© 2008 The Regents of the University of Michigan, Ann Arbor, Michigan 48109

Five-Year Strategic PlanFY09 –FY13

LaVaughn Palma-Davis

Senior Director, University Health and

Well-Being Services

Our Unique Opportunity to Improve Health

“We have the means to mount a broad, collaborative effort to fashion a prototype program to:

•promote healthy living,

•contain health care expenditures, and

•define optimal insurance coverage for individuals and families.

We can use our intellectual resources to help the nation in addressing the growing crisis in health care.”

- President Mary Sue Coleman Future Directions Presentation UM Regents, 4/22/04

UM Benefit ContributionsPercentage of Total Operating Budget

33

3.5% 3.8%4.1%

4.4%

3.3%

4.8%

7.0%

10.1%

0.6% 0.6% 0.6% 0.5%

7.5%

9.3%

11.7%

15.0%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

FY 1997 FY 2007 FY 2017 Projected FY 2027 Projected

Retirement Plan

Medical+Rx

Other Benefits

Total

“Other Benefits” includes dental, LTD, life insurance, opt out cash and Medicare Part B premium reimbursements; does NOT include University contributions for FICA, nor vacation or sick pay.

The Real Cost of Worker Health

Source: Goetzel, JOEM, 2001:43(1):Adjusted to 2006 dollars

Total: $13,988

Estimated 2006 Median Total Health Costper Employee

$6,532

$5,170

$1,134

$718$434

Group HealthTurnoverUnscheduled AbsenceNon-occ DisabilityWorkers' Comp

Does not include presenteeism costs

Health Care Cost Drivers

Insufficient prevention – 70% of health care costs are related to lifestyle and safety practices

Growth in chronic illness

Noncompliance and poor self-management

Aging population

Mental illness

Current US health care reimbursement system

Other socio-economic issues

Population Health Management

An Integrated Strategy Across the Health Continuum

Health & Well-Being

Low Risk

Optimal Health

At Risk

Inactivity, Obesity,

Stress, High

Blood Pressure

Acute Illness/Injury

Doctor Visits

ER Visits

Chronic Disease

Diabetes

Heart Disease

Disability

Traumatic Injury

Neurological Conditons

Wellness Management

•Information•Motivation•Preventive Screening

Risk Factor Management•Targeted Screening•Targeted Interventions•Reinforcement

Demand Management

•Self Care Information•Nurse Advice Line•Decision Support

Disease Management

•Clinical Management•Compliance Support

Disability Management

•Case Management•Decision Support•Risk Management

85% of employees; 15% of costs 15% of employees; 85% of costs

Source: David Anderson, Ph.D., StayWell Health Management16th Annual Art and Science of Health Promotion Conference, 3/24/06

Narrow Focus Misses Key Cost Drivers

Health & Well-Being

Low Risk

Optimal Health

At Risk

Inactivity, Obesity,

Stress, High

Blood Pressure, High Cholesterol, Smoking,

Alcohol Use, etc.

Acute Illness/Injury

Doctor Visits

ER Visits

Chronic Disease

Diabetes

Heart Disease

Disability

Traumatic Injury

Neurological Conditions

15% of employees; 85% of costs

Source: David Anderson, Ph.D., StayWell Health Management16th Annual Art and Science of Health Promotion Conference, 3/24/06

StayWell medical claims study•Multiple employers/51,200 employees•5 years of data (1997-2001)•Compared each year with next•High-cost 5% = 78% NEW each year!

59%of next year’s high-cost group

Key Drivers of Health CareCost Containment and ROI

Participation – Need to achieve optimal

participation/engagement (70-80+%).

Program effectiveness – Program performance must be monitored to assure risk reduction is being achieved.

Communications, Culture and IncentivesDrive Engagement

27%33%

41%44%

51%

65%

33%37%

53%

41%

51%

69%

0%

20%

40%

60%

80%

100%

Weaker Strong

Comm. Culture Comm. Culture Comm. Culture

Non-Cash Incentives

Cash Incentives

Benefits-Integrated Incentives

HA

Par

tici

pat

ion

Rat

e (%

)

Source: StayWell Financial Incentives Impact Study, 2007Copyright 2007 StayWell Health Management. All rights reserved.

Vision

The University of Michigan will be a model community of health where people thrive.

MHealthy:Five Year Strategic Health and Well-being Plan

Builds upon best practices and research Considers existing resources and gaps Identifies foundational priorities, critical to

achievement of MHealthy goals Guided by principles of rewarding healthy

behaviors, protecting confidentiality and reducing barriers to health improvement

An integrated strategy across the health continuum

Healthy At Risk Short Term

IllnessChronic

Diseases Disability

Wellness Promotion (Low Risk)

Information

Motivation

Preventive Screening

Opportunities to Maintain Health

Risk Factor Reduction

Targeted Screening

Targeted Risk Factor Interventions (smoking, high blood pressure, lipids, overweight, etc.)

Reinforcement

Use of Health Care Services (for Acute Injury/Illness)

Sufficient Access

Self Care Information

Help in Making Treatment Decisions

Disease Management

Effective and Timely Clinical Care

Patient Education, Compliance and Self Care Skills

Care Coordination

Disability Management

Care Coordination

Help in Making Treatment and Life Decisions

Risk Management

Return to Productivity

Effective Population Health Management

The goal is to move people to lower risk and improved health.

Components of Strategic Plan

Leadership support Supportive environment,

culture & infrastructure Communication Data management &

evaluation Program coordination Benefit design &

incentives

Wellness assessments with follow-up coaching

Targeted risk reduction Disease management Disability management Demand management Innovation

Highlights of Strategic Plan: Communication

Develop and implement a comprehensive, multi-year communications plan, including identification of specific strategies to market/communicate issues, programs and services and move people to action

Leadership Commitment and Support

- Provide leadership engagement and training at all levels

- Incorporate employee health performance expectations into leader evaluation process

- Develop/modify organizational policies to advocate optimal health

Supportive Environment, Culture and Infrastructure

- Develop plan to improve fitness center access

- Continue to offer fitness center and equipment discounts

- Expand efforts to establish a smoke-free environment across the university

- Sustain and expand other environmental supports in the areas of physical activity, healthy eating, safety and cleanliness

Benefit Design and Incentives

- Establish a cost-effective benefit design that supports prevention, risk reduction and improved compliance

- Ensure that design reduces barriers to obtaining care

- Provide incentives that promote the adoption and/or maintenance of healthy behaviors

Health Risk Assessments with Follow-Up Coaching

- In FY09, launch a University-wide health risk assessment program with biometric screenings, follow-up coaching and referral

General and Targeted Interventions

- Identify existing and new resources for targeted interventions based on UM health data profile

- Enhance availability and accessibility of services in key areas such as: weight mgmt., healthy eating, physical activity, stress mgmt., ergonomics, back health, tobacco cessation, and cardiovascular disease prevention

Mental/Emotional Health and Substance Dependence Services

- Continue awareness campaign to reduce stigma & promote prevention

- Maintain robust website including self-help tools and resource assistance

- Conduct manager and HR training

- Improve the return to work process

- Complete study of optimal mental health benefit design and equity/access issues with recommendations

Disease Management Programs

- Evaluate existing health plan offerings and make recommendations to assure effectiveness and optimal utilization

- Evaluate existing pilot programs (Focus on Diabetes, Focus on Medicines) for efficacy and determine future direction

- Work with the UM/BCN Joint Venture to identify other valuable pilot programs to address improved approaches to care

Getting Started – Year 1 FY09

Free and confidential wellness assessments offered to all benefit eligible employees beginning in January, 2009 On-line health risk questionnaire, Blood pressure, Cholesterol, HDL & glucose Height, weight and waist circumference Results coaching

Referral to helpful programs and resources at low or no cost High risk individuals will have an opportunity to have a personal

health coach

$100 incentive for participation in wellness assessment in 2009

FY09 B&F Key Initiatives

3.1 Effective internal implementation and early adoption of relevant University-wide initiatives

At least 40% of benefits eligible B&F staff will participate in a free and confidential MHealthy Wellness Screening by June 30, 2009.

Measuring MHealthy Program Outcomes

2/20/2011

Years 2 & 3

Short term metrics

Health assessment participation rates

Program participation rates, including enrolled, and completion rates

Program satisfaction Baseline health risks

compared to benchmarks

Baseline health issues driving health care costs and utilization

Medium term metrics

Reduction in health risks

Pre and post outcomes for select behavior change programs

Healthy culture indicators

Long term metrics

Health status improvements

Continued improvement or maintenance in health risk levels

Reduction in health care cost trend

Impact on avoidable costs

Health care utilization Impact on absenteeism

workers comp, disability

1/19/2008

Program Start8/11/2009

Year 112/5/2012

Year 3 and beyond

Conclusion

The University has made a commitment to invest in MHealthy to improve the health of our community and try to contain future health care costs.

We cannot achieve the high level of participation necessary to be successful without your leadership commitment as well.

We will do our part to help you with Communication tools and messages Delivering programs in your schools & departments Creating a supportive environment, policies and appropriate incentives