© 2008 The Regents of the University of Michigan, Ann Arbor, Michigan 48109
Five-Year Strategic Plan FY09 –FY13
LaVaughn Palma-Davis
Senior Director, University Health and Well-Being Services
Our Unique Opportunity to Improve Health
“We have the means to mount a broad, collaborative effort to fashion a prototype program to:
•promote healthy living,
•contain health care expenditures, and
•define optimal insurance coverage for individuals and families.
We can use our intellectual resources to help the nation in addressing the growing crisis in health care.”
- President Mary Sue Coleman Future Directions Presentation UM Regents, 4/22/04
UM Benefit Contributions
Percentage of Total Operating Budget
3 3
3.5% 3.8% 4.1% 4.4%
3.3%
4.8%
7.0%
10.1%
0.6% 0.6% 0.6% 0.5%
7.5%
9.3%
11.7%
15.0%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
FY 1997 FY 2007 FY 2017 Projected FY 2027 Projected
Retirement Plan Medical+Rx Other Benefits Total
“Other Benefits” includes dental, LTD, life insurance, opt out cash and Medicare Part B premium reimbursements; does NOT include University contributions for FICA, nor vacation or sick pay.
The Real Cost of Worker Health
Source: Goetzel, JOEM, 2001:43(1):
Adjusted to 2006 dollars
Total: $13,988
Estimated 2006 Median Total Health Cost per Employee
$6,532
$5,170
$1,134
$718 $434
Group Health Turnover
Unscheduled Absence Non-occ Disability
Workers' Comp
Does not include presenteeism costs
Health Care Cost Drivers
Insufficient prevention – 70% of health care costs are related to lifestyle and safety practices
Growth in chronic illness
Noncompliance and poor self-management
Aging population
Mental illness
Current US health care reimbursement system
Other socio-economic issues
Population Health Management
An Integrated Strategy Across the Health Continuum
Health & Well-Being
Low Risk Optimal Health
At Risk
Inactivity, Obesity, Stress, High Blood Pressure
Acute Illness/Injury
Doctor Visits ER Visits
Chronic Disease
Diabetes Heart Disease
Disability
Traumatic Injury Neurological Conditons Wellness Management
•Information
•Motivation
•Preventive Screening
Risk Factor Management
•Targeted Screening
•Targeted Interventions
•Reinforcement
Demand Management
•Self Care Information
•Nurse Advice Line
•Decision Support
Disease Management
•Clinical Management
•Compliance Support
Disability Management
•Case Management
•Decision Support
•Risk Management
85% of employees; 15% of costs 15% of employees; 85% of costs
Source: David Anderson, Ph.D., StayWell Health Management
16thAnnual Art and Science of Health Promotion Conference, 3/24/06
Narrow Focus Misses Key Cost Drivers
Health & Well-Being
Low Risk Optimal Health
At Risk
Inactivity, Obesity, Stress, High Blood Pressure, High Cholesterol, Smoking,
Alcohol Use, etc.
Acute Illness/Injury
Doctor Visits ER Visits
Chronic Disease
Diabetes Heart Disease
Disability
Traumatic Injury Neurological
Conditions
15% of employees; 85% of costs
Source: David Anderson, Ph.D., StayWell Health Management
16thAnnual Art and Science of Health Promotion Conference, 3/24/06 StayWell medical claims study
•Multiple employers/51,200 employees
•5 years of data (1997-2001)
•Compared each year with next
•High-cost 5% = 78% NEW each year!
59%
of next year’s high-cost group
Key Drivers of Health Care Cost Containment and ROI
Participation – Need to achieve optimal participation/engagement (70-80+%).
Program effectiveness – Program performance must be monitored to assure risk reduction is being achieved.
Communications, Culture and Incentives Drive Engagement
27%
33%
44% 41%
51%
65%
33% 37%
53%
41%
51%
69%
0%
20%
40%
60%
80%
100%
Weaker Strong
Comm. Culture Comm. Culture Comm. Culture
Non-Cash Incentives
Cash Incentives
Benefits-Integrated Incentives
HA Participation Rate (%)
Source: StayWell Financial Incentives Impact Study, 2007
Copyright © 2007 StayWell Health Management. All rights reserved.
Vision
The University of Michigan will be a model
community of health where people thrive.
MHealthy:
Five Year Strategic Health and Well-being Plan
Builds upon best practices and research
Considers existing resources and gaps
Identifies foundational priorities, critical to achievement of MHealthy goals
Guided by principles of rewarding healthy
behaviors, protecting confidentiality and
reducing barriers to health improvement
An integrated strategy across the health continuum
Healthy At Risk
Short Term Illness
Chronic
Diseases Disability Wellness
Promotion (Low Risk)
• Information
• Motivation
• Preventive Screening
• Opportunities to Maintain Health
Risk Factor Reduction
• Targeted Screening
• Targeted Risk Factor
Interventions (smoking, high blood pressure, lipids, overweight, etc.)
• Reinforcement
Use of Health Care Services (for Acute
Injury/Illness)
• Sufficient Access
• Self Care Information
• Help in Making Treatment Decisions
Disease Management
• Effective and Timely Clinical Care
• Patient Education, Compliance and Self Care Skills
• Care
Coordination
Disability Management
• Care
Coordination
• Help in Making Treatment and Life Decisions
• Risk
Management
• Return to Productivity
Effective Population Health Management
The goal is to move people to lower risk and improved health.
Components of Strategic Plan
Leadership support
Supportive environment, culture & infrastructure
Communication
Data management &
evaluation
Program coordination
Benefit design &
incentives
Wellness assessments with follow-up coaching
Targeted risk reduction
Disease management
Disability management
Demand management
Innovation
Highlights of Strategic Plan:
Communication
Develop and implement a comprehensive, multi-year communications plan, including identification of
specific strategies to market/communicate issues, programs and services and move people to action
Leadership Commitment and Support
- Provide leadership engagement and training at all levels
- Incorporate employee health performance expectations into leader evaluation process
- Develop/modify organizational policies to advocate optimal health
Supportive Environment, Culture and Infrastructure
- Develop plan to improve fitness center access
- Continue to offer fitness center and equipment discounts
- Expand efforts to establish a smoke-free environment across the university
- Sustain and expand other environmental supports in the areas of physical activity, healthy eating, safety and
cleanliness
Benefit Design and Incentives
- Establish a cost-effective benefit design that supports prevention, risk reduction and improved compliance
- Ensure that design reduces barriers to obtaining care
- Provide incentives that promote the adoption and/or maintenance of healthy behaviors
Health Risk Assessments with Follow-Up Coaching
- In FY09, launch a University-wide health risk
assessment program with biometric screenings, follow- up coaching and referral
General and Targeted Interventions
- Identify existing and new resources for targeted interventions based on UM health data profile
- Enhance availability and accessibility of services in key areas such as: weight mgmt., healthy eating, physical activity, stress mgmt., ergonomics, back health, tobacco cessation, and cardiovascular disease prevention
Mental/Emotional Health and Substance Dependence Services
- Continue awareness campaign to reduce stigma &
promote prevention
- Maintain robust website including self-help tools and resource assistance
- Conduct manager and HR training
- Improve the return to work process
- Complete study of optimal mental health benefit design and equity/access issues with recommendations
Disease Management Programs
- Evaluate existing health plan offerings and make
recommendations to assure effectiveness and optimal utilization
- Evaluate existing pilot programs (Focus on Diabetes, Focus on Medicines) for efficacy and determine future direction
- Work with the UM/BCN Joint Venture to identify other
valuable pilot programs to address improved approaches to care
Getting Started – Year 1 FY09
Free and confidential wellness assessments offered to all benefit eligible employees beginning in January, 2009
On-line health risk questionnaire,
Blood pressure,
Cholesterol, HDL & glucose
Height, weight and waist circumference
Results coaching
Referral to helpful programs and resources at low or no cost
High risk individuals will have an opportunity to have a personal health coach
$100 incentive for participation in wellness assessment in 2009
FY09 B&F Key Initiatives
3.1 Effective internal implementation and early adoption of relevant University-wide initiatives
At least 40% of benefits eligible B&F staff will participate in a free and confidential MHealthy Wellness Screening by June 30, 2009.
Measuring MHealthy Program Outcomes
Conclusion
The University has made a commitment to invest in
MHealthy to improve the health of our community and try to contain future health care costs.
We cannot achieve the high level of participation necessary to be successful without your leadership commitment as well.
We will do our part to help you with
Communication tools and messages
Delivering programs in your schools & departments
Creating a supportive environment, policies and appropriate incentives
