Overview

•Health Statistics

•ACA Framework for wellness

•Employer Strategies

•Wellness Bill and California Climate

U.S. Healthcare Facts

•While 70% of healthcare costs are preventable, only 1% of healthcare costs are invested in prevention & wellness.

•U.S. accounts for only 5% of the world’s population yet we consume 1/2 of all the prescription drugs manufactured world wide!

•Nearly one-third (31%) of us are clinically obese (body mass index of 30% or more).

Obesity leads to lots of ills, from heart attacks, strokes and diabetes. The annual costs for treating diabetes alone exceed $200 billion.

Obesity Trends* Among U.S. AdultsBRFSS, 1985

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

BRFSS, Behavioral Risk Factor Surveillance System http: //www.cdc.gov/brfss

Obesity Trends* Among U.S. AdultsBRFSS, 1990

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14%

Obesity Trends* Among U.S. AdultsBRFSS, 1995

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. AdultsBRFSS, 2000

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% ≥20%

Obesity Trends* Among U.S. AdultsBRFSS, 2005

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Obesity Trends* Among U.S. AdultsBRFSS, 2008

(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

Framework

• Health Insurance/Wellness Copays• http://www.healthcare.gov/prevention/index.

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• Provider Reimbursements

• Spurring innovation

Startup Incubators & Open Data Initiatives

Quantify self New EMR

Provider/Patient R/shipsSelf-DiagnosisMental Health

Enhanced Care DeliveryGet in shape

FoodQ&A

Find/Rate a DoctorPaying Bills

Cost TransparencyClinical Trials

Children

• healthdatapalooza.org• hhs.gov/digitalstrategy/open-data

Employer strategies (small business <50)

• Tiered contribution structures tied to:• Financial (or other) incentives

• Annual physical exam• Biometric screening

• Team contests;• Walk-a-thons

• Healthy Snacks

Wellness in California Insurance Market

• Rating (providing discounts) for smokers vs. non-smokers (allowed in ACA) was disallowed in California under AB 1083 last year.

• SB 189 (Monning) in Senate Health committee review now will greatly restrict wellness initiatives allowed by Federal ACA.

• Good intentions: avoid discrimination• Bad law: wrong approach