wellness & consumer driven health care

48
Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved. Data That Makes Sense and Making Sense of the Data

Upload: smeaco

Post on 28-May-2015

327 views

Category:

Documents


2 download

DESCRIPTION

See how 12,000 other businesses are using Wellness & CDHP as a business strategy. How does your company compare?

TRANSCRIPT

Page 1: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Data That Makes Senseand Making Sense of the Data

Page 2: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

2009 UBA Health Plan Survey Initiative

Page 3: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

About United Benefit Advisors

140 Member Firms

Over 165 Offices nationally

1,800 Benefits Professionals

One of the Five Largest Employee Benefits Organizations in the Country

Page 4: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

About United Benefit Advisors

Serving –

– nearly 40,000 Client Companies

– over 5.5 Million Employees & their families

– ~$16.5 Billion in Employee Benefits Expenditures

Page 5: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Why We’re Here

Page 6: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

Top decision-maker’s concern about the cost of health care benefits with respect to:

46.3% 47.8%

5.6%0.3% 0.1%

36.6%

53.0%

9.5%

0.8% 0.1%

Corporate Costs Impact on EmployeesCritical Concern Significant Concern Some Concern Little Concern No Concern

Page 7: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Increases in Health Insurance Premiums Compared to Other Indicators 1988-2008

9.27.7

6.17.3

11.2

13.912.910.9

8.25.3

0.8

8.5

18.0

12.014.0

0.02.04.06.08.0

10.012.014.016.018.020.0

1988

1989

1990

1993

1996

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

Health Insurance Premiums Overall Inflation Workers' Earnings

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits: 1999-2007; KPMG Survey of Employer-Sponsored Health Benefits: 1993, 1996; The Health Insurance Association of America (HIAA): 1988, 1989, 1990; Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1988-2007; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey (April to April), 1988-2007.

Page 8: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Health Care CostsPer Employee Per Year1969 $242

1979 $623

1995 $3,821

2009 $7,646 $0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

1969 1979 1995 2009

Page 9: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

2009 Health Care Trend –Med + RX

Source: United Benefit Advisors – Composite of Published Trends

Type of Plan 2009 Trend Preferred Provider Organization 11.1 % Health Maintenance Organization 10.0 % Point-of-Service Plan 10.5 % Consumer Driven Health Plan 10.6 % Indemnity Plan 12.2 % Prescription Drugs 9.8 %

Page 10: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

The Effects of Inflation on Medical Premiums @ 8% / 13%

Year Single Family Single Family

2008 $4,440 $10,812 $4,440 $10,812

2011 $5,593 $13,620 $6,406 $15,601

2014 $7,046 $17,157 $9,244 $22,510

2017 $8,876 $21,613 $13,338 $32,480

2020 $11,181 $27,226 $19,245 $46,865

8.00% Per Year 13.00% Per Year

Page 11: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

2009 Health Plan Survey

Page 12: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Survey Summary

# of Companies Participating

– 12,316

# of Medical Plans Reported

– 17,655

Page 13: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Survey Summary

# of states represented

– 50 (and D.C.)

# of cities represented

– ~ 3,300

Page 14: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Survey Summary

# of Employees

– 1.9 Million

# of Total Lives

– ~ 4.5 Million

Page 15: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Key Survey Findings

Page 16: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Wellness Programs

Page 17: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved. 17

Percent Offering Wellness by Employee Size

4.0%5.4%

9.0%

14.7%

28.9%

32.2%

52.5%

0%

10%

20%

30%

40%

50%

60%

3 - 24 25 - 49 50 - 99 100 - 199 200 - 499 500 - 999 1000 +

Page 18: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Summary - Wellness

Wellness programs are underutilized in companies <500

Wellness Plans from 2008 to 2009 grew from 9.8% to 11.1%; a 13.3% increase.

Over ¾ (78.4%) of firms with Wellness plans use Health Risk Assessments

Page 19: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Summary - Wellness

Over half (56.9%) of Wellness plans use Incentives:

– 30.9% use Cash / 401(k) / FSA incentives

– 56.9% use gift cards or health club memberships

2008 UBA ER Opinion Survey result: 49.6% said Wellness was Effective / Very Effective way to control rising costs

Page 20: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

20

Consumer Driven Health Care

Page 21: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved. 21

Prevalence of Plan Type by Region (CDHP)

23.0%

18.8%20.1%

12.4%

10.8%

0%

5%

10%

15%

20%

25%

Northeast Southeast North Central Central West

Page 22: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved. 22

% of Employers Offering CDHP by Employee Size

16.8%

19.7% 19.1%

15.6%

13.6%

11.2%

14.8%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

3 - 24 25 - 49 50 - 99 100 - 199 200 - 499 500 - 999 1000 +

Page 23: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

CDHC Plan Designs

Median CDHP Deductible = $2,000 / $4,000

Median CDHP Coinsurance = 100% / 70%

Median CDHP OOP Max. = $6,000 / $12,000

Median CDHP Office Visit CoPay = $20

Page 24: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Consumer Driven Health Plans

High Deductible Health Plans with an HRA or HSA, are 17.0% (a 33.9% increase over the 12.6 % last year), with 15.4% of all employees now enrolled in CDHPs

Over ½ (53.8%) of CDHPs are from companies with fewer than 100 employees, with the over 1000 employee groups accounting for 6.2% of the CDHPs

Page 25: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

HRAs And HSAs

Page 26: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Summary - CDHP

34.9% of CDHP Plans offer HRAs

68.7% offer 1st Dollar Preventative benefits

Median Employer HRA Single contribution: $1,000

65.9% of CDHPs offer HSAs

87.6% of HSA plans offer 1st Dollar Preventative

Median Employer HSA Single contribution is $417

Page 27: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Employer Contributions

Average HRA contributions:

– $1,310 single

– $2,502 family

Average HSA contributions:

– $621 single

– $976 family

Page 28: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

CONSUMER DRIVEN HEALTH CARE

HRAs or HSAs coupled with High Deductible Health Plans (HDHPs) are effective vehicles to:

60.9%17.8%

15.3%

16.8%

18.6%

24.5%

21.3%

78.2%

69.7%

64.7%

62.0%

6.5%

13.5%

16.6%

13.6%

Increase employee sensitivity toreal cost of health care

Provide a financial incentive forEEs to manage their health

Shift more cost to employees

Lower health care costs,including premium costs

Expand options for employees

Strongly Agree / Agree Disagree / Strongly Disagree Don't Know

Page 29: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

CONSUMER DRIVEN HEALTH CARE

HRAs or HSAs coupled with High Deductible Health Plans (HDHPs) are problematic because:

18.2%

24.1%

21.2%

24.0%

50.1%

54.6%

59.1%

66.7%

25.9%

24.2%

16.8%

15.2%The need to increase healtheducation for employees

The plan design complexity for ouremployee population

EEs have limited time or interest indirectly managing their health

Increased HR workload

Strongly Agree / Agree Disagree / Strongly Disagree Don't Know

Page 30: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Comparisons of Enrollment by Plan Type By Region

Page 31: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

5-Region Map

Page 32: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved. 32

% of Employees Enrolled by Plan Type by Region (CDHP)

14.5%

19.8%

23.0%

11.1%

4.2%

0%

5%

10%

15%

20%

25%

Northeast Southeast North Central Central West

Page 33: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Differences by Industry Category Many Prevention & Wellness Programs

– Health Care & Social Assistance

– Public Admin; Education; Utilities

– Finance, Insurance & Real Estate

Few Prevention & Wellness Programs

– Professional, Scientific, & Technical Services

– Information, Entertainment, Food & Accomm.

– Construction; Ag & Forestry; Mining; Transport

Page 34: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Health Plan Management

Page 35: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

Which specific strategies or programs do you currently have in place or planned for next year?

18.5%

34.8%

49.2%

12.6%

18.9%

19.8%

14.5%

11.8%

8.5%

In Place Now Likely Next Year Would Like Someday

Increase deductibles, coinsurance, and/or out-of-

pocket maximums

Increase office visit / immediate care / ER copay

Add higher Specialty Care Physician (SCP) copay

Page 36: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

Which specific strategies or programs do you currently have in place or planned for next year?

11.9%

18.1%

3.9%

10.5%

5.4%

6.8%

2.0%

3.4%

17.3%

21.3%

7.2%

14.7%

In Place Now Likely Next Year Would Like Someday

Implement a High Deductible Health Plan with an HRA

Implement a High Deductible Health Plan with an HSA

Implement a High Deductible Health Plan with no HRA or HSA

Implement a HDHP with an employer-funded medical

reimbursement plan

Page 37: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

Which health plan cost-control strategies/programs do you currently have in place or planned for next year?

15.9%

20.4%

33.9%

30.7%

7.3%

13.5%

3.0%

27.5%

36.0%

38.6%

25.6%

12.6%

In Place Now Likely Next Year Would Like Someday

Implement 24-Hour Nurse Hotline or Patient Advocate

Service

Implement a chronic disease management program

Implement a wellness program with health risk assessments

Increase employee share of premiums

Page 38: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

Health Plan Management

4.4%

7.7%

16.3%

7.4%

5.4%

5.4%

2.6%

2.7%

46.2%

26.8%

26.3%

31.9%

In Place Now Likely Next Year Would Like Someday

Implement different smoker vs. non-smoker premiums

Increase premiums or eliminate coverage for spouses eligible or

covered under another plan

Provide an opt-out bonus for employees or spouses waiving

coverage

Which health plan cost-control strategies/programs do you currently have in place or planned for next year?

Implement tiered network plan

Page 39: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Effectiveness of Plan Management Strategies

Page 40: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

Rate the effectiveness for these cost-containment strategies (whether you have such a program or not):

14.2%

11.2%

26.0%

12.4%

40.2%

41.4%

44.5%

49.6%

47.5%

32.7%

44.4%

36.2%

Very Effective / Effective Limited / None Don't Know

Chronic disease management programs

Wellness/prevention programs

Higher deductibles and/or reduced benefits

Increased employee premium cost-sharing

Page 41: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

35.5%

39.4%

61.4%

15.2%

30.5%

32.8%

23.4%

30.1%

31.7%Consumer drivenhealth plans

Tiered networkprograms

Coalitionpurchasingprograms

Very Effective / Effective Limited / None Don't Know

Rate the effectiveness for these cost-containment strategies (whether you have such a program or not):

Page 42: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Employer Predictions

Page 43: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

What do you predict will happen to health plans in the next 5 years?

56.8%

51.0%

86.8%

12.9%

12.1%

3.8%Costs will shift more to

employees

Consumer Driven Health Careplans will dominate

A move to Individual coverageand HSAs

Strongly Agree / Agree Disagree / Strongly Disagree

Page 44: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

What do you predict will happen to health plans in the next 5 years?

33.6%

38.1%

47.4%

22.0%

29.3%

20.3%

All cost and quality data will bedirectly accessible to employees

in advance of purchasing care

A return to more tightlycontrolled managed care plans

Smaller provider networks basedon quality and efficiency

Strongly Agree / Agree Disagree / Strongly Disagree

Page 45: Wellness & Consumer Driven Health Care

Copyright © 2008 United Benefit Advisors, LLC. All Rights Reserved.

What do you predict will happen to health plans in the next 5 years?

7.5%

25.9%

37.2%

62.1%

40.0%

21.3%Employers will move to a

compensation-only approach

No significant changes fromcurrent structure

The U. S. will switch to aCanadian-style, tax-based system

Strongly Agree / Agree Disagree / Strongly Disagree

Page 46: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Shared Wisdom…Powerful Results Talk with us after the seminar

– Representatives of Hierl Insurance Inc will be available for further discussion (920) 993-9573

Call us for more detailed, company-specific benchmarks and analysis

Page 47: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

Shared Wisdom. Powerful Results.

UBA is an alliance of the nation’s premier independent benefit advisory firms. By working collaboratively, UBA members are better positioned to help employers and employees respond more efficiently and effectively to the challenges of an ever-changing employee benefits marketplace. By combining diverse talents, seasoned experience, innovative technologies, and strategic partnerships, UBA Members offer employers exceptional employee benefits advisory services.

In only five years, UBA has become one of the nation’s five largest employee benefits advisory organizations, with nearly 1,900 experienced benefits professionals located in 165 offices across the country. UBA Members provide employee benefits consulting, brokerage services, and best-in-class products to over 37,000 private corporations and public employers. As trusted advisors, UBA Members help their clients manage nearly $16.5 billion annually in employee benefit expenditures on behalf of nearly 5.4 million employees and their families. Visit www.benefits.com for more information.

About United Benefit Advisors (UBA)

AboutHierl Insurance Inc

If You Believe There Has Be A Better Way To Manage Benefit Programs In Order to Get Better, Long Term Results…, You’ll Want To Spend Some Time With Us

Our approach deals with a specific set of problems and will provide a clear, proactive strategy for managing your risks. You’ll learn whether you’re paying money for unnecessary coverage, or if you have an exposure(s) that’s gone undetected… and therefore not covered. We’ll show you how to detect if your employees are engaged in the success of your company or if they’ve become dissatisfied and see your company only as a source for a paycheck?

If you’re experiencing high turnover, declining productivity, uncovered claims, or any other symptoms that are causing you to lose your best employees, we have the experience and proven strategies to help you turn things around. We’ll help demonstrate The Real Bottom Line ™ and how you can effectively measure the impact your programs are having on the success of your company.Sit down with us and take just 60 minutes to share your challenges and frustrations. If we believe that we can create a more effective strategy, we’ll put our full resources to work for you.

Visit us at www.hierl.com, or e-mail at [email protected].

Page 48: Wellness & Consumer Driven Health Care

Copyright © 2009 United Benefit Advisors, LLC. All Rights Reserved.

2009 UBA Health Plan Survey