Transcript GH members - Group Health

AGENDA
OVERVIEW
WELLNESS SOLUTION
CARE MANAGEMENT
OCCUPATIONAL
HEALTH SERVICES
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Poor employee health can cost you
200–300 percent more than the cost
of health benefits* due to:
• Sick days, absenteeism, and reduced productivity.
• Unmanaged chronic conditions like diabetes.
• Poor medication adherence, health complications,
and expensive hospitalizations.
* “What should employers do about health care,” Harvard Business School Working Knowledge,
Michael E. Porter, Elizabeth O. Teisberg, and Scott Wallace, 2008.
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Our solution?
Better outcomes for long-term value.
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Creating a culture of wellness.
Using data unique to your population and organization,
we can help you create a program that will change behaviors
for improved health. It’s smart technology that gets more
personalized the more it’s used.
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Leadership support
• Health assessment tools
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Organizational goals
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Budget
• Incentive and reward
strategies
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Employee interest survey
• Worksite events
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What’s currently driving costs
• Special programs
• Access to technology
• Employee engagement plan
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• Wellness team(s)
Industry-specific issues
• Health Profile completion
aggregate reporting
• Reports on utilization
of services
• Evaluation and program
adjustment based on your
population’s data
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WELLNESS SOLUTION
Help your population meet their wellness
goals with tools, resources, and trained
health care professionals.
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Programs to reduce disease risks can
improve your population’s health and morale.
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GH members: Direct access to an array
of resources.
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GH members: Health Profile reveals risk
of health issues.
• In-depth online health questionnaire
• Report with personalized health recommendations
• Promotes shared decision-making between doctors and patients
• Linked to medical record if member receives primary care
at Group Health Medical Centers
• Collective results help us refine your wellness program
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GH members: Lifestyle Coaching motivates
behavior change to lower health risks.
• High-risk members identified through Health Profile
“opt-in” for call outreach
• Coaches are specially trained registered nurses
with 10–15 years experience
• Coaching is based on behavioral science theory and application
• Three targeted risk areas: physical activity, nutrition,
and moderate depression
• Free to Group Health members 18 and older
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GH members: Quit for Life® helps tobacco
users become and remain tobacco free.
• 45 percent success rate, nine times
more effective than attempting to
quit without support*
• Helps members manage
withdrawal symptoms
• Teaches how to identify triggers
and develop new behaviors
• 5 phone calls with a
Quit Coach®
• Medications to support quitting
• Individual counseling or
group session
• Online tools
• Unlimited follow-up support
• Re-enrollment allowed at any point
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GH members: Fitness center discounts help
make exercise part of their daily lives.
• Discounts at more than 10,000 fitness facilities nationwide
• Discounts on exercise videos and equipment for home workouts
• NutriSystem® weight loss program also available at a savings
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GH members: Access to information helps
with medical decisions.
• One-stop health resource at
ghc.org with thousands of
health-related articles
reviewed by doctors
• Shared decision-making DVDs,
online videos, and booklets help
members explore treatment options
with their doctors
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Hip osteoarthritis
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Knee osteoarthritis
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Coronary artery disease
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Enlarged prostate
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Herniated disc
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Spinal stenosis
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Uterine fibroids
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Abnormal uterine bleeding
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Early stage breast cancer
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Ductal carcinoma in situ
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Breast reconstruction post-cancer
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Benign prostatic hyperplasia
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Chronic low back pain
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Acute low back pain
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GH members: Additional support through
classes and community resources.
• Group Health offers classes and support programs in our
clinics and online, including our popular six-week
Living Well with Chronic Conditions workshops
• Phone-based Resource Line includes hundreds of classes,
support groups, agencies, and other resources in its
database—from alternative therapies and parenting
tips to cancer support and sleep disorders
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GH members: Discounts for alternative
medicine and fitness providers.
• Complementary ChoicesSM provider network
• Over 900 providers statewide
• When care doesn’t meet employees’ coverage
or referral criteria, the network offers 20
percent discount to Group Health members
• Unlimited number of discounted visits
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Improve the health of your entire staff with
our new product featuring RedBrick Health
RedBrick’s digital platform uses innovative, interactive technology to
create a healthier, more productive workforce.
• A leader in health engagement technology
• Action-oriented program of tools and services
• Combines smart incentives and powerful social elements
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Entire population: New fee-based products
drive higher level of engagement
• Data analysis delivers real-time, personalized recommendations
• Presented in an easy-to-understand friendly approach
• Format drives more immediate engagement
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Entire population: Dynamic RedBrick
Health Assessment
• Lifestyle health questionnaire
• Reinforces Group Health’s clinical-based Health Profile
• Engaging visual format
• Provides instant feedback and rewards
• Focuses participants on behavior change programs
that are personalized for each individual
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Entire population: Activities motivate and
boost participation
• Worksite health fairs including mini-screenings for biometrics
• Games and team challenges that promote healthy habits
• Real-time leaderboards with current employee standings
• Social elements to encourage fun, entertaining competition
among staff
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Entire population: RedBrick platform features
device and smartphone integration
• Programs, challenges, and more are easily accessed via smartphone
• Integrates mobile apps like Runkeeper and device tracking
like Fitbit to aid tracking of healthy behavior
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Entire population: Unique approach to
financial rewards
• Drives lasting positive behavior change
• Personal approach to rewards
• Designed with simplicity and emotional appeal
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Add-on: Comprehensive biometric screening
events at your worksite*
• Helps with early detection of potentially serious health issues
• Nurses can check blood pressure, body mass index, cholesterol, and glucose
• Aggregate results provide valuable insights on your population’s health
• We provide resources—from planning to evaluation—to help make
the event successful
* Fee-based.
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CARE MANAGEMENT
Care management is an integral part
of the coordinated care support provided
to our plan members.
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Our Consulting Nurse Service is available
24 hours a day, 7 days a week.
• Phone-based triage for acute and chronic care needs
• Physician on-site for consultation and medication orders
• Advice on best next steps—self care, routine physician visit,
urgent care, or ER
• Coordination with primary care team if care is received at
Group Health Medical Centers
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Care managers provide phone-based
interventions to Group Health members
with complex health needs.
• Increase health-promoting
behavior
• Self-manage conditions
• Set personal goals
• Match personal goals and
needs to available programs
and services
• Help prevent unnecessary
and expensive hospital
admissions and ER visits
• Promote strong
patient/personal physician
relationship with shared
decision-making
• Empower patients to manage
and improve health and
minimize complications
• Optimize specialty care
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Transition management supports members
as they move between care settings.
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Disease management addresses specific
conditions where interventions can improve
health and lower costs.
• Part of our innovative approach to
primary care for all patients
• Telephone-based coaching
• Fully integrated with existing
Group Health programs, such as case
management, behavioral health,
disability, and other lifestyle programs
• Identifies members at high risk for elective
surgeries, high risk for chronic conditions,
high risk from lifestyle behaviors, and high
financial risk
• Targets more than 40 conditions
• No additional fee for fully insured groups;
fee-based service for self-funded groups
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Utilization review ensures members are
receiving appropriate care in the most
appropriate setting.
• Stringent monitoring process
• Program is staffed by physicians,
nurses, psychiatrists, psychologists,
and pharmacists
• Hospital/skilled nursing
facility stays
• Use of durable medical equipment
• Specific high-dollar procedures
• Follows standards set by ERISA,
NCQA, and applicable state and
federal laws
• Use of certain medications
• Mental health services
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OCCUPATIONAL HEALTH SERVICES
Streamline workplace health, safety,
and injured worker care with an
all-in-one source.
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Expert occupational health care for your
employees at Group Health Medical Centers.
• 12 clinics with occupational medicine physicians and specially
trained clinicians
• Providers are in the Washington State Department of Labor
and Industries’ Medical Provider Network
• Patient account reps trained in workers’ compensation paperwork
• Case managers to coordinate care and communication between
employer, claims manager, employee, and physician
• Services available to all employees, not just Group Health members
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Screenings and prevention services* to
meet your organization’s needs.
• Drug testing
• Pulmonary function testing
• Breath alcohol testing
• Vision testing
• Medical Officer Review
• Worksite exposure testing
• Random selection services
• Immunizations
• Hearing testing
• Travel medicine
* Fee-based.
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Industry-specific physicals and
employment exams.*
• Post-offer
• Emergency medical response
• Return-to-work
• Federal Aviation Administration
(FAA)
• Commercial Driver’s License
(CDL/DOT)
• Firefighter and law
enforcement officer
• Respiratory clearance
• Hazardous waste exposure
• Asbestos exposure
• Lead exposure
• Other heavy metal screenings
• Vivarium environment
* Fee-based.
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NEXT STEPS
We’d like to help you improve the health
of your population and the health of
your bottom line.
Contact your account manager to learn more
about Group Health Wellness Solution.
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