healthcheck360 selling wellness to your cfo 041712
DESCRIPTION
HealthCheck360 Selling Wellness to your CFO. Presented to the 2012 South Florida Worksite Wellness Forum and Awards, April 2012. Strategies to implement a results oriented self funding wellness health management program with positive outcomes and measurable results.TRANSCRIPT
Agenda
Introduction
The CFO’s Role
Wellness – Doing nothing is a losing strategy
Traditional Wellness
6 Key Features to Measure to Results
Conclusion
2Proprietary & Confidential
The CFO’s Role
…CFOs are uniquely situated to build and communicate an integrated risk view, optimize business decisions, and build a strong risk management culture. - McKinsey Quarterly
Financial Risks
Liability Risks
Health Risks
3Proprietary & Confidential
Doing Nothing is a Losing Strategy
Year 0
Low Risk (0-2 Health Risks)
27,951
Medium Risk (3-4 Health Risks)
10,670
High Risk (5+ Health Risks)
4,691
Migration study of 43,312 Individuals Over 3 Years
Source: University of Michigan Health Management Research Center
Year 3
Low Risk (0-2 Health Risks)
26,591
Medium Risk (3-4 Health Risks)
11,495
High Risk (5+ Health Risks)
5,226
Key Findings
Risk profile of a population gets worse over time
Number of high risk individuals increased 11.4%
Number of medium risk individuals increased 7.7%
Number of low risk individuals decreased 4.9%
Results are a function of American lifestyle habits and the realities of age
4Proprietary & Confidential
Excess Risk Equals Excess Cost
Source: University of Michigan Health Management Research Center
Inflation adjusted to 2009: http://www.halfhill.com/inflation.html
Cost Area Low Risk (N=671)
Medium Risk
(N=504)
High Risk (N=396)
Short-Term Disability
$160 $288 $444
Worker’s Compensation
$304 $325 $662
Absence $327 $455 $703
Medical & Pharmacy
$1,544 $1,983 $4,929
Total $2,335 $3,052 $6,738
High Risk Employees cost three times as
much as low risk
employees!
5Proprietary & Confidential
The Clear Path to Higher Costs
Lifestyle Decisions
Health Risks
Disease (Costs)
Six Key Features to Measure Performance
1. Outcome-based, objective biometrics to detect risk
2. Objective and clear scoring model
3. Portable and carrier independent
4. Meaningful incentives (Substantial, Understandable)
5. Support for positive behavior change (Health Coaching, Engagement Tools, Educational Resources)
6. Measured results and analysis
7Proprietary & Confidential
Key Feature #1 – Outcome Based
Objective measurement is key to success
Set baseline
Track trends
Real information, not a guess
Importance of on-site venipuncture biometric screening
Accuracy and flexibility of full panel results
Objective data points to measure over time
Participants don’t “know their numbers”
Biometrics determine follow up programming
Uncover hidden risks
8Proprietary & Confidential
Key Feature #2 – Clear, Objective Scoring
Easy to understand scoring drives engagement and participation
Objective scoring prevents errors with self reported information
Scored model translates risks into compliant measurement model
Long term measurement tool
9Proprietary & Confidential
Carrier Programs: Risk awareness– Carrier, not the client, owns the data
– Don’t share proactive risk data with risk bearer
– Customization/ Flexibility
“Being Carrier Independent allows your program to stay consistent
over time”
Key Feature #3 – Portable Information
10Proprietary & Confidential
Key Feature #4 – Meaningful Incentives
11Proprietary & Confidential
Incentives – Multiple Purposes
Participation Health Outcomes
Target: 80% to 100% participation
Rewards go to those who have less risks OR are making progress in
reducing risks
Engagement
As necessary to build momentum,
support change
12
Incentives
Proprietary & Confidential
Proprietary & Confidential
Cost Neutral Implementation
• Year 1: Increase contribution rates by $40 company wide
for singles and $80 for a family, then offer $40/$80
discount for participating
• Year 2: Upon retesting, offer discount for:
– maintaining high level of health
– improving health (5 points)
– doctor’s affidavit that states compliance with care
Properly Designed Program Pays for Itself
13
Incentive Value and Participation
• Results for completion of Health Risk Assessments show a direct correlation between incentive value and participation
• Incentives reward those who make healthy lifestyle choices
14Proprietary & Confidential
0%
20%
40%
60%
80%
100%
$0 $100 $200 $400 $600 $800 $1000
Incentive (Annual Cash Value)
Enro
llme
nt
Pe
rce
nta
ge
HIPAA Compliance
Wellness Program conditions and rewards MUST comply with HIPAA Wellness Program Regulations:
1. Limit on Reward
2. Reasonably Designed To Promote Good Health or Prevent Disease
3. Annual Opportunity to Qualify For Reward
4. Reasonable Alternative Standard
5. Disclosure Required
15Proprietary & Confidential
Key Feature #5 – Support Behavior Change
Personal Intervention Population/Social Programming
Communication campaign
• Marketing to drive participation
• Ensure understanding of available programs
• Effectively communicate incentives
Education Campaign
• Monthly Newsletter
• Twitter tip of the day
• Lunch n Learns
Activity Programming
• Weight loss challenges
• Pedometer programs
• Point based initiatives
Push/ Pull Targeted Communications
• Focus on personal risk factors
• Reward positive change
Coaching/ Medical Management
• Health Coaching
• Disease Management
• Case Management
Online Health Portal
• Health/Wellness content
• Activity/ Nutrition Tracking tools
• Program management
16Proprietary & Confidential
What Influenced You To Improve Your Health?
21%
48%
56%
63%
73%
91%
0% 20% 40% 60% 80% 100%
Co-worker inspired change
Illness of friend/family
Spouse was improving health
Taking online HRA
Want to pay lower insurance premiums
Receiving Biometric data
Somewhat agree, Agree and Strongly Agree
Biometrics and premium incentives are much more influential than online HRA or personal events in influencing decision to improve health.
17Proprietary & Confidential
N = 6,000
Attitudes towards Wellness Program
34%
67%
80%
89%
92%
92%
0% 20% 40% 60% 80% 100%
Alerted me to medical condition I wasn't aware of*
Articles I received motivated me to improve health
Premium Incentive motivated me to improve my health
Report helped me understand where to change
Provided valuable insight into my health
Program made it more likely for me to improve health
Somewhat agree, Agree and Strongly Agree
* Using Agree/Disagree scale only
There was very strong agreement that the wellness program not only provided good insight into health, but also help foster the desire to improve health. One-third of participants found out about a health issue that they were unaware of before the program.
18Proprietary & Confidential
N = 6,000
Key Feature #6 – Measured Results
Desired Reporting Capabilities
Individual Report
Executive & Aggregate Report
Claims analysis (if applicable)
Health Coaching Reporting
Risk Migration Analysis
Critical Value Reporting
Executive Review of Findings Presentation after assessments
19Proprietary & Confidential
Key Feature #6 – Measured Results
Know what you can measure
Easier to Measure:
Biometric migration
Claims data
Engagement
Harder to Measure
Productivity
Presenteeism
20Proprietary & Confidential
You Don’t Know What You Don’t Know
Biometric Screening Findings
• 111 with glucose in diabetic range
• 580 with glucose in pre-diabetic range
• 549 individuals with elevated systolic and diastolic blood pressure readings
• 815with elevated cholesterol
• 883 with BMI readings > 30, of which 396 (44.8%) are also pre-diabetic
Claims Information
• 50 have claims with a diagnosis suggesting diabetes or pre-diabetes
• 78 have claims with a diagnosis suggesting hypertension
• 98 individuals have claims with a diagnosis suggesting being at risk of a heart attack
21Proprietary & Confidential
N = 1,750 Mfg Firm
Employee Perception of Health
29%
59%
10% 1% 0%
Self reported Status of Health
Great
Good
Average
Below Average
Poor
33%
37%
18%
8%4%
Biometric Results
Ideal (85+)
Low (71-84)
Moderate (61-70)
High (51-60)
Very High (<=50)
88% of participants self-reported a good or great health status
70% of participants scored a 71 or higher (ideal or low level of risk)
1% of participants self reported a below average or poor health status
12% of participants scored a 60 or below (high or very high risk)
22Proprietary & Confidential
Claims Experience Correlated to Health Score
7/8/2012 Proprietary & Confidential 23
$4,229.58
$6,391.89
$7,826.56
$10,214.99
$-
$2,000.00
$4,000.00
$6,000.00
$8,000.00
$10,000.00
$12,000.00
Ideal (85+) Low Risk (71-84) Moderate Risk (61-70) High/ Very High Risk(<60)
Paid Claims
Overall Health Score – Repeat Participants
ABC Company
Participants who took HRA in 2010 AND 2011
General Statistics
2010 2011 Variance
Population 491 491 N/A
Average Score Increase/Decrease/No Change from Year 2 to Year 3
Average 81.1 83.1 2.0 2010 Range Increase Decrease No Change Total
St Dev 12.3 12.2 0.1 96+ 2.2 (4.8) NA (1.7)
95-90 3.9 (5.1) NA (0.3)
Overall Score Distribution 89-80 6.2 (6.6) NA 1.8
96+ 54 84 30 79-70 8.4 (6.8) NA 3.0
95-90 91 99 8 69-60 9.8 (4.3) NA 4.8
89-80 148 138 (10) 59-50 11.5 (5.4) NA 7.5
79-70 106 95 (11) <50 11.7 (3.0) NA 8.0
69-60 61 57 (4) Grand Total 7.0 (5.7) NA 2.0
59-50 27 14 (13)
<50 4 4 0
Total 491 491 0
Increase/Decrease/No Change from Year 1 to Year 2
2010 Range Increase Decrease No Change Total 2010 Range Increase Decrease No Change Total
96+ 18 27 9 54 96+ 33.3% 50.0% 16.7% 100.0%
95-90 42 38 11 91 95-90 46.2% 41.8% 12.1% 100.0%
89-80 93 48 7 148 89-80 62.8% 32.4% 4.7% 100.0%
79-70 64 32 10 106 79-70 60.4% 30.2% 9.4% 100.0%
69-60 37 16 8 61 69-60 60.7% 26.2% 13.1% 100.0%
59-50 20 5 2 27 59-50 74.1% 18.5% 7.4% 100.0%
<50 3 1 0 4 <50 75.0% 25.0% 0.0% 100.0%
Grand Total 277 167 47 491 Total 56.4% 34.0% 9.6% 100.0%
7/8/2012 Proprietary & Confidential 24
Case Study – Partial Union Environment
• Medical and drug costs have actually decreased on a per employee and per member basis over the last five years.
• If medical plan costs had increased at rate of 8% per year since 2007-08, ABC Company premiums would be $7.24 million dollars higher than today. Total Wellness investment less than $1m in same period.
Plan YearPlan Costs/Premiums per Covered
Employee
2007-2008 $8,852
2008-2009 $9,054
2009-2010 $8,365
2010-2011 $8,967
2011-2012 $8,823
25Proprietary & Confidential
Case Study – Partial Union Environment
Of the 612 repeat participants between 2010 and 2011, the overall average health score increased from 72.6 to 76.6. There was an improvement in health score in almost every risk category (with the exception of those scoring over 96).
Overall blood pressure for these same participants decreased, as did the overall cholesterol levels.
Of the 40 people who were at extremely high risk for blood pressure in 2010, 30 moved to be at moderate, low, or ideal categories.
Of the 173 people with high or very high cholesterol risk, nearly 45% moved to moderate, low, or ideal categories.
The number of people with very high glucose levels fell 35%.
Typical Profile of New v. Repeat Participant
Biometric Profile 2011 ScoreAvg. BMI
Avg. Weight
Avg. Systolic
Avg. Diastolic
Avg. Total Cholesterol
Avg. Glucose
Nicotine POS
Repeat Participants 76.6 29.0 192.8 120.4 76.3 192.6 97.8 26%
First Time Participants 67.9 29.9 203.2 124.4 78.3 195.7 101.7 22%
26Proprietary & Confidential
Repeat Participation = Reduced Claims Expense
$5,000.00 $5,500.00 $6,000.00 $6,500.00 $7,000.00 $7,500.00 $8,000.00 $8,500.00
Non-participant/ HRA Only
1 HRA w/ biometrics
2 HRA w/ biometrics
3 HRA w/ biometrics
$8,132.47
$6,202.27
$5,838.68
$5,493.29
27Proprietary & Confidential
Large Financial Services Firm
Medical Trend Claims Analysis
$7,000.00
$7,500.00
$8,000.00
$8,500.00
$9,000.00
$9,500.00
$10,000.00
$10,500.00
$11,000.00
$11,500.00
2006 2007 2008 2009 2010
Cost per employee on plan Average for Industry
Expected Claims
HealthCheck360°implemented in 2008.
2007: Client’s trends increase exponentially
2008: HC360° Implemented
2010 actual claims demonstrated:
– Trend reduced to low single digits for two straight years
– $959,051 saving from expected trend
– $1,470,386 savings from industry average trend
28Proprietary & Confidential
Correlation to Health Score in Population
Average claims per HRA participant:
Year 1 – $7,057.57
Year 2 – $6,023.68
$-
$2,000.00
$4,000.00
$6,000.00
$8,000.00
$10,000.00
$12,000.00
85+ 71-84 61-70 51-60 50 or less
Score Correlation
Linear (2009) Linear (2010)
29Proprietary & Confidential
N = 1589
Biometrics and Medical Expense
$2,316
$2,973
$4,253
$2,000
$2,500
$3,000
$3,500
$4,000
$4,500
Ideal < 100 Moderate 100-125 High 126+
Glucose Level Correlation to Avg. Claims (medical claims only)
Avg. Claims Linear (Avg. Claims)
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
< 18 18-25 25-29 30-34 35-39 40+In
curr
ed
Me
dic
al C
laim
s
BMI
BMI Level Correlation to Avg. Claims (medical claims only)
30Proprietary & Confidential
Actual Results from HC360° Client Pool
Impact of Nicotine Use on Claims
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
18-29 30-39 40-49 50-59 60+
Nicotine Use Correlation to Avg. Claims (medical claims only)
NEG POS
31Proprietary & Confidential
N = 18,000
Impact of Health on WC Costs
Total
Total Score Counts Avg WC
<50 150 $875.76
50-59 206 $1,007.89
60-75 561 $771.36
76-85 342 $703.24
86+ 330 $366.25
Total 1,589 $713.09
N = 1,589
32Proprietary & Confidential
Wellness Circle of Success
Engage
• Meaningful Incentives
• Effective Communication
Identify
• Biometric Screening - Full Blood Panel
• Health Risk Assessment
Support
• Coaching for all Participants
• Program Integration
• MyHealthCheck360.com
Educate
• Individual Reporting
• Monthly Newsletter
• Targeted Communications
Measure
• Measure and Evaluate Results
• Executive/ Aggregate Reports
33Proprietary & Confidential
HealthCheck360° Key Features
1. Outcome Based, using objective, biometrics to detect risk
2. Clear-cut scoring and measurement model
3. Carrier Independent
4. Meaningful Incentives (Substantial, Understandable)
5. Full spectrum support for positive behavior change (Health Coaching, Engagement Tools, Educational Resources)
6. Measured Results and Analysis
34Proprietary & Confidential
Presented By:Jim Wachtel
National Sales Director
563-289-7360