Building a Successful Building a Successful Health Management StrategyHealth Management Strategy

Why Health Management?Why Health Management?

• Researchers estimate that preventable illness makes up 70% of

the total health care cost. – New England Journal of Medicine

• Obese individuals generate 2x the number of WC claims and 13x more lost days from work compared to individuals

maintaining a normal Waist Circumference/ Body Mass Index. –

Duke University

• 66% of adult Americans are overweight/obese. – CDC & Prevention

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A Well Designed, Long-TermA Well Designed, Long-TermHealth Management Strategy…Health Management Strategy…

• Improves the health and well-being of employees (& their families)

• Enhances employee morale and productivity

• Enhances organizational performance

• Reduces costs

• Provides an example to the community

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Where WE Are Going…Where WE Are Going…

Our goal is to implement a

long-term strategic plan

with engagement across the organization,

an effective communication strategy

and

meaningful incentives that

drive participation, behavior change and cost-containment

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Program Components Program Components

• Health (Biometric) Screenings Campaign (On-site or PCP)

• Health Risk Assessment Questionnaire Campaign

• Lifestyle Management

• Disease Management

• Routine Annual Exams

• Health Improvement Programs & Activities (Ergonomics, Safety, Weight Management, Tobacco Cessation)

• Value Base Benefits Design

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2011 2012 2013 2014

Target Population

All Insured Employees All Insured Employees All Employees & Insured Spouses All Employees & Insured Spouses

Incentive Strategy

2011 & 2012 Incentive based on participation in:1. Health Risk Assessment (HRA) 2. Biometric Screening- PCP or onsite -Q4

2013 Incentive based on participation in:1. HRA 2. Biometric Screening3. Routine annual Exams (age/gender) 4. Health Improvement Programs/Activities

2014 Incentive based on participation in:*1. HRA *2. Biometric Screening3. Routine annual Exams (age/gender) 4. Health Improvement Programs/Activities*If the spouse does not participate, the employee does not receive the discount

2015 Incentive based on participation in:*1. HRA *2. Biometric Screening3. Routine annual Exams (age/gender) 4. Meet Established Biometric Standards &/or participate in alternative standard*If the spouse does not participate, the employee does not receive the discount

Incentives 2011 Raffle

Medical Premium Discount(Max: 20% of TOTAL annual medical premium of EE)

Medical Premium Discount (Max: 20% of TOTAL annual medical premium of EE)

Medical Premium Discount (Max: 20% of TOTAL annual medical premium of EE)

Medical Premium Discount (Max based on HCR: 30% of annual medical premium for EE, ES & EF)

Goal(s) 1. Establish based line data forHRA and screenings 2. Provide aggregate risk data to employees3. Provide individual risk datato employees

1. Increase/Maintain participation in HRA & Biometric Screenings2. Measure Risk Reduction 3. Establish baseline data in programs & activities

1. Increase/Maintain participation in HRA & Biometric Screenings2. Increase/Maintain participation in programs & activities 3. Measure Risk Reduction of the population4. Measure prevalence & trends of cohort population

1. Increase/Maintain participation in HRA & Biometric Screenings2. Increase/Maintain participation in programs & activities 3. Measure Risk Reduction of the population4. Measure prevalence & trends of cohort population

Action Items

Q3 1. Define accountability 2. Brand Program & Develop Mission Statement 3. Develop an effective communication strategy with leadership endorsement4. Determine budget & resources5. Determine Incentive structureQ4 6. Launch HRA and Biometric Screening Campaign

1. Implement Program/Activities based on aggregated risk data2. Launch HRA and Biometric Screening Campaign

1. Engage Insured Spouses 1. Implement Value BasedBenefits Design

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Sample Strategy –Using Carrier/TPA ModelSample Strategy –Using Carrier/TPA Model

MEDICAL PREMIUMDISCOUNT

BONUS SWEEPSTAKES PTO

REWARD Up to 20% of employee +employer contribution

Amount: TBD

Cash BonusAmount: TBD

Grand Prize Drawing for alarge give-awayPrize(s): TBD

Paid Time OffAmount: TBD

CRITERIA Year 1

Participate in BiometricScreening + HRA

Participate in BiometricScreening + HRA

Participate in BiometricScreening + HRA

Participate in BiometricScreening + HRA

PROS -Non-taxable-Depending on structure,provides for programfunding -Educates employees onthe true cost of theirmedical benefit -Customizable

-High Consumer Demand,tangible reward-Consumer ease of use-Addresses non-insured employees-No limit to incentive-Customizable

-High Consumer Demand,tangible reward-Consumer ease of use-Fixed budget cost -Addresses non-insuredemployees-No limit to incentive-Customizable

-High Consumer Demand, tangible reward-Consumer ease of use-Addresses non-insured employees-No limit to incentive-Customizable

CONS -Does not reward noninsured employees -maintain 100% employerpaid medical insurance, ifapplicable-non-tangible reward-Administration-Incentive limitations

-Tax implications-100% cost to the employer, does not provide program funding-Administration & delivery

-Tax implications-100% cost to the employer, does not provide program funding-Administration & delivery-Lack of reward for allparticipants

-100% cost to the employer, does not provide program funding-Administration & delivery

Sample Incentive StrategySample Incentive Strategy

The Success of the Program Hinges on The Success of the Program Hinges on Engagement of the Target PopulationEngagement of the Target Population

The following components are critical to engagement:

• Senior Executive Level Support

• An Effective Communication Strategy

• Meaningful Incentives

• Measurable Outcomes

62% of U.S. companies use incentives to motivate participation and behavior change. -Working Well: A Global Survey of Health Promotion and Workplace Wellness Strategies, 2010

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Stand-alone Vendor Medical Carrier

Benefits

•Customization•Flexibility•HRM is their focus•Dedicated account management•If you move Carriers you don’t lose your programming•Availability of programming for non-insured members & their family•Individualize intervention based on results•Ability to brand program and provide to the community (free & fee based)

•Brand recognition and trust •Data & program integration across the continuum of care•Enhanced engagement strategies and opportunities•Single point of access for participants•Individualize intervention based on results•Cost

Challenges

•Program integration across the continuum of care more difficult to achieve•Data integration/ownership•Cost

•Availability of programming for non-insured members & their family•Risk data now available to the Carrier•Leaving Carrier would result in loss of programming & employee engagement•No dedicated account management for health risk management•Flexibility

Program ComparisonProgram Comparison

Health Risks

Chronic Illness

Medical Cost

Injury Risk

Disability Cost

Absenteeism

Presenteeism

Top Down Support

Defined Accountability

Communication

Cultural Change

Incentives

Awareness

Education

IndividualizedIntervention

Plan Design

BehaviorChange

HealthierEmployees

Happier,More

ProductiveEmployees

Derivable GainsHealth Plan CostsSick Leave Costs

Workers’ CompensationCosts

Disability CostsPresenteeism Costs

Potential GainsQuality ConsumerismStamina & Resilience

Cultural ShiftCompany Loyalty

MoraleRecruitment

Retention

A Framework for SuccessA Framework for Success

INTERVENTIONSNEEDS EFFECTS IMPACT

Source: Leutzinger, J., Sullivan, S. & Chapman, L. The Platinum Book: Practical Applications of the Health & Productivity Management Model. IHPM, 2004

Pharmacy Cost

Engagement

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Building a Successful Building a Successful Health Risk Management StrategyHealth Risk Management Strategy

DiscussionDiscussion

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