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The Big Picture Health plan costs are escalating at more than 5 times the rate of corporate profits and 5 times the rate of inflation Why Wellness?
People with lifestyle-related chronic conditions account for 88% of all prescriptions written, 72% of all physician visits and 76% of all inpatient hospital stays. • We spend $6280/year for every man, woman and child for health care in the US and exactly $1.21 on prevention. • Employers resort to new methods of shifting costs to employees every year (CDHC, HSA, HRA, etc..) never affecting trend • “Wellness Programs” to-date lack “single source of truth”, measurable outcomes and focused interventions and are largely a waste of time and money as a result. The truth is, despite all the hype…. no ROI is forthcoming any time soon…unless you improve lifestyles. • Don’t confuse Early-Detection and Disease Management with Wellness and Health Promotion. Historical Perspective
Has this been your Wellness Strategy….is it working? (Is it wellness??) =
“71 cents of the healthcare dollar is spent on treating conditions that are lifestyle related and potentially reducible by behavioral changes.” – Prof. Roger Seehafer, Purdue University Cost Shifting Alone Is Insufficient • 40 million Americans have diabetes and nearly 40% of them do not know it. • Nearly half of cancer cases could be prevented by greater use of screenings and subsequent application of existing knowledge around diet and lifestyle improvement. • 20 million Americans have undetected chronic kidney disease and another 20 million are at risk. The NIH says that 85% of all disease is lifestyle-related….virtually all of these are predicted by a few key, simple to measure biomarkers….. which is where we focus!
More cost shifting (via “Better Plan Design”) • Benefit reductions (squeeze the balloon) only shifts costs • Hope that employees will utilize fewer services because of cost implications ………..can have (overall negative effect on trend) Bottom line: We’ve been doing this for years with little or no meaningful results! Health Savings Accounts, etc… • Encourages shopping to an “unknowing consumer” • Assumes that employees understand value/priorities of health-related products and services for their specific circumstance. They don’t. • LifeStrive Targeted Wellness Intervention • “Good driver discount” for health! • Focuses employee on few biomarkers that have most impact and they can understand • Lifestyle rewards (doesn’t penalize non-modifiable risk factors) • Creates and fulfills targeted need for health promotion with measurable results • Allows us to “run the experiment” of cultural transformation The Options
Categories: NIHGenerous: Blood Glucose: <110 <130 Total Cholesterol: <200 <230 LDL Cholesterol: <100 <130 Tobacco/Nicotine: None None Ex. Health Screening -Blood Glucose -Total Cholesterol -LDL Cholesterol -Tobacco Use How are employees screened for healthy lifestyles? These are the biometrics that indicate the lifestyle factors that drive trend. If results are within a specific range, employees immediately qualify for wellness credits towards Premium Contribution Credits, additional Supplemental Benefits, HRA Contributions or Health Rewards Points. The screening is preformed once per year, prior to the start of the plan year. Employees can also earn unearned credits through participation in our e-Learning Modules, satisfying the HIPAA requirements for non-discrimination.
Doesn’t penalize sick people, rewards healthy lifestyles • Decisively shifts responsibility (not just cost) for health to employee • Keeps employees aware of their current health condition and focuses them on prioritized biometrics (those that drive trend) • Workers Comp, dental, vision rates all positively influenced • Influence culture over time with our web-based tools: Health Coach Web Portal with Health Promotion Programs and E-Learning Center Access Health Coach Internet Radio Health Coach Forum and Weekly Chat Room Just Released…. Health Coach University! Advantages
Works outside of the base health plan! Our wellness product auto-administers credits earned and notifies payroll, TPA, etc…as desired by employer. • The average employee will become engaged in the process and clearly understand that their lifestyle counts! • The program is: • Confidential • Patented • Flexible
Premium Contribution at $0/month Core Medical Plan Example Plan Prior to LifeStrive
Separate Fully Insured RDP Policy Blood Test $200 LDL Chol. $100 Blood Sugar $100 Non Tobacco $100 Tot. Chol. $100 Employee Cont. Raised to $600/year Or $50/month The LifeStrive Program is installed Employees earn $100-$600 Towards Premium Contribution, HRA Contribution (or supp. Benefits) Core Plan Unearned credits are then subject to e-Learning Completion to satisfy HIPAA Reasonable Alternative Requirements
Submitting to Blood Screening Credit $200 Total Wellness Credit Available $600 LDL Cholesterol Credit $100 Non Tobacco Use Credit $100 Employee #1 Blood Glucose Credit $100 Total Cholesterol Credit $100 This employee earned all five credits and has either Zero premium Contribution, an increased HRA contribution, or supplemental benefits bank…they are also a LOW User of the Health Plan Statistically Core Medical Plan
For: ABC CORPORATION Fee Structure based on: 68 Singles 105 Families _173_Total Expected Current Annual Premiums: $1,255,792 Estimated Premium Savings from a $700 deductible increase: $ 101,719 (Increase from $300/$600 to $1000/$2000) (8.10%) Healthy Solutions Program Fees & Projected Savings
For: XYZ CORPORATION Fee Structure based on: 680 Singles 320 Families 1000 Total Premium Contribution Increase: $750/Single, $1200/Family Premium Contribution Credit: $500 Single, $800 Family Net Premium Increase: $20.83/Mo. Single, $33.33/Mo. Family Premium Contribution Credits Fees & Projected Savings
The Savings VALUE EQUATION W/PREMIUM CONTRIBUTION REWARDS
Any combinations of group standards and credit amounts can be set for Biometrics. • The closer the group standards are to national standards (NIH), the more claims trend will be effected. • Can raise premium contribution by more than allowed earn-back amount and use the savings to pay for all wellness screenings, etc… • Using a pre-screening allows and motivates employees to make changes when using more stringent standards. • Those that don’t achieve one or more earned credits still have an opportunity to earn those credits through participation in our e-Learning Programs. As a result, program isn’t seen as punitive. Choose easily achieved criteria year one and tighten over time Wellness Criteria Parameters Are Flexible
“Wellness Program With a Future” For more information call: Richard Perryman @ (602) 956-3401