HealthCheck360 A Winning Approach to Wellness

A Winning Approach to Wellness

April 2014 HEALTHCHECK360.COM

Direct Phone: 563.587.5415 [email protected]

Presented By: Roy Lines, CFP®, CRPS®

Business stakeholders have a choice: “Pay now through wellness programs or pay much more in health care costs later…”

AGENDA

• HealthCheck360° Value Proposition – Unique & Cost Effective – Ease of Administration – Verifiable & Manageable Results

• Define the Benefits of a Wellness Program – To the Employer – To the Employee

• Why Have a Wellness Program • The HealthCheck360° System and Why It Works

– Demonstrate the Financial Impact for Employers

• The HealthCheck360° Process • Benefits Gained

Our system has three broad categories of benefits to business clients and prospects:

1. Cost Effectiveness 2. Ease of Administration 3. Verifiable & Manageable Results

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Setting Up HealthCheck360°’s Value Proposition

HealthCheck360° is not just another wellness provider. HealthCheck360° has a financially focused, easy to

adopt 5-step best practices health management program that is unique, cost effective and delivers verifiable results to enable company stakeholders to effectively mitigate and manage health care costs while at the same time improve the health and productivity of their employees.

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HealthCheck360°’s Value Proposition

HealthCheck360° is unique because we provide a progressive program that integrates participatory, activity-based and outcome- based programs.

Over 90% of our clients migrate towards outcome-based incentive structures within 2-3 years.

HC360° can (and often does) integrate our Condition Management (disease and compliance management) programming.

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Why is HealthCheck360° Unique?

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What are the Benefits of a Wellness Program?

Employer Benefits

1. Awareness of “lifestyle diseases” & the direct correlation to health care costs 1. Health maintenance & disease

prevention 2. Improve health & disease/condition

management 3. Improved medication adherence 4. Lower insurance premiums (vs. trend) 5. Decrease out-of-pocket expenses 6. Improve quality of life

Employee Benefits

I. Increase operating efficiency by increased employee productivity 1. Improved performance 2. Decreased sick days 3. Decreased leaves of absence 4. Reduce medical, disability & worker’s

compensation claims costs 5. Lower overall health insurance

benefit expenses (vs. trend) 6. Ability to retain and recruit quality

employees

WHY HAVE A WELLNESS PROGRAM?

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Source: Co-Occurrence of Leading Lifestyle-Related Chronic Conditions Among Adults in the United States, 2002-2009 http://www.cdc.gov/pcd/issues/2013/12_0316.htm This page was updated on May 01, 2013, to incorporate the corrections in Vol. 10. Earl S. Ford, MD, MPH; Janet B. Croft, PhD; Samuel F. Posner, PhD; Richard A. Goodman, MD, MPH; Wayne H. Giles, MD, MSc

70% of deaths and 75% of health care costs in the U.S. are attributable to chronic diseases

The prevalence of having 1 or more or 2 or more of the leading lifestyle-related chronic conditions increased steadily from 2002 to 2009. If these increases continue, particularly among younger adults, managing patients with multiple chronic conditions in the aging population will continue to challenge public health and clinical practice.

Conclusion: “The root causes trace back to lifestyle factors such as diet, exercise & smoking”

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KAISER FOUNDATION 2013 EMPLOYER HEALTH BENEFITS SURVEY

77% Employer &

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Why Have a Wellness Program?

Source: Workplace Wellness Programs Study Final Report to Congress 2013 Rand Health Corporation sponsored by U.S. Department of Labor and U.S. Department of Health & Human Services

Rand Study estimates medical cost savings of $378 annually per member/ per year

KAISER FOUNDATION 2013 EMPLOYER HEALTH BENEFITS SURVEY

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Firms offering health benefits continue to offer wellness and health promotion programs: 77% of firms offer at least one wellness program, 24% offer employees health risk assessments, 57% offer at least one disease management program. Small percentages of these firms use financial incentives in order to encourage workers to participate or complete these activities.

Source: 2013 Employer Health Benefits Survey, Aug 20, 2013 http://kff.org/?post_type=report-section&p=82269

WHY HAVE A HEALTHCHECK360° WELLNESS PROGRAM ?

$8,852 $9,054 $8,365

$8,967

$8,823 $8,247

$7,429 $7,861 $8,334

$9,033

$9,730 $10,346

0

2,000

4,000

6,000

8,000

10,000

12,000

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13

To Reduce Health Plan Medical Costs per Covered Employee

HC360 Actual Large Employers

Question: Why are their health costs continuing to go up? Answer: Traditional wellness programs are not financially focused

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Source: Mercer National Survey of Employer Sponsored Health Plans 2012 Page 17

How does HealthCheck360° effectively limit rising health care costs?

Through a Performance – Based Health Management Program

A systematic way – to keep healthy employees healthy, improve the health of the unhealthy and enables better care compliance for those with chronic conditions.

DOES IT WORK?

• What is the impact of HealthCheck360° program on health risk status? – Health risk migration is the foundation for establishing ROI

• Sample: >55,000 participants • Dates: 2008-2013 • Method: Study repeat participants only (no sample bias) and track

aggregate change in health risk using HealthCheck360° scoring algorithm.

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YEAR 1 TO 2 MIGRATION

0

2000

4000

6000

8000

10000

12000

14000

Ideal Low Moderate High Very High

10941

13526

8080

5206

3884

11977

13954

7599

4786

3321

2 Year Repeat Migration – Participants: 41,637

Year 1 Year 2

15% Decrease

10% Increase

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YEAR 1 TO 5 MIGRATION

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Ideal Low Moderate High Very High

1020

1787

1149

736

560

1710 1797

919

500

326

5 Year Repeat Migration – Participants: 5,252

Year 1 Year 2 Year 3 Year 4 Year 5

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IS IT COST EFFECTIVE?

What’s the Financial Impact? Medical Cost Gap Analysis

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$12,000

$13,200

$10,263 $10,992

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

2013 2014 (Projected)

ABC Costs vs. Mercer Benchmark

ABC

Mercer 500

WHY IS THIS CLIENT AT A COMPETITIVE DISADVANTAGE? ANALYZE HEALTH COST TREND

$1,241,550

N=450

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$781,650

CONTINUE WITH A DO NOTHING STRATEGY

$-

$5,000.00

$10,000.00

$15,000.00

$20,000.00

$25,000.00

$12,000.00 $13,200

$14,520

$15,972

$17,569.20

$19,748.23

10,263 $10,992

$11,772 $12,607

$13,503 $15,578

ABC = 10% Trend vs. Mercer Average of 7.1%

JEP

Mercer <500

N=450

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2013 2014 2015 2018 2017 2016

$-

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000

$20,000

Year 1 Year 2 Year 3 Year 4 Year 5

HC360 Cost of Program + Health Plan Cost per Employee

HC360 Program Cost

Cost Per Employee

OR INVEST IN HEALTHCHECK360°

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N=450

IS IT COST EFFECTIVE?

$-

$5,000

$10,000

$15,000

$20,000

$25,000

Year 1 Year 2 Year 3 Year 4 Year 5

HC360 Plan: Cost Reduction by 1% per Year

ABC + HealthCheck 360

Mercer 500

ABC

Savings: Year 2: $38,000 Year 3: $222,000 Year 4: $520,000 Year 5: $963,000

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N=450

VERIFIABLE RESULTS

$6,000

$6,500

$7,000

$7,500

$8,000

$8,500

$9,000

$9,500

$10,000

$10,500

$11,000

2007-08 2008-09 2009-10 2010-11 2011-12 2012-13

$8,852 $9,054

$8,365

$8,967 $8,823

$8,247

$7,588

$8,107

$8,506

$9,012

$10,221

$10,581

$7,429

$7,861

$8,334

$9,033

$9,730

$10,346

Health Plan Costs per Covered Employee

Actual Manufacturing Large Employers

A health plan competitive cost disadvantage of $1,264 per employee has been transformed into a competitive advantage of $2,334 per employee

N=2,000 HC360 Manufacturing Client

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HC360° PROCESS: IDENTIFY THE ROOT PROBLEM IF YOU CAN MEASURE IT YOU CAN MANAGE IT

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Biometric Screening Findings

• 111 with glucose in diabetic range • 580 with glucose in pre-diabetic

range

• 549 individuals with elevated systolic and diastolic blood pressure readings

• 815with elevated cholesterol • 883 with BMI readings > 30, of

which 396 (44.8%) are also pre-diabetic

Claims Information

• 50 individuals have claims with diabetes or pre-diabetes

• 78 individuals have claims with hypertension

• 98 individuals at risk of a heart attack

N = 1,750 Manufacturing Firm

Management may already know… What if they knew…

QUANTIFY HEALTH RISK IN YOUR POPULATION

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0 20 40 60 80

100 120 140 160 180

40%

20%

35% 31%

19%

Projected Health Risks in ABC Population

# Health Risks

N=450

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4 16 4

16

4

100 Points

All of these health conditions can be modified by a

combination of an employer’s decision on financial incentives, health behavior intervention &

compliance management programming.

Most importantly, by the

employee’s health decisions!

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Scoring Model

CORRELATE RISK LEVELS TO HEALTH SCORE

HealthCheck360° Scorecard Risk Level Correlated to HC360° Health Score

Ideal ≥ 86 A

Low 71-85 B

Moderate 61-70 C

High 51-60 D

Very High ≤ 50 F

HealthCheck360° has an easy to interpret scoring system that translates biometric values into a simple to understand score that is highly correlative to health risk factors. Ease of interpretation for both participants and company reports for analysis and planning. Financial incentive strategies easily integrate with this progressive scoring system and simplifies the reasonable alternative process.

TRANSLATE HEALTH RISKS INTO AN ACTION PLAN (POPULATION HEALTH DISPERSION)

30.70% 31.10%

18.90%

10.20% 9.10%

Ideal (85+)

Low Risk (71-84)

Moderate Risk (61-70)

High Risk (51-60)

Very High Risk (<60)

HC360 Sample Population Study: N=10,262 2012

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Keep this

Group Healthy Improve

this Group’s Health

Drive Behavior Change &

Manage Care Compliance

24.1%

32.6%

21.0%

10.3% 12.0%

Ideal (18.5-24.9)

Low Risk (25-29.9)

Moderate Risk (30.0-34.9)

High Risk (35.0-39.9)

Very High Risk (40+)

ABILITY TO DRILL DOWN TO DETERMINE SPECIFIC HEALTH RISKS EXAMPLE: BMI POPULATION DISPERSION

HC360 Sample Population Study: N=10,262 2012

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Keep Up the

Good Work Eat

Healthy Exercise Program

Weight Management

Program

ESTABLISH YEAR 1 BASELINE TO SHOW Y-O-Y POPULATION HEALTH IMPROVEMENT

R² = 0.9662

R² = 0.8815

66

68

70

72

74

76

78

80

82

84

20 25 30 35 40 45 50 55 60 65

HR

A T

otal

Sco

re

Age

HC360 Repeat Participants vs Baseline

Baseline

HC360 Participants

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HC360 Sample Population Study, Baseline N = 38,000 2012

CORRELATING CLAIMS COSTS TO RISK LEVELS

HealthCheck360° Risk Level Cost

Ideal $1680.35

Low $2279.46

Moderate $2855.74

High $3040.94

Very High $3879.80

Competitor Risk Level Cost

“Best” $2260.85

“Moderate” $2676.97

“Poor” $3012.15

HealthCheck360° includes two additional levels of stratification to accurately identify health risk levels. This gives consultants and business owners more accurate data to create targeted interventions resulting in a much higher probability for cost reduction.

$8,132

$6,202 $5,838

$5,493

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

Non-participant/ HRA Only 1 HRA w/ biometrics 2 HRA w/ biometrics 3 HRA w/ biometrics

Fully Insured: Use Wellness Data to Begin Tracking Results Self Insured: Correlate Wellness Data to Paid Claims Per Participant

32.5% reduction in claims from non-participants. 12.4% reduction in claims from 1st to 3rd year of the program.

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Why Have a Healthcheck360° Wellness Program?

N=1,132 2009-2012

HEALTHCHECK360° 5-STEP BEST PRACTICES WHY OUR SYSTEM WORKS!

• Objective biometric collection process – Identify & measure health risks

• remove subjective predispositions from self-reported HRA

• Superior scoring algorithm – Translate lab values into an easy to understand health score

• correlated to established benchmarks that are highly predictive of health costs

• Flexible and effective incentive management – Motivate participation with flexible design that evolves with program

• Reward progress not perfection while maintaining HIPAA & ACA compliance

• Mitigate known and unknown health risks – Multimedia engagement programs driven by individual biometric data

• Health coaching & Condition management programming

• Manage to maximize results – Participation analysis, Engagement levels & Risk migration

• Claims integrated client specific reporting

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PROPRIETARY OBJECTIVE SCORING SYSTEM – DRIVES RESULTS

• Our scoring algorithm is directly correlated to present and future cost drivers

• Balanced across all major cost drivers

• Transparent to participant

• Designed to reward positive change across health spectrum

• Designed to integrate with medical management

• Easily understood 0-100 scale

• Developed and reviewed by physicians

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A SCORING MODEL THAT IS EFFECTIVE

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• Marketplace – Difficult to understand

(negative to positive) – Rely on some measure of self

reported information – Incentive structure is fixed – Easy to administer – Complicates Reasonable

alternative process – Inaccurate scoring leads to

inability to identify where change is needed to improve health & costs

• HealthCheck360° – Easy to interpret 0-100 score

similar to education system – No self reported information – Incentive structure can evolve

with success – Easy to administer – Simplifies Reasonable

Alternative Process – Accurate identification of cost

drivers and scoring leads to correct appropriation of rewards and interventions

HEALTHCHECK360° MANAGES COMPLIANCE

• HealthCheck360 provides: – Incentive Consulting & Reporting – HIPAA Compliance – Reasonable alternative management – Recommended language for SPD

wrap document

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Your dedicated go to consultant for all support and service needs

Consult on effective incentives, scheduling, and processes Customized implementation guide and timeline 8-10 week pre-event employee communication plan Biometric screening coordinator

Data and analytic report liaison

DEDICATED ACCOUNT MANAGEMENT

IMPLEMENTATION PROCESS

We will provide & manage written service timeline for:

• Intake process • Training your team • Employee Communication period • Screenings & Assessments • Coaching & Programming • Monthly events & communications

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Implementation Timeline

CLIENT SPECIFIC REPORTING

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* If applicable

• Individual Report • Executive & Aggregate Report • Claims analysis* • Health Coaching Reporting* • Risk Migration Analysis • Critical Value Reporting • Executive Review Presentation

– Provides synopsis of various reports – Identifies key issues to manage – Compares company data to industry cohorts

BENEFITS GAINED

Effectively manage your wellness program – • like you manage your business; with employee accountability, goal achievement and more predictable outcomes

A systematic way to achieve better health outcomes – • which will mitigate your health spend while increasing productivity resulting in higher operational efficiency and profitability

Expert consultation enables you to set realistic goals and benchmarks – • Enables management, employee benefits team, consultants and providers to effectively monitor, measure & manage for program success

Saves you valuable time in the strategic planning process – • results in developing an evolving program that is congruent with your corporate goals and initiatives

Effectively analyze your population’s health risk migration – • and correlate to claims data; better enabling predictive modeling alignment with ROI expectations

Program is designed to be cost neutral – • program hard costs will have minimal impact on cash flow if implemented as recommended

Program is administratively simple and efficient – • Saving you both soft & hard dollars on administering your wellness program

With access to an employee’s Personal Health Information – • we are in the best possible position to influence a shared vision of good health and healthy habits

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BENEFITS GAINED

Expertise with HIPAA and HITECH regulations – • compliance oversight maintains your program integrity and reduces time and cost for staff

Expert consultation on prudent financial incentive strategies – • that are intuitive and member specific programming will foster high participation and engagement; ensuring program sustainability and overall goal

achievement

Empowering employees to take more personal responsibility – • Over their health increases their confidence in the program resulting in sustainability

A trusted partner – • you can depend on HealthCheck360° for world class customer service and support

A systematic way – • to keep your healthy employees healthy, improve the health of the unhealthy and enables better care compliance for those with chronic conditions

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HEALTHCHECK360° CONTACT

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For a meeting, webinar or plan proposal call or email:

Roy C. Lines, CFP®, CRPS® Sales Executive

Office 563.587.5415 | Cell 563.599.2844 | Fax: 563.587.6602

www.HealthCheck360.com | [email protected] HealthCheck360° 800 Main Street | PO Box 1475 | Dubuque, IA 52004-1475