Transcript Slide 1

Pioneering Solutions for…
Optimal Health and Controlling Cost
© Wellness Coalition America
High Risks Drive Costs
3.4%
Membership
Acute
50%
Plan Cost
Case Management
Chronic
Disease Management
At Risk
Wellness Management
10%-20% of members account for 81% of plan cost.
Turn Your Approach
Upside Down
Flipping the Pyramid allows us to be
proactive instead of reactive!
How do you manage the out of
control consumer?
License to Spend
Why Focus on Prevention?
The big aha!
70% of disease is
modifiable or preventable.
www.cdc.gov
Corporate Cultural Shift
• Company’s have begun the shift from
being reactive to proactive
• 81% of American businesses have
some type of corporate wellness program
Long-Term Plan
• Identify
• Stratify
• Treat, Triage, and Enroll
• Activity
• Compliance
• Medical Outcomes
• ROI
What Ensures Success
Management buy-in
 Understanding the culture

Program and Plan Design
Participation:
•Voluntary or mandatory?
•Incentives for compliance? Tied
to premiums?
•All employees or just those on
the health plan? Spouses?
Plan Design:
•Preventative screenings
•Waived co-pays
•Rx compliance programs
Member Buy-In
• Educate and communicate through
multiple modalities based on corporate
culture
• Ask for feedback (Employee Interest Survey)
Feedback from Employees = Higher Program Buy-in
Building trust to ensure full participation and clearly
communicating wellness objectives to employees
is key to the overall success of any program.
ABC Company:
Executive Summary
Employee Interest Survey Results
Onsite Programming
•Healthy eating: 46%
•Weight loss: 45%
•Stress management: 40%
•Exercise classes: 38%
•Walking program: 36%
Challenges: Time
Incentives: Health premium discounts
Show me the Money$$$
Incentives tied to compliance
influence employee buy-in.
Operation Jump-Start :
Healthy Lifestyle Campaign
Available in Spanish
3 Year Action Plan with Defined
Quarterly Goals
Planning and implementation meetings
October
Monday
1
Tuesday
2
Wednesday
Thursday
Friday
3
4
5
10
11
12
Program rollout
meeting with
management
8
9
Operation
Jump-Start
Kick Off meeting
for employees
Screenings and
Health
Assessments
begin
Screenings and Health
Assessment Forms
Value of Screenings
•Health advocacy
•Baseline lab values
•Benchmarking
•Screenings uncover 25%
•Immediate triage
•Out of compliance
•Early detection saves lives and money
•Sends a message that you care
What do you do with the data?
Track, audit and measure activity,
compliance and medical outcomes!
Health Identification Phase
Factors in:
• Rx
• Claims
• Self-report
• Labs
Identifies:
• Highest to lowest risk
• Demographics
• Co-Morbidities
Optimal Success…
is achieved when both the members’
medical needs and personal wants
are met.
Health Continuum
• Identify
• Stratify
• Treat, Triage, and Enroll
• Medical Management
– Disease Management
• Wellness Management
– Prevention Management
– Lifestyle Management
Next Steps
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Primary care physician
Specialist
Onsite clinic
Nurse coaching telephonic
Local programs
Onsite programs
Nurse coaching telephonic
Advocacy Campaign
Grass roots
Maternity
Weight
Management
Asthma
Hyperlipidemia
Wellness Screening
Compliance
Heart Disease
Lifestyle
Hypertension
Cholesterol
Diabetes
Ongoing Support of
Human Resources
Take the stress off of HR
Ongoing Education & Support
Multiple Modalities
•Printed
•Electronic
•Video
•Web-based
•On-site
•Telephonic
•Wellness Kiosk
•Bulletin board
•Closed circuit TV
•Teleconferencing
Electronic Health Record
Electronic Health Record
On-Going Electronic Education
• Website
• Monthly E-Zine – Electronic Magazine
• Weekly E-Blasts
– Motivational Monday
– Wellness Wednesday
– Food Fact Friday
• EduGame – Online Tutorial
Quote:
The higher your energy level, the more efficient your body. The more efficient your body,
the better you feel and the more you will use your talent to produce outstanding results.
– Anthony Robbins
Week 1:
Setting goals.
What do you want to change about your life? Where do you want to be in five years from
now? Creating a personal mission statement allows you to set your own goals and
measure your own progress. Set realistic goals for yourself in all areas of your life and
make a plan for reaching those goals. Whether it is to become more flexible, lose ten
pounds, or eat more vegetables, writing your goals on paper helps you to visualize your
Walnuts: to yourself.
goals and make a commitment
Walnuts are a great source of omega-3 fatty acids and they contain ellagic acid,
which is a powerful antioxidant. The amino acids found in walnuts can reduce the risk of
heart attack. Try eating 1.5 ounces of nuts per day. One ounce is equal to 14 walnut
halves. Trail mix is an easy way to mix your favorite nuts with your favorite dried fruit.
It also serves as an excellent afternoon snack when you are in need of some extra energy.
Potty Talk
Potty Talk
Your quick health education resource
“Yes”
Yes” – Great! Make sure you are being proactive
and consulting them before something goes wrong.
“No”
No” – You need to take a moment to think about
your personal health and wellness. Even the most
health conscious people get sick or have questions
that only a medical professional can answer. By
having a trusted medical resource, you are
guaranteed that you are receiving the most
appropriate and accurate care for you. Do not let the
Internet be your primary medical resource!
Contact your Human Resources department to be
connected you with an in-network medical provider
that you can consult for advise, treatment, and
medications.
•Select a Primary Care Physician
•Ask your doctor about generic prescriptions
•Comply with your doctor’s recommendations
•Keep up with regular health screenings
•Minimize hospital visits
Available in Spanish
informed choices…healthier lives
Markers for Success
↑ Participation
↑ Health literacy
↑ Lifestyle behavioral changes
↑ Overall employee health and wellbeing
↑ Improve employee morale
↑ Increase productivity and presenteeism
↓ Reduce absenteeism
↓ Reduce the stress on HR
Value of Investment (VOI)
↑ Primary care physicians
↑ Preventative screening
↑ Rx and disease management compliance
↓ Specialists
↓ Inpatient admissions
↓ Length of hospital stays
↓ Number of inpatient days
↓ Outpatient procedures
↓ Emergency room usage
↓ Prescription cost trend
↓ Overall Health care costs
Success Recap
Management buy-in
• Understanding the culture
• Program & plan design (incentives and prevention)
• Member buy-in (trust and ownership)
• Three year action plan with defined quarterly goals
• Communicate initiatives and never stop
• Identification and stratification phase
• Enroll identified members into specific programs
• Communication loop regarding high risk
• Provide ongoing support (members and HR)
• Provide ongoing education (multiple modalities)
• Measure, track and audit activity, compliance
and medical outcomes
•
There is no Quick Fix
• Wellness and Medical management is a
long-term investment
• It takes time to influence and change behavior
• Continual commitment and support from
management is critical
• Creating a healthy work environment takes
time and effort
The Members are our Clients
Building trust, education, providing
support and communication is key to
ensuring member buy-in, participation
and satisfaction.
You can’t just build it and expect them to come!
Pioneering Solutions for…
Optimal Health and Controlling Cost
© Wellness Coalition America