king county employee health and well being program
DESCRIPTION
2012 State of Reform Health Policy Conference January 4, 2012. King County Employee Health and Well Being Program. Overview of King County Employee Health and Well-Being Program Results/Program Effects Lessons Learned Next Steps. Agenda. Strategy. Supply Side : - PowerPoint PPT PresentationTRANSCRIPT
KING COUNTY EMPLOYEE HEALTH AND WELL BEING PROGRAM
2012 State of Reform Health Policy ConferenceJanuary 4, 2012
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AGENDA
Overview of King County Employee Health and Well-Being Program
Results/Program Effects Lessons Learned Next Steps
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STRATEGYSupply Side: •Work with Puget Sound Health Alliance (PSHA) to improve quality of care, pay for value
Demand Side: •Improve employee health•Increase employee health consumer skills
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Employers, physicians, hospitals, patients,health plans working together to measure and report
Best Care + Least Waste
SUPPLY SIDE
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DEMAND SIDE--Healthy IncentivesSM Improve employee health
Healthy Incentives program—annual wellness assessment and individual action plan
Worksite health promotion—Eat Smart, Move More, Stress Less
Increase employee health consumer skills Own Your Health Campaign Community Checkup Report on provider
quality
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Comparison of original Gold, Silver and Bronze Member Out-of-Pocket Expenses
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Item KingCareSM Gold 2006-2009
KingCareSM Gold 2010-2012
Group Health Gold2010-2012
(No Change from 2009)
Deductible (medical) $100 per individual$300 per family
$300 per individual$900 per family None
Coinsurance (medical) 90% In network 70% Out-of-network
85% In network 65% Out-of-network $20 copay for office visits
Annual out-of-pocket maximum for member coinsurance (medical)
In network services$800 per individual$1,600 per familyOut-of-network services$1,600 per individual$3,200 per family
No change from 2009In network services$800 per individual$1,600 per familyOut-of-network services$1,600 per individual$3,200 per family
$1,000/ individual$2,000/family
Prescription drug copays (at pharmacy)
$10 generic drugs$15 preferred brand $25 non-preferred brand
$7 generic drugs$30 preferred brand $60 non-preferred brand
$10 generic drugs$15 preferred brand $25 non-preferred brand
New Out-of-Pocket Expense Levels in 2010
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WORKSITE WELLNESS Health Matters website Health Matters Newsletter Health Promotion Leadership Team
Leadership Forums Annual surveys/focus groups
Employees and s/partners
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WORKSITE WELLNESS Gym discount program Live Well Challenge Weight Watchers at Work Farmer’s market Farm to Work fresh produce delivery Employee Demonstration/Giving Garden Healthy vending Choose well consumer education/Own Your Health
campaign Flu shots Health Heroes Lunch and Learn sessions on timely topics
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Employees Improved 12 out of 14 health risk factors.
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0.0%2.0%4.0%6.0%8.0%
10.0%12.0%
11.0%
6.2%
Average Annual Growth Rate of Medical and Prescription Expenditures per Member, 2001-
2005 & 2006-2010
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2007 2008 2009 2010 2011 2012$0
$50,000,000
$100,000,000
$150,000,000
$200,000,000
$250,000,000
$300,000,000
Actual Total Exp.Actuary's 2011 3-Yr Financial PlanActuary's 2012 3-Yr Financial Plan
Based on results in medical and prescription drug claims in 2010 and early 2011, King County was able to reduce the overall Employee Benefits Budget projections for 2011 by $23 and 2012 by $38M.
King County Benefits Cost Actual vs. Budget Projections 2010-2012
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2007 2008 2009 2010 2011 2012$0
$200$400$600$800
$1,000$1,200$1,400$1,600$1,800
King County Benefits Cost 2010-2012Actual vs. Budget Projections Per Employee
Per Month
Actual PEPMActuary's 2011 PEPMActuary's 2012 PEPM
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Out-of-Pocket Employer Total$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
$1,309
$11,819$13,128
$517
$7,504 $8,021
King Care Group Health
Group Health HMO Costs 37% Less Than KingCare SM PPO per Employee
per Year
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No significant difference in the age, gender, education level, smoking, body mass, ethnicity, salary or general health status between members in Group Health and KingCareSM
Group Health provides the most fully integrated staff model health care in the Seattle metropolitan area
Analysis shows less use of brand name drugs, surgery,
diagnostic radiation and other preference sensitive treatments in Group Health compared to providers in the KingCare SM plan
More Information on Group Health Compared to KingCareSM for the King
County Employee Population
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Healthy IncentivesSM Participants Lost More
Weight Than a Comparison Group
2006 2007 2008 2009 2010 201127.227.327.427.527.627.727.827.928.028.128.2
Healthy IncentivesSM 5-year CohortHealthy IncentivesSM 5-year Cohort
Body
Mas
s In
dex
(BM
I)
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Weight Loss by Obese Members
≥ 5% Weight Loss ≥ 10% Weight Loss0%
5%
10%
15%
20%
25%
30%
35%
40%
MEPS 1-yr KC 1st-yr KC 5-yr
% o
f Obe
se C
ohor
t
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Women Benefit More Than Men 20-Somethings Don’t Benefit At All African-Americans Benefit the Most College Graduates Benefit Less
Healthy IncentivesSM successfully managed weight for King County employees, spouses and partners
This is the first study to find significant benefits for a large percentage of employees over a multi-year period
Impact On Obesity
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LESSONS LEARNED Partnership with Labor is essential Engaged Leadership is critical Most effective strategy for moderating
costs requires 3-part focus Supply—Improve quality, reduce waste Demand—better health, smarter
consumers Plan design that rewards both providers
and patients to “do the right thing.”
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NEXT STEPS New benefit plan RFP for new wellness vendor Work with the Puget Sound Health Alliance,
Washington State and other partners to improve quality/reduce waste in healthcare “Whether it’s the employee or the employer,
it doesn’t matter who gets stuck with the bill if the bill itself is growing exponentially.”
King County Executive, Dow Constantine
Continue to engage Leadership Study causes for reduced PEPM costs 2005-2012
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FOR MORE INFORMATION Programs: http://
kingcounty.gov/employees/HealthMatters.aspx Toolkit: http://
kingcounty.gov/employees/HealthMatters/Visitors/HRIToolkit.aspx
Contacts: Karleen Sakumoto, Manager, Employee Health and Well-
Being, Human Resources Division, Department of Executive Services, [email protected]
John Scoggins, Health Care Economist, Office of Performance, Strategy and Budget, [email protected]