The Value of On-SitePittsburgh CEBSOctober 5, 2017

Kristin Hasley, MHPESenior Manager, Population Health Management

Today’s Objectives• Establish Common Challenges Facing Health in the

Workforce• The Benefits of a Population Health Strategy: Cost and Risk

Mitigation• On-site Product Solutions• Current Real World Results

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• Following national and international trends, the region’s work force is aging

• Our region’s work force is older on average than the nation and other peer nations

• There are not enough younger workers in the region to fill projected job openings

• Developing an effective strategy to address projected worker shortfalls requires a targeted long-term approach

U.S. Census Data for Region Workers Get Older, Employers Headaches Get Bigger

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On Average, We are Getting Older

US Adult Population by Age Groups

2010 US Population

Data Source: US Census Bureau State Population Projections: Baby Boomers Year of Birth 1946 to 1964

Age Group

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Leading to Much More Health Care Use

Age in Years

Source: IFEBP HCCM Program

Average Age of Our Workforce

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0-1 1-4 5-19 20-44 45-54 55-64 65+0.5

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1.5

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2.5

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Male

FemaleBaby Boomers

Behaviors Drive Medical, Disability, Absenteeism, Workers’ Compensation, and Total Employer Costs

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$0$1,000$2,000$3,000$4,000$5,000$6,000$7,000

19-34 35-44 45-54 55-64 65-74 75+

Edington. Am J Health Promotion 15(5):341-349, 2001

High Risk

Medium Risk

Non-Participant

Low risk

Identifying Key Cost Drivers of Absence

41% of Short-Term Disability Costs

24% of Workers’Compensation

29% of Absence

38% of Medicaland RX Costs

Above cost estimates include:1. STD - Indemnity only2. Workers’ Compensation - Medical, indemnity, and other costs3. Absence - Productivity losses

Wright, Beard, Edington. JOEM. 44(12) 1126-1134, 2002. = The Need for a Population Health Strategy

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Employer Health & Productivity Road Map™ “Understand, Improve, and Partner with Your Doctor”

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Optimize Environment

Speed Transitions

Care-Home-Work

OptimizeChronic

Care

Minimize Acute Care

Increase Healthy

Behaviors

Reduce Excessive Surgery

Parkinson MD. Employer Health and Productivity Roadmap™ Strategy. JOEM 55:12 (Supp) S46-51; 2013.

Originally focused on screenings and shots for new employees.

An on-site health and wellness center embodies a holistic, central hub for multiple aspects of care, including:• Acute care • Lifestyle and condition management through health coaching• Coordination of health care services• Life Solutions• Work-related injury treatment/triage

On-Site Health and Wellness Centers

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Entry Point to Total Health ManagementOn-site health and wellness centers act as the employee’s entry point for total health management.

On-Site Health

and Wellness Center

EAP

Health Coaching

PCP

On-sitecare

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• Displace costly ER, UC visits• Triage compensation injuries• PCP integration• Address gaps in care

Care Optimization

Population Health Strategy: On-site Health and Wellness Services

Direct the right care, at the right place, at the right time.

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Population Health Strategy: On-site Health and Wellness Services

On-site convenience drives efficiency and productivity

• Convenient location• No traveling time• Increase in productivity• Limited wait (avg. 20-30 min visit)

Productivity Savings

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Population Health Strategy: On-site Health and Wellness Services

“Health” is more than just medical treatment

• Rx for Wellness referrals• Lifestyle coaching• Condition management

Health Management

Integration

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Employees are at least 20% more engaged when they have the right work-life balance.*

• Imbalanced?– 2.5x more likely to be hostile.– 2.7x more likely to be disengaged.

• The convenient location of on-site health and wellness centers helps maintain balance.

Improving Employee Engagement

*Albrecht, Brown, and Harkbarth. “Workplace Wellbeing: Providing Meaningful Benefits to Energize Employee Health, Engagement, and Performance.” www.quantumworkplace.com sponsored by limeaid®.

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Improving Employee EngagementOn-Site health and wellness centers can refer employees to services that will help them be a stronger, healthier, and more fully engaged employee.

FREE:• Private counseling for stress reduction, financial planning, weight management,

and more.• Access to health coaches, nutrition planning, and exercise options and other

services have been shown to improve quality of life.

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Support for lifestyle and condition management

Coach on Call

A quick dose of support:

• Eating smart on the go• Planning healthy meals• Creative exercise tips• Smoking cessation

Condition and Health Management

• Understand a diagnosis• Symptom management

• Community resource access• Shared decision-making

support

Lifestyle Improvement

• Healthier eating• Stress management

• Increase physical activity

Health Coaching

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On-site Health and Wellness: Industry Consideration

On-site services can be tailored to serve and manage the health needs of employers and their 200+ employees. Health services may include:

• Total health management

• Occupational services

• Non-occupational services

• On-site, near-site, or mobile delivery

• Telehealth and kiosk options

A discovery and needs assessment is vital to review the employer’s wellness goals as well as several factors such as employer size, location, and funding in order to make a recommendation that will best serve the employer and the health of their employee population.

19 Your Logo

1 2 3 4

Discovery & Assessment

Recommend Customized Plan

Communication & Implementation

Evaluation

On-site Health and Wellness Services: Our Approach

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The Right Service for the Right Company

Convenience – ‘On-the-go’ options for your busy life

Members can engage in face-to-face video urgent

care visits within minutes of requesting an

appointment through their smartphones or

tablets

Since 2013:• 24,000+ acute care visits• 8,000+ referrals to PCP/WC/Rx for

Wellness/Specialists/ER• 640,000+ employee health encounters

Population Health Strategy: On-site Health and Wellness for UPMC

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*Based on 2015 contracted rates**Estimated cost per visit based on weighted average costs

Visit Type Savings/Visit Savings

EH Visit $45 $3,944,745

EH Flu $25 $1,192,275

EH new hire evaluation* $100 $1,264,800

Acute care visit ** $89 $794,859

Total -- $7,196,679

FY2016 ROI: $2.89M

Additional $563,000 estimated productivity savings

Estimated savings by performing services in-house in 2016 is almost $7.2M!

Cost Mitigation of the Population Health Strategy

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• 50.1% of new hires were identified as high risk for at least 1 biometric value* since 2009

Over 34% of high risk members took action within 90 days of screening

Those identified as high risk for diabetes had highest action rates• Over 23% visited a PCP within 90 days• Over 50% filled diabetic managing prescription

*Cholesterol, Diabetes, Hypertension , BMI

Breakdown of Actions Taken

Risk Mitigation of the Population Health Strategy

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Results: University of Pittsburgh – 12 Month StudyFirst external on-site center for faculty and staff. Heart of University of Pittsburgh Oakland Campus.

The University of Pittsburgh ROI – FY17

Acute Visits 1,837 Occupational Health Visits 6,367 Employee Hours Saved1 5,511 Employee Savings2 $53,221 Avoided Acute Cost Savings3 $180,990 Avoided Employee Health Cost Savings4 $621,224 Productivity Savings5 $147,364 Estimated Total Savings $1,002,799 Operating Costs6 ($501,370) ROI: Total Savings $501,429

1Employees save an estimated 3 hours with an on-site visit, 3 hours x 1,837 visits 2Average employee out-of-pocket savings is $25.50 x 1,837 acute visits 3Avoided Acute Costs Savings – measures care optimization/visit displacement from UC, ER, PCP, retail – using diagnosis codes at a blended rate

of $98.52/acute visit 4Avoided Employee Health Cost Savings – measures employee health visit displacement from an outside vendor at a blended rate of $97.57/occupational visit 5Productivity Savings – calculated using 3 hours saved per acute visit (per D.W. Edington), multiplied by average hourly rate of $26.74 6Operating costs – include amortized capital costs, overhead fees, staff salaries, supplies and service fees, EPIC fee

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Satisfaction Results: University of Pittsburgh

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Questions?