Roadmap to a Partnership

Kalispell School District

December 8, 2010

About New West

Established in 1998• Provider Sponsored – Montana Based• Quality Focused• Approximately 41,000 covered lives• Current Accounts

• Federal Employees• University System of Montana• State of Montana Employees• CMS Approved (Medicare Advantage)• Over 500 Employers

• Financially Sound

Vision Statement

We Believe in Simplifying Healthcare

Change In How We Measure Value• From health as the absence of disease to health

as vitality and energy.• From focusing on the cost of health care to the

total value of health; most current health care reform proposals mistakenly focus on the costs of coverage (and who pays this cost).

• From individual participation to population engagement.

• From behavior change to creating a culture of health. Even if a few individuals change behaviors, the gains will not be sustained if they return to the same culture.

Integrated Strategy

New West Member

Employer

Providers

EmployeeAgent/Broker

New West

What does the customer get?

• Lower premium• Better access to quality health care• Better health leading to more predictable

future premiums• Less frustration and anxiety about

coverage• Right information at the right time• Problems solved quickly and effectively

Employee Satisfaction

• Claim Payment Accuracy – over 98% YTD

• Claims paid within 13 days on average

Commercial Business (Goals) Week Ending

11/05/10

Nov 2010 Month to

Date

Previous Month

2010Year to Date

ACD Calls N/A 1,513 1,513 5,752 60,938Average Speed to Answer

:30 0:33 0:33 0:32 0:45

Abandoned Calls 3%

1.5%(23 Calls)

1.5%(23 Calls)

2.4%(136 Calls)

3.2%(1,926 Calls)

Average Abandon

TimeN/A 1:21 1:21 1:20 1:41

New West Health Services “The Plan”

Long Term Strategy

• H.S.A. concepts• Access to an online portal

– View and pay claims online– Estimate the cost of medical services– Manage healthcare spending

• A state-of-the-art wellness program with a proven track record– Participation incentives and rewards– Benchmarks

Prevention

• New West believes in quality and affordable health care and we focus on prevention and wellness for our valued members

– Well child covered at 100%– Immunizations covered at 100%– Breast cancer screening covered at 100%– Cervical cancer screening covered at 100%– Colorectal cancer screening covered up to $1,300– Prostate cancer screening covered at 100%– Cholesterol and Lipid disorder screening covered at 100%– One yearly vision screening exam for a $10 copay

Medical Services

• Utilization Review – smart use of appropriate services within benefit plans = cost containment

• Case Management – Registered Nurses to help problem solve and identify options

• Transition of Care – temporary out of network use• Happy to serve as your advocates

Network Access

• Montana Network – Provider Search - Results | New West Health Services

• National Physician and Facility Participation– Beech Street – Beech Street Corporation– For use while traveling out of state– For use when the services are not available in MT

H.S.A. Concept• Dual Option provides choice for employees• Employer contribution can drive behavior• Employees and employers save money on

premiums• Employees can invest what they save• Reduces utilization• Employees become empowered to make

informed purchasing decisions• No use-it-or-lose-it and portability

Wellness• MyNewWest

• Fully integrated online portal• Comprehensive content and tools• Online Health Assessment• Interactive health coaching• Personal health record• Incentives and rewards• Nutrition, fitness, weight loss, stress, diabetes, heart

health and smoking cessation modules

Introducing

Plan Designs• Guardian $500

• $500/$1,000 Deductible• $2,000/$4,000 Maximum Out of Pocket• 80/20 Coinsurance• $20/40/60 Co-payment for pharmacy• $500 First dollar coverage for in-network urgent care

visits and office visits

Plan Designs• High Deductible Health Plan

• $3,000/$6,000 Embedded Deductible• $3,000/$6,000 Maximum Out of Pocket• 100/0 Coinsurance• $500 Preventive Endorsement• Well Child Care paid at 100% through age 7• Health Savings Account eligible• Integrated Pharmacy Benefit

Plan Summary• New West Health Services:

• Provides Kalispell School District with a wellness solution that is measurable

• Provides top of the line preventive and wellness benefits• Provides employees with a member portal to manage

their medical spending• Provides employees with a secure, robust wellness

portal to help employees manage their health• Provides stable pricing, reporting management software

and true cost management

Rapid Implementation• New West Health Services:

• Establish a timeline• Determine employee enrollment meetings• Provide enrollment packets and training• Meet individually with folks undergoing current care• Electronic enrollment is possible pending data available:

• Current membership report• Payroll records (SSN, contact info, etc.)• Current billing statement and 12 months prior

• The New West Rapid Implementation Team!

“Believe” in the right choice for Montana!

NORTHERN MONTANA

Hospital

Roadmap to a Partnership

Kalispell School District December 8, 2010