Destination Wellness: Blue Care Connection ®

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

www.bcbstx.com/hs

Why Isn’t Wellness Easy?

Behavior

Behavior is a significant driver of health and wellness.

There is often resistance to change from employees wary of their employer regulating off-the-clock behaviors.

How will BCBS help to influence and change behaviors?

Uncertainty

Employees often want to change, but don’t know how to begin, or where to find the right tools to make decisions.

How will BCBS help educate and guide your employees?

Motivation

Some employees will maintain their lifestyle improvements on their own.

Others will need additional help to keep going.

How will BCBS help motivate your employees through their wellness journey?

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Population-Based Medical Care Management Program

Well Members

• Wellness/ Preventive Care Guidelines • Preventive Care/ Wellness Initiatives • • • • Outbound Calls Targeted Mailings Birthday Cards Colon Cancer Screening • HEDIS Outcomes • BlueResource SM • BlueExtras SM

Low- Risk

• • • Health Risk Assessment 24/7 Nurseline and Audio Health Library Personal Health Manager • • • Ask a Clinician… Blue Points Get Fit, Eat Right • Lifestyle Management • • • Weight Management Tobacco Cessation Stress Mgt (co-morbid)

Moderate- Risk

• Focused Medical Management • Targeted Preadmission and Discharge Outreach • Episodic Case Management • Behavioral Health • Special Beginnings

High-Risk

• Asthma • Diabetes • Coronary Artery Disease • Congestive Heart Failure • Chronic Obstructive Pulmonary Disease • Metabolic Syndrome • Hypertension • Hyperlipidemia • Obesity • Low Back Pain • Oncology • Rare Conditions • Impact Conditions

Complex / Catastrophic

• Acute/Late Stage • End of Life • Catastrophic • Acute and Outpatient Management • High Risk Obstetrics • Neonatal Intensive Care • ESRD • HIV/HCV • Transplants • Pediatric Oncology (local) • Complex Malignancy

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Mastery of Self-management Techniques Chronic Condition Controlled Optimize Health Status Satisfaction with the Program Direct Access to BCA

Blue Care Connection: Blue Care Advisor

Graduate Identify

HRA, Medical, Pharmacy and Lab Claims, Predictive Model, Vision and Radiology, self referral, physician referral, health fairs, authorizations, customer service and the client’s third party vendor partners Preventive care Condition-specific Screenings Emergency Action Plan Condition-specific Knowledge Medication Compliance Durable Medical Equipment

Close Gaps in Care

Communicate member engagement Treatment Plan Validation/Consultation Alerts for Untoward Events Biometric Results

Blue Care Advisor

Collaborate with MD Coach Outreach/ Engage

Telephonic Outbound Calling Mailing for Unable to Reach Lost to Follow-up Outreach Seasonal Mailers Web-based Secure Messaging Campaign Manager Reinforce Physician’s Treatment Plan Promote Medication Compliance, Self management Techniques, Trigger and Symptom Management Biometric Screenings Condition-specific Education

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Behavior Change

Member Engagement Campaign Manager delivers “targeted” messages 1 Member Member calls in with routine questions 2 Customer Advocate conducts warm transfer to the Blue Care Advisor Member enrolls 5

Complete a Health Risk Assessment Be informed about your overall health and well-being.

A Health Risk Assessment (HRA) helps assess a member’s health risks, interests, and readiness to change.

• Examines a member’s overall health and well-being • Detailed report with overall health and well-being score • Sub-scores for: Medical health, job satisfaction, life load, risk and lifestyle, mood, nutrition, sleep, stress, pain and body weight • Recommends areas for improvement

Members can earn Blue Points SM

for completing the health and well-being Health Risk Assessment Blue Points limited to the general HRA, and twice within any 12 month period Confidential and secure

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24/7 Nurseline Advice anytime.

Round-the-clock health and the wellness advice from licensed professionals

Advice isn’t just needed from 9 to 5.

Our 24/7 Nurseline is here to help.

• Nurses provide health advice and information • Audio health library on topics such as kicking the smoking habit • HealthSelect Nurseline Number- 888-334-9473

Available in English and Spanish 24/7 7

Tobacco Cessation and Weight Management Programs Tobacco Cessation:

Support for members who want to quit smoking

Weight Management:

Support for a Healthier You

Self-Paced Approach

• Online tools and resources via the Personal Health Manager • Secure e-mail outreach to keep members on track • BlueExtras

SM

Discounts to support member efforts: • Discounts on Jenny Craig, Curves, Pilates, yoga, vitamins, meditation, yoga, acupuncture and more!

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Personalized Lifestyle Management Support

Counseling and coaching with licensed Wellness Coaches 24/7 Nurseline Referrals when appropriate

Motivational toolkits mailed to members who are ready to change

“Ask A” Online Advisor Ask the experts.

Expert advice from licensed professionals via the Personal Health Manager

Expert advice at your fingertips.

Our “Ask A” Feature is here to help.

Ask a Nurse:

Members can interact online with a Blue Care Advisor on non emergency, health related questions using the “Ask A Nurse” feature.

Ask a Trainer, Dietitian or Life Coach:

Members can send questions about fitness, nutrition, or managing stress.

CONFIDENTIAL AND SECURE Receive a response within one business day

Medical questions directed to a coach are verified with a Blue Care Advisor to ensure appropriate response and referral to the proper medical resources.

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BlueResource SM Communications BlueResource is a collection of health and wellness communications available to Benefit and Wellness Coordinators.

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Download directly from the HealthSelect Web site

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Multiple file formats available, from posters to e-mail banners and copy Topics include:

• Fit for Work • Health and Wellness • Health Observances • Health Screenings • Healthy Tips • Nutrition & Walking • Online Resources • Preventive Health • Weight Loss • Stress Management

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Destination Wellness: Online Tools, Resources, and Rewards for HealthSelect Participants

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

11 www.bcbstx.com/hs

Tools, Resources, and Rewards for HealthSelect Participants

www.bcbstx.com/hs 13

Blue Access for Members

TEA 6/25/09 XXXXXXXXXXX TEA 6/25/09 XXXXXXXXXXX

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Personal Health Manager Demo 15

Personal Health Manager Home Page

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Blue Points = Rewards 17

Blue Extras-Value Added Discount Programs

• • • • • • Davis Vision TruHearing Jenny Craig Curves Complementary Alternative Medicine • Fitness centers (Gold’s and Lifetime) • Massage therapy • Acupuncture Lifetime Fitness

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HealthSelect Wellness Page 19

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Questions

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Thank You!

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