1 health management a mandatory business practice presented by erick hathorn, health management...
TRANSCRIPT
1
Health Management
A Mandatory Business Practice
Presented byErick Hathorn, Health Management
Practice Leader
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Today’s Agenda
• Why Wellness• Today’s Reality • Healthcare is Changing• Gallagher Health Management
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Every 100 Employees
• 68 are overweight or obese• 21 smoke• 31 use alcohol excessively• 20 don’t wear seatbelts• 24 don’t exercise• 25 have cardiovascular disease• 12 are asthmatic• 10 are diabetic• 26 have high blood pressure• 30 have high cholesterol• 4 suffer from stress
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The Facts• Heart Disease Costs Employers $18,618 PEPY
• $5,617 Healthcare Plan• $6,052 Sick Leave• $4,845 STD• $981 Workers Comp.• $945 Unpaid Leave• $178 LTD
• Smoking Costs Employers $5,318 PEPY • $2,295 Excess Medical Expense• $2,175 Smoke breaks• $465 Absenteeism• $206 Death• $176 Workers Comp.
• Diabetes Costs Employers $11,744 PEPY More
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Obesity is an Epidemic
• 68% of the American population is either overweight or obese• Obese Employees are 4x more likely to be absent from work• Obese Employees pay
• 77% more in RX • 36% more at Physicians • 45% more for hospital stays
OUCH!
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1999
Obesity Trends* Among U.S. Adults1990, 1999, 2009
2009
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
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Healthcare is the second largest business expense to most organizations
87% of corporate leaders listed rising healthcare costs as their #1 concern
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Industry Misconceptions
• Wellness – Wellness is not screening your employees, its helping them make better health decisions
• Engagement – Engagement is the value proposition between the company and employee
• Return On Investment – There is no such thing as a like company. There are over 50 different variable to consider.
• Budget – Wellness programs are expensive
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How the Industry has Managed Rising Healthcare Costs
Increased Employee
ContributionsDecreased Benefits
Switched Carriers
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The Total Impact of Health
Productivity Costs
PresenteeismAbsenteeismLTDSTDOvertimeTurnoverTemp StaffingAdministrativeReplacementRetention
25% of Cost
75% of Cost
Medical Health Costs
• Medical Care• Pharmacy
$3,376 PEPY
$10,128 PEPY
Keep the Healthy, Healthy
Claims Continuum
5%
20%
75%
Contributing Factors:• Aging Population• Obesity• Inactivity• Stress• Smoking
50% of claims cost ---
Chronic Condition
Chronic Disease
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The Evolution of Health Management
1930’sRisk Management
1970’sDisease Management
1990’sWellness
2010’sEnterprise Health Management
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From Disease & Cost, to Health & Investment
Enterprise Health
Management
Wellness Disease Management
Care Management
RxHealth
AdvocacyBehavioral &
Clinical Coaching
Culture & Environment
Absenteeism &
Presenteeism
Behavioral Health
Onsite Medical
Communications
Benefit Plan Design &
Incentives
Aligning Your Company Vision With That of Your Employees
A Shift In Thinking
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Zero Trend Healthcare
Breaking Down Barriers & Driving Engagement
• Incentives Lead to
participation1st
• Participation Leads to Employee Engagement
2nd•Engagement Leads to a Cultural Shift
3rd
• A Cultural Shift Plus Empowered Employees Leads to Trend Reductions
4th
Wellness is not finding out what’s wrong; its fixing what’s wrong.
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Incentives Lead to Engagement
Contribution Premium Differential (Incentive/Disincentive)
Eligibility• Participation on Insurance• Participation on Richer Plan
Plan Design• Diabetes Plan Design• Waiver of Deductible/Coinsurance
Rewards—Gift Cards or Prizes
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Healthcare Reform & Legislation
20% Employee Premium
Differential for Attainment
201430% Employee
Premium Differential for
Attainment
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Keys to Success
• Communication Strategy• The Assessment – Strive to Maximize
Participation• The Fix – Four key behavioral change
components
Weight Management Physical Activity Stress Management Tobacco
• Coaching – Clinical & Behavioral• Integration – Wellness and Disease
Management
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The Science of Engagement
Stages of Behavior Change
CommunicationFocus Communications Activities and Resources
Pre-contemplation Capturing participant attention
• Ongoing promotion of Healthy Enterprise components through postcards, newsletters, annual enrollment communications, Web site features, etc.
• Promotion of program incentives to drive initial entry into program (e.g. via health risk assessment)
Contemplation Relating to the participant and his/her needs
• Health risk assessment follow-up communications with clearly identified next steps and actions
• Promote preventive care benefits
Preparation Education • Connecting the participant with information regarding programs that target his/her condition – or lifestyle-specific needs
Action Support • Connecting the participant to lifestyle coaching or disease management resources
• Explanation of how the benefits program supports participant’s health needs
Maintenance Engagement and sponsorship
• Recognition and promotion of participant success stories (via testimonial)
• Check-in communication with the participant at regular intervals