The Value of Well-being

A Presentation

for HMSA Providers

11/17/2015 2

In 1938, we

started as a

community

health insurance

company.

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In 1938, we

started as a

community

health insurance

company.

Today, we’re

focused on

being the

best health

organization

for Hawaii.

Our mission is to

advance the

health and

well-being of

Hawaii

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Social

15% Health Care

10%

Environment

5%

Behavior

40%

Genetic

30%

Determinants of Health

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Well-being goes

far beyond

physical health

Purpose Social Financial Community Physical

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HMSA’s Well-being Approach

Keep healthy

people

healthy.

Get the most

impactful care

to people who

need it most.

Address risks

to people’s

health.

Help people

with chronic

diseases live

full lives.

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Doctors are

essential

stakeholders

in our

well-being

solution

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Well-Being 5:

Individuals

set their

well-being

goals

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Your patients

can take

control of

their own

well-being

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Providers

can have

meaningful

influence

on their

patients’

well-being

Gallup Healthways Well-Being 5

Well-being Report

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The Science Behind the WBA:

Construct Validity

Demonstrating that we are measuring

what we intend to measure, accurately and reliably.

Well-being Vision and Foundational Research

17

Early 2000s …. Gallup consulted and drew from the work of leading academics.

2001 -2007 … conducted tens of thousands of interviews internationally.

2004 -2007 … considered thousands of items and pulled 340 to be tested.

Well-being Vision and Foundational Research

18

Creation of the Well-Being Index

• From the initial testing, 340 items were narrowed to a core set.

• In 2007, the core items were field tested in 12 stratified segments of the

population based on age, health, and health risk status.

• Final survey formulated and organized into a model with six domains.

Life Evaluation

Emotional Health

Physical Health

Healthy Behaviors

Work Environment

Basic Access*

*Basic Access: community satisfaction, access to food/shelter/medicine, financial

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Well-Being Quantified

A Definitive National Benchmark

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• The world’s largest data set on well-being,

with ~2 million completed surveys to date.

• Provides real-time measurement and insights to

improve health, increase productivity, and lower

health care costs.

• 25-year joint venture initiated January 2, 2008.

• Telephonic-based for “community” survey.

• 500 completed surveys per day, seven days a week

• Design support and oversight from leading

behavioral economists, psychologists, and experts in

psychometric survey design and statistical analysis.

Understanding the

critical factors

contributing to or

detracting from well-

being in the cities

and states where

people live … across

the nation.

Gallup-Healthways Well-Being 5

21

• Leveraging the 1.9MM completed longitudinal WBI surveys and 800K+ WBA/Finder surveys, investigation started in 2012 combining the best of each instrument to optimize measurement and diagnostic capabilities with actionable results.

• 150 items were combined for field testing in three cohorts collected by the University of Rhode Island, Gallup Panel, and Healthways, respectively.

• Factor analysis reduced this set into core items that capture the five elements of well-being:

Gallup Healthways

Well-Being 5

Gallup Well-Being Finder

Individual Well-Being Assessment

2007 2014

Purpose Social Financial Community Physical

The Science Behind the WBA:

Criterion Validity

Demonstrating that what we are measuring

is meaningfully connected to outcomes.

Well-Being Level is the Strongest Independent Predictor of

Hospitalizations and ER visits

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Less

important

More

important

*** P ≤ 0.0001

* P ≤ 0.05

Gandy et al. Well-Being and employee health – How employees’ well-being scores interact with demographic factors to influence risk of hospitalization or

an emergency room visit. Pop Health Mgmt, 2013.

Well-being Improvement and

Change in Claims Costs

24

Well-being improvement over one year was associated with significantly lower claims costs

** Statistically significant (p <.05)

* Statistically significant (p <.01)

Study population: Fortune 100 employer, N = 4,765

Sears, et al. Overall Well-being as a Predictor of Healthcare, Productivity, and Retention Outcomes in a Large Employer. Pop Health Mgmt, 2013.

Those whose Well-

being improved Those whose Well-

being decreased Difference between

Groups

Average Change in Total Claims Cost

(Med + Pharmacy Costs) - $181.90 $103.70 $285.60**

Average Change in Medical Costs Paid

-$164.10 $64.43 $228.53*

Average Change in Pharmacy Cost - $17.77 $39.27 $57.04*

What we’ve learned about well-being

25

• Well-being is a strong predictor of outcomes.

• The Elements of Well-being are linked.

• Well-being change translates to outcomes

of value.

• Well-being has complex relationships

to outcomes.

• We can improve well-being through application

of support and resources.

The 5 Elements of Well-Being

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Purpose Social Financial Community Physical

• Blue Zones

Project™

• Health

Education

• Dr. Ornish’s

Program for

Reversing Heart

Disease™

• Quitnet®

• Well-Being

Connect

• Ramsey

Financial

Well-

Being™

Powered by

Dave

Ramsey

• Blue Zone

Project™

• Care Model

• Cozeva

• HMSA’s Online

Care

• HMSA365

• Health Coaching

• Health Education

• Minute Clinic

• Ornish

• QuitNet

• SilverSneakers

• Well-Being

Connect

• WB5

Well-Being Improvement

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• For three decades, Healthways has

been dedicated to making the world a

healthier place – one person at a

time. And with a foundation of

science, we’ve been building,

implementing and enhancing a

scalable solution that does.

• Healthways and external third-party

researchers have published peer-

reviewed articles and reports showing

the value and effectiveness of our

approach.