Transcript Document

Empower, Educate, Engage™
Why Wellness?
The Big Picture
Health plan costs are escalating at more than 5 times the rate of corporate
profits and 5 times the rate of inflation
500
450
400
350
300
After tax Profits
Health Benefits Costs
250
200
150
100
50
0
1996
1997
1998
1999
2000
Historical Perspective
People with lifestyle-related chronic conditions account for 88% of all
prescriptions written, 72% of all physician visits and 76% of all inpatient
hospital stays.
We spend $6280/year for every man, woman and child for health care
in the US and exactly $1.21 on prevention.
Employers resort to new methods of shifting costs to employees
every year (CDHC, HSA, HRA, etc..) never affecting trend
“Wellness Programs” to-date lack “single source of truth”, measurable
outcomes and focused interventions and are largely a waste of time
and money as a result. The truth is, despite all the hype…. no ROI is
forthcoming any time soon…unless you improve lifestyles.
Don’t confuse Early-Detection and Disease Management with
Wellness and Health Promotion.
Has this been your Wellness Strategy….is it
working? (Is it wellness??)
=
Cost Shifting Alone Is Insufficient
“71 cents of the healthcare dollar is spent on treating conditions that are lifestyle related and
potentially reducible by behavioral changes.”
– Prof. Roger Seehafer, Purdue University
•40 million Americans have diabetes and nearly 40% of them do not know it.
•Nearly half of cancer cases could be prevented by greater use of screenings and
subsequent application of existing knowledge around diet and lifestyle improvement.
•20 million Americans have undetected chronic kidney disease and another 20
million are at risk.
The NIH says that 85% of all disease is lifestyle-related….virtually all of these are
predicted by a few key, simple to measure biomarkers….. which is where we focus!
The Options
More cost shifting (via “Better Plan Design”)
Benefit reductions (squeeze the balloon) only shifts costs
Hope that employees will utilize fewer services because of cost implications
………..can have (overall negative effect on trend)
Bottom line: We’ve been doing this for years with little or no meaningful results!
Health Savings Accounts, etc…
Encourages shopping to an “unknowing consumer”
Assumes that employees understand value/priorities of health-related products and
services for their specific circumstance. They don’t.
LifeStrive Targeted Wellness Intervention
 “Good driver discount” for health!
Focuses employee on few biomarkers that have most impact and they can understand
Lifestyle rewards (doesn’t penalize non-modifiable risk factors)
Creates and fulfills targeted need for health promotion with measurable results
Allows us to “run the experiment” of cultural transformation
How are employees screened
for healthy lifestyles?
Ex. Health Screening
-Blood Glucose
-Total Cholesterol
-LDL Cholesterol
-Tobacco Use
Categories:
NIH
Blood Glucose:
<110
<130
Total Cholesterol:
<200
<230
LDL Cholesterol:
<100
<130
Tobacco/Nicotine: None
Generous:
None
These are the biometrics that indicate the lifestyle factors that drive trend. If
results are within a specific range, employees immediately qualify for wellness credits
towards Premium Contribution Credits, additional Supplemental Benefits, HRA
Contributions or Health Rewards Points. The screening is preformed once per
year, prior to the start of the plan year. Employees can also earn unearned credits
through participation in our e-Learning Modules, satisfying the HIPAA
requirements for non-discrimination.
Employee Wellness Dashboard Example
Advantages
Doesn’t penalize sick people, rewards healthy lifestyles
Decisively shifts responsibility (not just cost) for health to employee
Keeps employees aware of their current health condition and focuses
them on prioritized biometrics (those that drive trend)
Workers Comp, dental, vision rates all positively influenced
Influence culture over time with our web-based tools:
Health Coach Web Portal with Health Promotion Programs and
E-Learning Center Access
Health Coach Internet Radio
Health Coach Forum and Weekly Chat Room
Just Released…. Health Coach University!
Works outside of the base health plan! Our wellness product auto-administers credits
earned and notifies payroll, TPA, etc…as desired by employer.
The average employee will become engaged in the process and clearly understand
that their lifestyle counts!
The program is:
Confidential
Patented
Flexible
Example Plan Prior to
LifeStrive
Premium Contribution at $0/month
Core Medical Plan
The LifeStrive Program is installed
Separate Fully Insured RDP Policy
Blood
Test
$200
LDL
Chol.
$100
Blood
Sugar
$100
Non
Tobacco
Tot.
Chol.
$100
$100
Employee Cont. Raised to $600/year
Or $50/month
Employees earn $100-$600 Towards
Premium Contribution, HRA Contribution
Core Plan
(or supp. Benefits)
Unearned credits are then subject to eLearning Completion to satisfy HIPAA
Reasonable Alternative Requirements
Employee #1
Submitting to Blood Screening Credit $200
LDL Cholesterol Credit $100
Non Tobacco Use Credit $100
Total Wellness
Credit Available
$600
Blood Glucose Credit $100
Total Cholesterol Credit $100
Core Medical Plan
This employee earned
all five credits and has
either Zero premium
Contribution, an
increased HRA
contribution, or
supplemental benefits
bank…they are also a
LOW User of the Health
Plan Statistically
Healthy Solutions Program Fees & Projected Savings
For:
ABC CORPORATION
Fee Structure based on: 68 Singles 105 Families _173_Total
Expected Current Annual Premiums:
$1,255,792
Estimated Premium Savings from a $700 deductible increase: $ 101,719
(Increase from $300/$600 to $1000/$2000)
(8.10%)
The Savings
LifeStrive Program
No. of
Employees
Web Portal Access+
Wellness Screening
C.I./Wellness (Est.)
Single
Family
Admin. Fee
(coord. Lab results.
earned credits. Agg.
Risk reports, etc.)
Start-up Fee
(first year only)
First Year Total
173
First Year Savings
Plus:
Web Access/Wellness
PEPM Savings
68
105
278
Fee per
Employee/Mo.
Total
Monthly Fee
Total
Annual Fees
($120,652 Value)
$11.35
$17.68
$ 2.00
$ 772
$1,856
$ 556
$ 9,264
$ 22,272
$ 6,672
$
1,000
$ 39,208
$ 62,511
($120,652 Value)
$ 30.11
Premium Contribution Credits Fees & Projected Savings
For:
XYZ CORPORATION
Fee Structure based on: 680 Singles 320 Families 1000 Total
Premium Contribution Increase: $750/Single, $1200/Family
Premium Contribution Credit: $500 Single, $800 Family
Net Premium Increase: $20.83/Mo. Single, $33.33/Mo. Family
The Savings
LifeStrive Program
Web Portal Access
Plus:
Start-up Fee (first year only)
Health Screenings
First Year Total
No. of
Employees
Fee per
Employee/Mo
Total
Monthly Fee
Total
Annual Fees
1,000
$4.50
$4,500
$ 54,000
1,000
$ 1,000
$ 80,000
$135,000
$ 80
Premium Contr. Rewards
Estimated Premium Savings
Less:
First Year Total
First Year Net Savings
PEPM Savings
$298,000
$135,000
$163,000
$13.58
VALUE EQUATION W/PREMIUM CONTRIBUTION REWARDS
Single
Family
Combined Totals
Premium Contribution Increase
$510,000
$384,000
$894,000
Less: Premium Rewards
$340,000
$256,000
$596,000
Estimated Premium Savings
$298,000
Wellness Criteria Parameters Are Flexible
Any combinations of group standards and credit amounts can be set for
Biometrics.
The closer the group standards are to national standards (NIH), the more claims
trend will be effected.
Can raise premium contribution by more than allowed earn-back amount and use
the savings to pay for all wellness screenings, etc…
Using a pre-screening allows and motivates employees to make changes when
using more stringent standards.
Those that don’t achieve one or more earned credits still have an opportunity to
earn those credits through participation in our e-Learning Programs. As a result,
program isn’t seen as punitive.
Choose easily achieved criteria year one and tighten over time
What is Wellness to you?
OR
“Wellness Program With a Future”
For more information call:
Richard Perryman @ (602) 956-3401