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Bob Soroosh – Dir. of Benefit Administration – Affinia Gp. BA - Baylor U. (Ed/Com) MBA – U. of Colorado 1994-2000: Ben.Plan Admin-Clevite 2003-2004: Lead AAG’s Prev. Scng. 2004: Dir. of Ben. Admin.- Affinia. 1. Dr. Elias Zerhouni 6-4-04.

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Bob Soroosh – Dir. of Benefit Administration – Affinia Gp

BA - Baylor U. (Ed/Com)

MBA – U. of Colorado

1994-2000: Ben.Plan Admin-Clevite

2003-2004: Lead AAG’s Prev. Scng.

2004: Dir. of Ben. Admin.- Affinia

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Dr. Elias Zerhouni 6-4-04

“On your journey through life, always share your best ideas with others – the biggest challenge you will face is not people stealing them, but people resisting them !”

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Rude Awakening Cost Increases(versus nat’l avg)

Year ending 6/01: +16% (vs 8%)

Year ending 6/02: +28% (vs 10.7%)

Year ending 6/03: +36% (vs 9.3%)

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Affinia’s Journey to Health

  • 2000-01-02: Rude Awakening
  • 2003: Health Management separate from Medical Plan
  • 2004-05: Design integrated plan & select vendors
  • 2006: Integrate health management with medical plan

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Paradigm Shift

If we promote the health of our people, reduce health risks & manage chronic conditions, we will reduce the economic burden of disease and disability both on our people and our company.

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2003-04 Prevention Program: Affinia Group USA only

-- Risk assessment + preventive screening) @plants>50

-- Follow-up risk reduction program

-- Allen Plant: disease mgmt program

-- Cost:$125/EE => ROI: 3:1 by yr 3

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2003 Prevention Program

  • Held sign-up meetings for 4,688 people at 23 locations; 4,420 (94%) completed 28-question health risk assessment and received biometric screening. Sorted into HI, MED, or LOW risk.
  • Biometric Screening included height, weight, BMI, blood pressure, total cholesterol, HDL cholesterol, and glucose (blood sugar).
  • All participants reviewed results with a health educator. If they had moderate or high risks, were invited into NextSteps, a phone or mail-based health education program. 33% signed up !!

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results with conclusions
Results with Conclusions
  • Since 25%>age 50 & 65%>age 40,
  • Since 33% are hi health risk & 36% smoke,
  • Expect above avg growth rate (avg=8%)

Conclusions:

  • Strengthen emphasis on prevention, smoking cessation, & disease management
  • Keep some form of consumer-driven plan

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long term solution
Long Term Solution
  • Integrate prevention program into the design of the basic health plan
  • A 2nd paradigm shift !

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key plan design changes
Key Plan Design Changes
  • $1,000 premium difference for Covenant: EE & spouse participate in risk assessment, screening, & where indicated in disease mgmt program
  • ↑ generic use by giving WHI generic-only card for covenant / compliance with disease mgmt
  • Pay costs for smoking cessation, & motivate smokers to quit by giving lower benefit for company-paid life

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key goals metrics
Key Goals / Metrics
  • Goal: maximize participationrate in H/mgmt & D/mgmt programs
  • Goal: migrate people in Hi & Med health risk categories to Low risk
  • Goal: reduce growth rate of total cost (direct health care expenses + indirect STD, LTD, life, W/C)

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disease management
Disease Management
  • 45% of people with chronic conditions (diabetes, asthma, high blood pressure, etc) account for 78% of total health care costs
  • So, link disease management program with health mgmt

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Key Prevention Programs:

Definity (HealthDialog)

StayWell

6500 EE/sp: voluntary health risk reduction programs – 47% of 99% in follow-up

500 people: outreach to people with chronic conditions

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(B) 500 people (in highest risk group - CAD, diabetes, asthma, hi risk pregnancy) are referred to & get follow up fm Health Dialog

(A) 6,000 people

Receive StayWell HRA & biometric screening – and 500 receive on-site referrals to Health Dialog &/or doctor

(C) 07: Personal Health Record captures data from multiple sources

(E) 07: Claims data fm Definity & drug data fm Medco

(D) Health Dialog receives all HRA & biometric data (fm StayWell) + claims / drug data fm Definity & does predictive risk modeling & follow up (may reach 500 people already ID’d by StayWell referral)

(F) StayWell targets hi health risk people for follow up risk reduction programs

How do Providers Share Data?

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preliminary results
Preliminary Results
  • Medical claims costs down from 2005
  • Prescription drug costs down from 2005
  • Total costs (including admin) down from 2005

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filename projects health mgmt hero sep 06 hero meeting soroosh ppt ver of 7 17 06
Filename: /projects / health mgmt / hero /

SEP 06 HERO MEETING SOROOSH.ppt

ver of 7/17/06

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