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Bob Soroosh – Dir. of Benefit Administration – Affinia Gp

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

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  1. 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

  2. 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 !” 2

  3. 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%) 3

  4. 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 4

  5. 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. 5

  6. 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 6

  7. 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 !! 7

  8. Results: Affinia USA

  9. 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 9

  10. Long Term Solution • Integrate prevention program into the design of the basic health plan • A 2nd paradigm shift ! 10

  11. 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 12

  12. 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) 13

  13. 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 14

  14. 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 15

  15. (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? 16

  16. Preliminary Results • Medical claims costs down from 2005 • Prescription drug costs down from 2005 • Total costs (including admin) down from 2005 17

  17. Questions ? 18

  18. Filename: /projects / health mgmt / hero / SEP 06 HERO MEETING SOROOSH.ppt ver of 7/17/06 19

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