We decided to start with the New Basics!

(1)

(2)

What employees think of healthcare…

Confusing…

Frustrating…

We decided to start with the “New” Basics!

Uhh,

What?...

(3)

Agenda

• City of Dallas Challenges

(what caused our approach to benefits to change)

• What are our “New” Basics

• Strategies & Solutions

• Results?

(4)

Our Challenge

Ø

Increasing cost of health care

ØActive & Retiree Costs increasing

Ø

Rising burden of disease in our population

Ø

Aging population

Ø

Confusing health care system

Ø

Underutilization of Preventive care

Ø

Complex Benefit Designs

Ø

Budgetary constraints

Ø

Rising Employee Frustration

Something had to change…

4

(5)

City of Dallas Challenge:

Engaging Leadership

5

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Medical plans are not as simple as they used to be:

• High deductibles

• Increased Coinsurance & Cost Share

• Health Reimbursement Accounts

• In Network only plan strategies

• Educating Senior Leadership about Healthcare was fundamental

to getting support. We focused on two questions:

• What is driving our health care spend?

• How employee decisions impact the cost of their care and the

overall cost to the City?

(6)

The New Basics

1. Leveraging technology to help employees become better

consumers of health care.

2. Getting employees the right care, from the right provider,

at the right time.

3. Supporting our employees managing chronic conditions.

4. Encouraging our healthy employees to stay that way!

Providing incentives and resources to help them

maintain their health.

6

(7)

*UnitedHealth Premium Tier 1 physicians have received the Premium designation for Quality & Cost Efficiency, or Cost Efficiency and Not Enough Data to Assess Quality

Leveraging Technology

“Promoting The Resources Available”

7 Problem: Get employees accustomed to utilizing web based

resources and mobile technology to become better educated

health care consumers.

Solution: We leveraged mobile applications, mobile pricing

transparency tools, and designed a custom web portal to help

our employees manage their progress within our Wellness

(8)

*UnitedHealth Premium Tier 1 physicians have received the Premium designation for Quality & Cost Efficiency, or Cost Efficiency and Not Enough Data to Assess Quality

Leveraging Technology

“Promoting The Resources Available”

8

The Results?

3,500 Individuals Shop for Healthcare Services on line

20,000 Mobile Application Hits

1,000 Coaching Engagements

(9)

9 Right Care, Right Place, Right Provider

“Create Awareness”

Problem: Health Assessment results revealed the following:

• 80% of our Population was overweight or obese

• 70% were unaware of their cholesterol

• 40% of our employees didn’t know their blood pressure

Solution: We preached “Know Your Numbers”, brought in onsite

vendors for biometric events, leveraged our onsite clinic, and

contracted with additional urgent care centers to give our employees

a no cost option to get screened

(10)

High Quality High Performance Physician Networks

focused on Evidence Based Medicine

Appropriate sequencing of diagnostic tests, procedures,

treatment and monitoring

Avoid duplicate testing and adverse drug interactions

Reduced failed therapy and complications

(fewer readmissions and redo’s)

UnitedHealth Premium Tier 1 physicians have received the Premium designation for Quality & Cost Efficiency, or Cost Efficiency and Not Enough Data to Assess Quality

10 Right Care, Right Place, Right Provider

“Where do I go”

Additional screenings within our population led to an increase in

diagnosis. The next step was getting employees to the right

(11)

Problem: Emergency Room utilization

rising fast (and cost rising faster)

Solution: Implemented 3 Strategies to help

reduce ER over utilization:

11 Promoted “Appropriate Place of

Service” and advertised Urgent

Care Centers

Contracted with Urgent Care

facility to expand urgent care

facility options

Advertised free Onsite Clinic

1

2

3 Right Care, Right Place, Right Provider

“Where do I go for Treatment”

(12)

Support Our Employees

Engage Chronic Disease Population

12 Report

Deliver

Attract

Identify

Find the right

people at the

right time

Enroll individuals

through effective

engagement

strategies

Work towards

creating

behavioral and

clinical change

through

meaningful

interactions

Share outcomes;

partner to

address future

opportunities

Problem: How do we get employees with chronic diseases to make

optimal healthcare decisions?

(13)

• Generic Utilization has Increased from 77% -

82%

• 3% Increase in Hypertension Medication

Compliance

• 2.6% Increase in Diabetic Medication

Compliance

• 8% Decrease in Diagnosis of Diabetics with

Complications

• 9% Decrease in Diagnosis of Hypertension

• 12% Decrease in Diagnosis of Intervertebral

Disc Disorders

• 3% Reduction in ER Utilization

• 14% Increase in Preventive Care Utilization in

Members over 40

Support Our Employees

Helping Them Make Better Decisions

13 Right Provider

Right Care

(14)

UnitedHealth Group.

14 Support Our Employees

Leveraging Multiple Strategies

• Promotional communications

• Mailed program invitations

• Biometric monitoring event invitations

• Health assessments

• Program referrals

• Provider referrals

(15)

Keep Healthy Employees Healthy

Meet Them Where They Are

50-75%

15 Lifestyle habits and

health decisions

of costs

Benefits 101

Medical plan options, how they work, terms and acronyms,

tips, tools and resources, encourage preventive screenings.

Wellness program

Offers financial incentives for individuals that take steps to

maintain or improve their health

Problem: With an emphasis on our cost drivers, we can’t lose

sight of keeping our entire workforce healthy

(16)

Keeping Employees Healthy

16 Employees who earned all 250 Wellpoints

Retirees < 65 who took

the health assessment

Individual activities tracked

_{Met biometric targets}

Participants completing

health risk assessment

Completed online

programs

Participated in

educational

offerings

(17)

Keep Healthy Employees Healthy

Ongoing Support

• Monthly Health and Wellness Learning Sessions

• Early Detection

• Urgent Care/ER/Convenience Care

• Diabetes, Obesity, Heart Disease – cost drivers

• Annual Physical and Biometric Screenings –

• Begin a relationship with a physician

• Raise awareness of numbers and areas to improve

• Behavior Change Activities - exercise, weight loss programs,

ongoing Line Dancing/Zumba to encourage movement and fun

• Benefits 101 – back to the basics when you have a question,

mobile technology, estimate health care costs

• Online Health Coaching

• Wellness Mini Conferences

• Health Fairs

17

(18)

Impact on Plan Cost

18 Measure

% Change

Medical Net Paid

(per employee per month excluding RX)

-6.88%

High Cost Claims

-10.7%

Emergency Room Utilization

-2.65%

Preventive Care (Over 40)

+14.3%

(19)

19