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Health Management

A Mandatory Business Practice

Presented byErick Hathorn, Health Management

Practice Leader

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Today’s Agenda

• Why Wellness• Today’s Reality • Healthcare is Changing• Gallagher Health Management

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Every 100 Employees

• 68 are overweight or obese• 21 smoke• 31 use alcohol excessively• 20 don’t wear seatbelts• 24 don’t exercise• 25 have cardiovascular disease• 12 are asthmatic• 10 are diabetic• 26 have high blood pressure• 30 have high cholesterol• 4 suffer from stress

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The Facts• Heart Disease Costs Employers $18,618 PEPY

• $5,617 Healthcare Plan• $6,052 Sick Leave• $4,845 STD• $981 Workers Comp.• $945 Unpaid Leave• $178 LTD

• Smoking Costs Employers $5,318 PEPY • $2,295 Excess Medical Expense• $2,175 Smoke breaks• $465 Absenteeism• $206 Death• $176 Workers Comp.

• Diabetes Costs Employers $11,744 PEPY More

Cost Reality

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Obesity is an Epidemic

• 68% of the American population is either overweight or obese• Obese Employees are 4x more likely to be absent from work• Obese Employees pay

• 77% more in RX • 36% more at Physicians • 45% more for hospital stays

OUCH!

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1999

Obesity Trends* Among U.S. Adults1990, 1999, 2009

2009

1990

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

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High Claims & Body Weight

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High Claims & Inactivity

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Today’s Reality

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Healthcare is the second largest business expense to most organizations

87% of corporate leaders listed rising healthcare costs as their #1 concern

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Industry Misconceptions

• Wellness – Wellness is not screening your employees, its helping them make better health decisions

• Engagement – Engagement is the value proposition between the company and employee

• Return On Investment – There is no such thing as a like company. There are over 50 different variable to consider.

• Budget – Wellness programs are expensive

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Why Healthcare Costs Continue To Rise

AdministrativeInflation TechnologySedentary

Society

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How the Industry has Managed Rising Healthcare Costs

Increased Employee

ContributionsDecreased Benefits

Switched Carriers

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Healthcare is becoming a question of Sustainability

10% Trend

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The Total Impact of Health

Productivity Costs

PresenteeismAbsenteeismLTDSTDOvertimeTurnoverTemp StaffingAdministrativeReplacementRetention

25% of Cost

75% of Cost

Medical Health Costs

• Medical Care• Pharmacy

$3,376 PEPY

$10,128 PEPY

Keep the Healthy, Healthy

Claims Continuum

5%

20%

75%

Contributing Factors:• Aging Population• Obesity• Inactivity• Stress• Smoking

50% of claims cost ---

Chronic Condition

Chronic Disease

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Healthcare is Changing

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The Evolution of Health Management

1930’sRisk Management

1970’sDisease Management

1990’sWellness

2010’sEnterprise Health Management

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From Disease & Cost, to Health & Investment

Enterprise Health

Management

Wellness Disease Management

Care Management

RxHealth

AdvocacyBehavioral &

Clinical Coaching

Culture & Environment

Absenteeism &

Presenteeism

Behavioral Health

Onsite Medical

Communications

Benefit Plan Design &

Incentives

Aligning Your Company Vision With That of Your Employees

A Shift In Thinking

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Zero Trend Healthcare

Breaking Down Barriers & Driving Engagement

• Incentives Lead to

participation1st

• Participation Leads to Employee Engagement

2nd•Engagement Leads to a Cultural Shift

3rd

• A Cultural Shift Plus Empowered Employees Leads to Trend Reductions

4th

Wellness is not finding out what’s wrong; its fixing what’s wrong.

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Incentives Lead to Engagement

Contribution Premium Differential (Incentive/Disincentive)

Eligibility• Participation on Insurance• Participation on Richer Plan

Plan Design• Diabetes Plan Design• Waiver of Deductible/Coinsurance

Rewards—Gift Cards or Prizes

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Healthcare Reform & Legislation

20% Employee Premium

Differential for Attainment

201430% Employee

Premium Differential for

Attainment

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Keys to Success

• Communication Strategy• The Assessment – Strive to Maximize

Participation• The Fix – Four key behavioral change

components

Weight Management Physical Activity Stress Management Tobacco

• Coaching – Clinical & Behavioral• Integration – Wellness and Disease

Management

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Gallagher Health Management

Exclusive Prepared By

Wellness starts with Communication

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The Science of Engagement

Stages of Behavior Change

CommunicationFocus Communications Activities and Resources

Pre-contemplation Capturing participant attention

• Ongoing promotion of Healthy Enterprise components through postcards, newsletters, annual enrollment communications, Web site features, etc.

• Promotion of program incentives to drive initial entry into program (e.g. via health risk assessment)

Contemplation Relating to the participant and his/her needs

• Health risk assessment follow-up communications with clearly identified next steps and actions

• Promote preventive care benefits

Preparation Education • Connecting the participant with information regarding programs that target his/her condition – or lifestyle-specific needs

Action Support • Connecting the participant to lifestyle coaching or disease management resources

• Explanation of how the benefits program supports participant’s health needs

Maintenance Engagement and sponsorship

• Recognition and promotion of participant success stories (via testimonial)

• Check-in communication with the participant at regular intervals

Readiness For Change

Evaluation

Inventory

Building A Case For Wellness

Market Scans

Master Profile

Carrier Drill Down

Multi-Year Plan

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Thank You