Bon Secours Virginia Creating a Culture of Wellness

2012

Today’s Discussion

– Creating a Culture of Wellness

– Personal Health Assessment Results

– Becoming Accountable for Our Care

– Employee Wellness Strategies

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Program Guiding Principals

1. Create a culture of Wellness and Wellbeing that empowers employees to make healthier choices at home and at work

2. Decrease healthcare costs through prevention, wellness and interventions

3. Provide programs and services to motivate employees to make life-long behavioral changes.

4. Collect and analyze data to develop, support and maintain program design and optimal results.

5. Decrease controllable risk factors.

By coordinating and centralizing the care of employees, companies can take control of medical costs and tailor services to meet employees needs.

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$176.2

$195.6

$217.1

$241.0

$158.7

$210.1

$180.1

$194.5

$143.0

$182.5

$173.8

$165.5

$157.7

$125

$150

$175

$200

$225

$250

FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015

11.0% 8.0% 5.0%

$166.8

$150.2

• Value-Based Design• Patient-Centered

Medical Home• On Site Clinic• Total Health

Management• Integrated Health and

Disability • Best in Class Vendors• Decision Support/Data

Warehouse• Employee ACOT

RE

ND

Bon Secours trend reduction: $159M savings over 5 yearsEvery 1% reduction in trend saves average $5.5M per year 2011-2015

Ann

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High Cost of Poor Health

• HYPERTENSION: Hypertension is associated with a cost of $392 per employee per year. • DIABETES: Annually, an employee with diabetes will cost $13,243 on average, while an

employee without diabetes costs only $2,560 on average•

ASTHMA. Annual per capita employer expenditures for asthmatic patients is approximately 2.5 times those for control subjects ($5,385 vs. $2,121, respectively).

• The estimated direct cost of obesity to the medical plan for Bon Secours Virginia is:

• $5.3 Million or $1429/employee/year.

• Indirect costs are related to absenteeism and productivity loss.

• Research shows that as the weight of a worker increases, productivity decreases and absenteeism increases.

•

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Understanding our Challenges

• 20% of the employee population

drives 80% of current year cost

• Poor lifestyle choices drive 50% -70%

of health care cost

Determinants of Health

A Small % Drives CostPopulation Costs

Source: Institute for the Future, Centers for Disease Control and Prevention

A 1% reduction in employee utilization =

$750,000

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Personal Health Assessment Results

Personal Health Assessment (PHA)

• Prior to 2011 40% of employees participated in the PHA.

• Beginning in 2012 the PHA was aligned with the Health Plan and employees who did not participate paid $800.00 more per year for Health Insurance.

• Coupled with a strong incentive and an equally robust communication and branding strategy, in 2012 95% (12,350) of employees participated in the PHA process.

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PHA Participation and Risk Stratification Hampton Roads Richmond

Risk Category Count Percent Count Percent

Low Risk (0-2 Risks) 1221 42% 2738 44%

Moderate (3-4 Risks) 1043 36% 2048 33%

High (5+ Risks) 663 23% 1378 22%

PHA Participation 2927 89.2% 6073 95%

Average # Risk Factors 3.10 3.02

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Top 8 Controllable Risks

Overweight (BMI >27.5) 55%Sedentary Lifestyle 48%Hypertension 35%High Cholesterol 36%Low HDL Cholesterol 17%High Stress 17%Low Job Satisfaction 15%Low Life Satisfaction 11%

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Becoming Accountable for Our CareBuilding an Employee ACO for

Bon Secours Virginia Health System

ACO Program Description

The ACO pilot targets the highest risk employee population in Bon

Secours Virginia. This program is strictly voluntary and operates outside

the BSHSI benefit plan. In order to attract and retain a significant number

of this targeted group, it is necessary to offer financial incentives. The

incentives are paid out over the course of the program as the employees

reach clinical and lifestyle change milestones. Each employee who

participates in the program will be assigned a Good Health Navigator at

InHealth. The Navigator is responsible for establishing goals and tracking

progress made throughout the course of the ACO program.

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Management of High Risk

• Partner with high risk employees to support changes in lifestyle and

navigate to a Medical Home

• Telephonic Health Coaching

• Goal oriented and incentive based.

• Confidential and Voluntary

– Diabetes

– Hypertension

– Asthma

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Early Results

% w/Decreased A1C 64%% w/Decreased BMI 75%

ACO Diabetes Program Statistics for Enrolled Employees

% w/Decreased BMI 56%

ACO Hypertension Program Statistics for Enrolled Employees

Employee Wellness Focus2012

Moderate Risk

High Risk

Communication Web-based information Targeted messaging and emails

reminders of prevention screenings and disease prevention

Weekly wellness tips and Bimonthly Good Life Newsletter

Incentive Program Complete the PHA and Wellness plan Complete all age related

recommended screenings. Examples: Physical with PCP, Annual Mammogram (or baseline for women 35-40) and Pap for women or Prostate Exam and PSA for men

Complete Self-care workshop and complete personal health record for future visits to PCP

 

Same as low risk plusCommunication

• Quarterly tailored messages, email and home mailing on specific risks such as hypertension.

Incentive Program• Group Coaching (Healthy Weigh,

Compass to the Good Life)• Complete 1-2 coaching Sessions

either in person or telephonic • Complete 2 Healthstream/Webinars

based on wellness goals 

Same as low risk plusCommunication

• Invitational letter from EWS mailed to home with a follow up phone call from CENVANET to those who have not responded.

Incentive Program• If Diabetic, Hypertensive, Asthma or Back (Ortho)

complete 6 coaching sessions with CENVAT for disease and medication management or enroll into disease management program such as DTC or Cardiac Wellness.

• Other high risk employees not identified in the 4 groups above will work with the nurse navigator

Weight Management: Referral into weight loss program based on BMI

Physical Activity

If you are Diabetic and/or Hypertension, Group exercise classes made available

Physical ActivityIf you are Diabetic and/or Hypertension, Physical assessment and group training sessions available over a 3 month period then a reevaluation.

Physical Activity

Bon Secours Virginia Employee Wellness Model of Care

Tobacco Cessation: Quitline or Freshstart in person class

SeIf-Care/Mental Health

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2012 Targeted Wellness Programs

Accountable Care Interventions• Driving employees to Primary Care

Physicians• Patient Navigators Targeting High Risk

Good Health Clinic• Episodic care and case management

of High Risk

Healthy Eating and Foods• Nutrition Education• Revamping Cafeterias and Vending

Self Care Initiative• Take Charge of Your Health• Get a Doc and Get a Physical

Campaign

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2012 Targeted Wellness Programs

Physical Activity• Get Moving campaign• Stairwell campaign • Commit to Get Fit Campaign• Team Lean – “Biggest Loser”

Competition• Walking paths• Fitness challenges• Onsite group exercise classes• Fitness Center Discounts

Weight Management and Nutrition• Healthy Weigh webinar based lifestyle

modification• Medical Weight Loss Pilot• Weight Watchers at WorkTobacco Cessation• Reinforcement of tobacco free

campus • Freshstart classes (1:1, web based,

telephonic, group)

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Good Results

Participation FY12

3,070 pounds lost

87 quit smoking

251 joined fitness classes

112, 507 Wellness Website log ons

1,121 participated with a Wellness Coach

fy11 vs. fy12

Good Results fy11 vs. fy12

• Bon Secours Richmond’s Personal Health Assessment (PHA) participants experienced a 12.10 % ↓ in medical claims while non-participants experienced a 14.80 % ↑. The total cost avoidance equals $1.5 million.

• Health insurance rates have ↓ $10 per employee per month.

• Participants in the Bon Secours Richmond Good Life Wellness Program showed a 43% ↓ in “Controllable Risk Factors” for a net reduction in medical claims of $1 million.

• Sedentary lifestyle ↓ from 41.9 % to 38.4 %.

• Average number of risk factors ↓ from 2.46 to 2.3 per employee.

• Productivity ↑ by 26 % by targeting those medical conditions most affecting the work force such as migraine headaches, allergies and musculoskeletal pain.