U N I V E R S I T Y O F A L A S K A F Y 2 0 1 3 W E L L N E S S & I N I T I A T I V E S

E X P E R T I S E P A R T N E R S H I P V A L U E

J u n e 1 4 & 1 5 , 2 0 1 1

T R E N D S A N A L Y S I S S T A T I S T I C S P L A N N I N G T O O L S

History of UA Wellness program

 University of Alaska started wellness program in November 2006 with WIN for Alaska – First phase was to increase program visibility, awareness and provide health education to faculty and staff (Nov 06 to Nov 07) – – Second phase was to increase participation in the wellness program. (December 2007 to June 2008)  Introduction of Individualized Health Planning Sessions (IHPs) and an individualized Get the Point (GTP) incentive program IHPs started in 2008  Year 1, the program was available in Anchorage and Juneau  Year 2, the program included Fairbanks –  IHP program has demonstrated improved health in participants The UA wellness program offers multiple face to face to interactions thru IHPs, Wellness breaks and Mass Screening events  PWP (Health Risk Assessment) started in 2009 and discontinued PWP and $100 incentive for FY 2012. – 2009 participation of 39% of total eligible population (employees and spouses) – 2010 participation of 33% of total eligible population (employees and spouses) 2

UA Wellness Plan Guiding Principles

 Measurement − Establish a baseline of all employees  UA has partial baseline through IHP program  Historically PWP (Health Risk Assessment) information − Continuous Measurement from areas of improvement  Incentives and Communications − − Utilize point system to reduce medical plan employee charges Reward outcomes and not just activity  Target high risk individuals − − Reduce health risk factors Improve employees health thru tools and programs  IHP 3

UA’s Wellness Program Goals

 UA’s Wellness Program Goals – – Establish a culture of wellness Continue to identify the risk factors or problems University of Alaska employees and spouses have – Help University of Alaska employees improve their health by providing tools and programs to assist employees and spouses – – Slow the rate of increase in health plan costs Keeping Healthy People Healthy 4

Wellness program

 Personal Wellness Profile (PWP) – 2010 Report with areas to focus on were Fitness, Weight management, Nutrition and Blood Pressure.

 Of those that took the PWP, 694 have prehypertension (120/80 – 139/89) and 196 (8.7%) already have high blood pressure (140/90)  Individualized Health Planning Sessions (IHPs) – The individuals that have participated have experience positive results     Employees that lost at least 10 pounds – 116 participants Employees that lost at least 2 inches from their waistline – 229 participants Employees that decreased their blood pressure to a normal level from 140/90 (high blood pressure) – 147 participants Employees that decreased their total cholesterol by at least 40 points – 121 participants  February 2011 Alere and VSP started to build data exchange 5

FY 2013 Wellness Programs

Health Risk Identification & Improvement Participation Incentive Strategies

Identification and Improvement Programs

- Health Status Questionnaire - Smoking Cessation -2 or Less Risk Factors

Participation Incentive Strategies

- Biometric Screenings - Healthy Weight - Health Coaching Participant

Premium Contribution Discounts Gift Cards 0% 20% 40% 60% Participation Percentage 80%

A dollar lost is valued by the individual more than a dollar gained

100%

7

FY 2013 Potential Wellness Strategy

 FY 2013 – July 1, 2012 − Utilize “Point System” of activities with points correlating to a discount on the employee charges − Points will be heavily weighted toward Health Risk Assessment, Biometrics and smoking cessation − Know Your Numbers (Mass Screenings) events employees complete full biometric screening (cholesterol, blood pressure) and sign release to provide information to WIN and Lockton − − Establish two tier employee charge discount Utilize WIN to track, record and report information (already have Get The Point) − − All Activities will be completed by April 15, 2012 – Open Enrollment FY 2013 Begin Communications in August 2011 on the updated point system 8

EXAMPLE - Incent Healthy Behaviors

Activities

Employee Completes PWP Spouse Completes PWP Employee Biometrics Submitted via Mass Screening, Doctor Affidavit Spouse Biometrics Submitted via Mass Screening, Doctor Affidavit Actively Engaged in Disease Management Program (if identified as a candidate based on risk factors or claims utilization) Complete 5 sessions of IHP w/pre & post biometrics

Program Participation Activities

Participate Weight Loss Program Receive Flu Shot Employee receives annual physical

Points

50 50 200 200 125 50 100 25 75 Spouse receives annual physical Employee - Work out 3 times a week Spouse - Work out 3 times a week Complete Tobacco Cessation Program 75 75 75 75 Total Potential Points 775 9

EXAMPLE - Points to Employee Charge Discount

Program Participation Rewards Employee Only Points

Greater than 300

Employee + Family Points

Greater than 600 150 to 299 400 to 599 Less than 150 Less than 400

Award Level

Tier 1 Tier 2 Not Qualified

Award

20% Employee Charge Discount 10% Employee Charge Discount No Discount 10

EXAMPLE - Estimated FY 2013 Employee Charges

500 Plan

Employee Employee + Spouse Employee + Child(ren) Employee + Family

FY12 Annual Charge FY13 Annual Charge*

$2,547 $3,502 $5,094 $4,584 $7,131 $7,004 $6,303 $9,805

750 Plan

Employee Employee + Spouse Employee + Child(ren) Employee + Family

FY12 Annual Charge FY13 Annual Charge*

$1,116 $1,535 $2,232 $2,009 $3,125 $3,069 $2,762 $4,297

HDHP

Employee Employee + Spouse Employee + Child(ren) Employee + Family

FY12 Annual Charge FY13 Annual Charge*

$395 $543 $790 $711 $1,106 $1,086 $978 $1,521

10% Discount

$3,152 $6,304 $5,673 $8,825

10% Discount

$1,381 $2,762 $2,486 $3,867

10% Discount

$489 $978 $880 $1,369 *Employee Charges increased 10% for FY13 and increased for discount

20% Discount

$2,802 $5,603 $5,042 $7,844

20% Discount

$1,228 $2,455 $2,210 $3,438

20% Discount

$435 $869 $782 $1,217 FY 13 Rates are illustrative and do not in anyway indicate what actual rates will be in FY 13 11

Recommended Wellness Plan

Who FY 2012 AWARENESS

Employees & Spouses (on medical plan)

FY 2013 BASELINE

Employees & Spouses (on medical plan)

FY 2014 OUTCOMES

Employees & Spouses (on medical plan)

Program Incentive

To qualify for the July 1, 2012 employee charge discount/incentive, employees & spouses can complete a list of activities to gain points for premium differential: • Complete Health Risk Assessment (PWP) • • • • Communications: • Biometrics Recorded Have a preventive exam Have a flu shot Work out 3 times a week Communicate in August/September 2011 To qualify for the July, 1, 2013 ee charge discount/incentive, employees & spouses can complete a list of activities to get points and points for in range health risk factors: Activities • Complete Health Risk Assessment (PWP) • Biometrics Recorded • • • Health Risk Factors • Have a preventive exam Have a flu shot Work out 3 times a week E.g. Cholesterol <180 Communications: • Outcomes based program communicated in Aug 2012 • • To qualify for the July 1, 2014 ee charge discount/incentive, employees & spouses must: • Complete HRA • Complete biometric screening AND Meet biometric outcomes measures- can administer using score, status, metrics, etc.

OR Complete alternative activity if metric is not met Communications: • Continuation of outcomes based program in August 2013 • Resources available Employee Charge Reduction of X% Employee Charge Reduction of X% Employee Charge Reduction of X% 12

July 1, 2014Outcomes and Activities

Required Activity Complete Health Risk Questionnaire Program Participation Rewards Bio-Metric Screening (employee choice of Designated Medical Center, Onsite exams or Personal Physician) Attend One (1) Health Coaching Session Complete Disease Management / Health Coaching Program (If indentified as a candidate based on risk factors or claims utilization) Award

Part of the Employee Charge Discount

Reduce Health Risk Factors Alternative Standard Award Level Tier 1 Tier 2 Cholesterol < 180 < 200 Blood Pressure < 120/80 Glucose < 100 Waist Circumference Males < 40 inches < 130/85 < 110 Females <35 inches Not Qualified Tier 2 Alt Physician Affidavit of Medical Condition Complete Weight Loss Program Tobacco Use No Complete Tobacco Cessation Program Award

(Subject to HIPAA Limitations)

20% EE Charge Discount 10% EE Charge Discount No Discount $X Flat Dollar Amount 13

What’s Next

    Finalize wellness plan design for July 1, 2012 – Determine activities – – Determine employee charge discount Date activities complete Finalize smoking surcharge/credit – Smoke/Tobacco surcharge or credit – Smoke/tobacco free date  Smoking/tobacco cessation program date – – Allow mid-year update Affidavit language Determine HRA or HSA for July 1, 2012 – Seed money – Yes or No if HAS Finalize FY 2013 Benefits Timeline 14

What’s Next

 Cost analysis of individuals who have participated in an IHP and/or took the PWP compared to non-participants  Gather Metabolic Syndrome Data to target communications and wellness programs and tools – WIN will gather and track risk factors associated with Metabolic Syndrome and provide data to Lockton for analysis with InfoLock  5 Risk Factors: HDL Cholesterol, Blood Pressure, Triglycerides, Glucose and Waist Circumference – Require pre/post full biometric screening − Lockton to receive pre/post screening report with Metabolic Cluster on IHP participants from WIN. − – Lockton to integrate this report into InfoLock claims data and provide University of Alaska with risk reduction to demonstrate savings. Lockton to provide cost analysis to University with those individuals that have metabolic syndrome and those that do not  Schedule Two-Day Vendor Summit to facilitate integration in April 2012 – Vendor presentations on current and future state of University of Alaska and Alaska healthcare – Continue integration of information between WIN, Alere, VSP and ComPsych 15

Appendix

Wellness – What We Believe

 Healthcare Reform is going to increase medical trend over and above current projections  Participants must have “skin in the game” through active engagement and financial accountability.

− Incentives should drive participation and reward those who do achieve results  Integrated claim, Health Risk Assessment, and Biometric data establish the Risk Profile and allow for continuous program measurement – Targeted and population based, integrated with plan design and outcome based  Outcomes should be tracked by improving aggregate health status: − BMI, Blood Pressure, Cholesterol/Fasting Glucose and Tobacco Use  Long-term health improvement and cost reduction can only be achieved with: − High consumer engagement (80% over 3-5 years) 17

Wellness – What We See

 One of the foundational tenets of the field of corporate wellness is that it is clearly better to prevent health problems than to treat them later on.  On average $1 of medical and pharmacy costs there is about $2.3 of health related productivity costs that employers must pay – and that figure is much greater for some conditions.

1  A recent study reports that for every dollar spent on wellness programs there are $3.37 dollars returned in reduced medical costs and $2.73 returned in reduced absenteeism.

2  When done effectively, health promotion has demonstrated a successful history of both improving health and providing a significant return, with ROIs ranging from 3:1 to 5:1 or higher.

3  Measure risk factors  Measure change in biometric data 1,2 http://www.thehealthcareblog.com/the_health_care_blog/2010/09/front-line-managers-are-key-to-wellness-program-participation.html

3 http://www.livewellcolorado.org/assets/pdf/partners-in-action/worksites-and-businesses/ucsw-white-paper.pdf

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Other Suggestions

   Brainstorm ideas to integrate Nursing School and PA School Increase number of dental cleanings for diabetics and pregnant women Onsite Medical Clinic and Pharmacy for Fairbanks and Anchorage  Put Blood Pressure cuff and scale at various University locations – – $70 for cuff and $100 for scale Blood pressure and scale monitored through third party vendor 19

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