25.910.1 (4/08) Are you ready for the future of wellness?

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Page 1: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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?

Page 2: 1 Gaston Regional Chamber Healthcare Summit 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

Page 3: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 4: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 5: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 6: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 7: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 8: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

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Disease Management

Page 9: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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Page 10: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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Page 11: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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Page 12: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 13: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 14: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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Page 15: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 16: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 17: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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.”

Page 18: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 19: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 20: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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Page 21: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

Sensitivity Analysis: Time Horizon

Health Affairs 2007; 26: 186

Page 22: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 23: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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Page 24: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 25: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 26: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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…

Page 27: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 28: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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

Page 29: 1 Gaston Regional Chamber Healthcare Summit Leading edge wellness strategies for your organization 00.25.910.1 (4/08) Are you ready for the future of wellness?

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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