driving down health care costs with corporate health centers cajpa conference september 16, 2015...

Driving Down Health Care Costs with Driving Down Health Care Costs with Corporate Corporate Health Health CentersCenters

CAJPA ConferenceSeptember 16, 2015

David Zanze, President

Pinnacle Claims Management, Inc. 1

Today’s Agenda

The Cost of Poor Health of EmployeesThe Evolution of Corporate Health Centers and the Benefits for Both Employers and EmployeesSetting Up Your Health CenterSuccessful Case StudiesEnsuring High Utilization of Your Center Next StepsQ&A

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Average Family Premium is $16,834 per year – up 3 percent from last

year **

Why are Health Care Costs Still Going Up?

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**Source: Kaiser Family Foundation 2014 Employer Health Benefits Survey

Employees’ Poor Health is Costing the U.S. Economy $576 Billion a Year

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Source: Based on landmark employee productivity survey conducted by the Integrated Business Institute, a non-profit group. Statistics were drawn using data from the U.S. Bureau of Labor and the institute’s benchmarking data based on 60,000 U.S. employers.

$227 billion on lost productivity$117 billion from absences due to illness, workers compensation and

short and long-term disability

$232 billion from medical treatment and pharmacy-

related costs

Employee Productivity Levels Affected by Habits

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• Employees with an unhealthy diet were 66% more likely to have a loss of productivity compared to healthy eaters.

• Employees who rarely ate fruits or vegetables were 93% more likely to have a higher loss of productivity.

• Employees who had difficulty exercising during the day were 96% more likely to experience a loss of productivity.

• Unhealthy habits were found to have the most impact on employees between 30-40 years old.

Source: Based on a survey of 20,000 employees conducted by Brigham Young University and published in the academic journal, Population Health Management.

What Do Chronic Conditions Cost Us?

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Chronic Condition Absenteeism cost per employee with condition

How Many People in the United States it Affects Annually

COPD $9,823 12 million diagnosed

Coronary heart disease $7,963 375,000 die from it

Diabetes $7,900 29.1 million (9.3% of population)

Congestive heart failure $7,262 670,000 diagnosed

Depression $3,682 One in 10 diagnosed

Anxiety $2,382 40 million adults 18 and older (18% of population)

Chronic Insomnia $2,280 40 million

Obesity $1,429 78.6 million or 34.9% of adults

Irritable bowel disorder $1,147 25-45 million (10-15% of population)

Implementing Wellness Initiatives to Help Manage Health Care Costs

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• Health risk assessments and biometric screenings

• Discounts to local gyms and weight loss programs

• Wellness programs including stress management, smoking cessation and walking clubs

• Chronic disease management

• Onsite corporate health centers

Who is Offering Wellness Programs?According to Kaiser Family Foundation 2014 Annual Employer Health Benefits Survey:

•Nearly a third of employers who offer health benefits offer a health risk assessment but few make it a requirement to join program. 51% of large employers (200+) are more likely to ask for a risk assessment compared to 32% of small employers. •Among large firms that offer a risk assessment, 51% report providing a financial incentive to employees to complete it.•51% of large firms and 26% of smaller offer biometric screenings.•Virtually all large employers and most small employers offer at least one wellness program.

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Economic Benefits of Preventing Disease

• Those who increased their physical activity (2 ½ hours a week) and lost 5-7% of their weight reduced risk of type 2 diabetes by 58%

• By reducing the average population’s sodium intake to 2,300 milligrams per day, we could save $18 billion in health costs annually

• For a 1% reduction in weight, blood pressure, glucose and cholesterol risk factors, we would save $83 to $103 in medical costs per person annually.

• By increasing the use of preventive services to 90% of the recommended levels, we could save $3.7 billion annually in medical costs

Source: Surgeon General’s National Prevention Strategy.

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Implementing a corporate onsite or near-site health and wellness center (aka health care clinic) can be an effective tool in driving health care costs down.

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Why are Onsite Health Care Centers Popular Again and Part of a Winning Strategy?

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They Started as Onsite Occupational Clinics

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Today’s Corporate Health Centers

Modern Day Health Centers Look at an Modern Day Health Centers Look at an Employee’s Whole Health – Not Just One PartEmployee’s Whole Health – Not Just One Part

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On-Site Health Center Services Offered

Traditional Services

• Traditional occupational health services/worksite injuries

• Primary and urgent care needs

• Promote health and wellness programs

• Employee Assistance Program, mental health triage

Newer type services

• Referrals to quality specialists and physicians when needed

• Provide health coaching and care management

• Dispense commonly prescribed Rx medications

• Telemedicine • Visits to clinic from medical

professionals

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Helping Employees Be Compliant with Medications is One of Many Potential

Benefits for Employers

Many Potential Benefits for Employees

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Success Case Study #1

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Success Case Study #2

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Success Case Study #3

Setting Up Your Health Care Center

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Questions to Ask Yourself

Setting Up Your Health Care Center

• Affordable Care Act (ACA)• Employee Retirement Income Security Act

(ERISA)• Consolidated Omnibus Budget

Reconciliation (COBRA)• Health Insurance Portability and

Accountability Act (HIPAA)• Americans with Disability Act (ADA)• Genetic Information Nondiscrimination Act• State Laws

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Legal Considerations

Setting Up Your Health Care Center

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Factors in Measuring a Center’s Effectiveness

Setting Up Your Health Care Center

StaffingServices offeredBuilding costsOutside vendor costs

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Set Up Costs

Cost savings from fewer visits to emergency room Reduced employee absenteeism due to less time away when

employees receive earlier treatment of illnesses or injuries Cost savings –price tag for visiting a health care center is lower

than a traditional doctor visit Improved retention of employees Healthier employees means overall less costs in health care

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Setting Up Your Health Care Center

What to Consider when Measuring your Return on Investment

Ensuring High Utilization of Your Center

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Ensuring High Utilization of Your Center

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Provide Incentives

Ensuring High Utilization of Your Center

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Provide Frequent Communication

What Are Your Next Steps?

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Questions?

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