Transcript Slide 1

Building a Successful
Health Management Strategy
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
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66% of adult Americans are overweight/obese.
– CDC & Prevention
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A Well Designed, Long-Term
Health Management Strategy…
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Improves the health and well-being of employees (& their
families)
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Enhances employee morale and productivity
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Enhances organizational performance
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Reduces costs
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Provides an example to the community
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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 costcontainment
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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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Sample Strategy –Using Carrier/TPA Model
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 Screening
3. Routine annual Exams
(age/gender)
4. Health Improvement
Programs/Activities
2014 Incentive based on
participation in:
*1. HRA
*2. Biometric Screening
3. Routine annual Exams
(age/gender)
4. Health Improvement
Programs/Activities
2015 Incentive based on
participation in:
*1. HRA
*2. Biometric Screening
3. 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)
*If the spouse does not participate,
the employee does not receive the
discount
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 for
HRA and screenings
2. Provide aggregate risk data
to employees
3. Provide individual risk data
to employees
1. Increase/Maintain participation in
HRA & Biometric Screenings
2. Measure Risk Reduction
3. Establish baseline data in
programs & activities
1. Increase/Maintain participation
in HRA & Biometric Screenings
2. Increase/Maintain participation
in programs & activities
3. Measure Risk Reduction of the
population
4. Measure prevalence & trends of
cohort population
1. Increase/Maintain participation
in HRA & Biometric Screenings
2. Increase/Maintain participation
in programs & activities
3. Measure Risk Reduction of the
population
4. 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 endorsement
4. Determine budget & resources
5. Determine Incentive structure
Q4 6. Launch HRA and Biometric
Screening Campaign
1. Implement Program/Activities
based on aggregated risk data
2. Launch HRA and Biometric
Screening Campaign
1. Engage Insured Spouses
1. Implement Value Based
Benefits Design
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Sample Incentive Strategy
MEDICAL PREMIUM
DISCOUNT
BONUS
SWEEPSTAKES
PTO
REWARD
Up to 20% of employee +
employer contribution
Amount: TBD
Cash Bonus
Amount: TBD
Grand Prize Drawing for a
large give-away
Prize(s): TBD
Paid Time Off
Amount: TBD
CRITERIA
Year 1
Participate in Biometric
Screening + HRA
Participate in Biometric
Screening + HRA
Participate in Biometric
Screening + HRA
Participate in Biometric
Screening + HRA
PROS
-Non-taxable
-Depending on structure,
provides for program
funding
-Educates employees on
the true cost of their
medical 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-insured
employees
-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 non
insured employees
-maintain 100% employer
paid medical insurance, if
applicable
-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 all
participants
-100% cost to the employer,
does not provide program
funding
-Administration & delivery
The Success of the Program Hinges on
Engagement of the Target Population
The following components are critical to engagement:
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Senior Executive Level Support
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An Effective Communication Strategy
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Meaningful Incentives
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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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Program Comparison
Stand-alone Vendor
•Customization
•Flexibility
•HRM
Benefits
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)
•Program
Challenges
integration across the continuum
of care more difficult to achieve
•Data integration/ownership
•Cost
Medical Carrier
•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
•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
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A Framework for Success
NEEDS
Health Risks
Chronic
Illness
Medical
Cost
INTERVENTIONS
EFFECTS
Top Down
Support
Happier,
More
Productive
Employees
Defined
Accountability
Communication
Pharmacy
Cost
Cultural Change
Injury Risk
Awareness
Disability
Cost
Absenteeism
Incentives
Education
Behavior
Change
Individualized
Intervention
Plan Design
Presenteeism
Healthier
Employees
Engagement
IMPACT
Derivable Gains
Health Plan Costs
Sick Leave Costs
Workers’ Compensation
Costs
Disability Costs
Presenteeism Costs
Potential Gains
Quality Consumerism
Stamina & Resilience
Cultural Shift
Company Loyalty
Morale
Recruitment
Retention
Source: Leutzinger, J., Sullivan, S. & Chapman, L. The Platinum Book: Practical Applications of the Health & Productivity Management Model. IHPM, 2004
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Building a Successful
Health Risk Management Strategy
Discussion
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