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THE COST DRIVERS. BRUTAL FACT – ’04 Shock Claims. CVD Relationship. R. x. CVD COSTS. #1 LIPITOR #2 ZOCOR #3 PLAVIX. 417 CVD prescriptions at $ 47,250.00. AVERAGED. PER MONTH. THE TI STRATEGY. ESSENTIAL ELEMENTS. Focuses on Cardiovascular Disease.

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slide3

R

x

CVDCOSTS

#1 LIPITOR

#2 ZOCOR

#3 PLAVIX

417 CVD prescriptions

at $ 47,250.00

AVERAGED

PER MONTH

slide5

ESSENTIAL ELEMENTS

Focuses on Cardiovascular Disease

Includes health screening in benefits design

Follows evidence based medical standards

Stratifies risk based upon clinical findings

Directs “high-risk” to interventions that lower risk & normalize lab values

Distributes non-compliant/un-successful into appropriate management

slide6

LEVEL 5 LEADERSHIP

If you can’t measure it…

You can’t manage it!

slide7

CREATIVE PLAN DESIGN

80/20

Base Plan

80/20

Participation

In Screening & Interventions

$1000 Deductible

Premium Plan

$250 Deductible

slide9

Highest Risk

Risk Reduction

ELEVATED CHOLESTEROL

Abnormal Glucose

High Blood Pressure

Overweight

Indicator

Intervention

Identify Risks

Root

Cause

POOR DIETARY HABITS

Physical Inactivity

Tobacco Use

RISK REDUCTION STRATEGY

FOCUS ON CHOLESTEROL

Reduce the population ‘At Risk’

Virtually No Risk

CVD Risk Factors are shared by Diabetes, Digestive Diseases,

Certain Cancers , Stroke and many other chronic and acute conditions

slide10

WE IDENTIFIED

High Risk/High Cost…

slide11

HEALTH SCREEN

Identify Associates at High Risk

HRA - BMI - Blood Pressure - Glucose - Lipid Profile

cholesterol
CHOLESTEROL

Identified Root Causes

>240

12%

<150

12%

200-239

31%

150-198

31%

32 – Identified @ Significant Risk

slide13

WE ATTACKED

High Risk/High Cost…

slide14

ELIMINATE ROOT CAUSES

Risk Reduction

“Tell me and I forget,

Teach me and I remember,

Involve me and I learn.”

- Benjamin Franklin

Risk Reduction Dietitian

Non-Compromising

“Can Do” Philosophy

improving our environment
IMPROVINGOur Environment
  • Vending Labeling
  • Meetings
  • Cafeteria

Walk the Talk

slide16

IMPLEMENTED

Physical Activity

10,000 Steps

slide17

ESTABLISHED

Tobacco Use Policy

slide18

DEMANDED

Consistency of Message

slide19

CARTERSVILLE, GA

OUR OUTCOMES

Measurement of Success…

slide20

AFTER

CLINICAL IMPROVEMENT

Before and After Risk Reduction Program

BEFORE

slide21

2005

TI Automotive

Project Outcomes

-17%

-18.4%

Total Cholesterol

Cholesterol

-73%

258

CHD Mortality

202

-44%

All Cause Cancer

“At Risk”

Group Avg

Post

Risk Reduction

TI Automotive - Risk Reduction Group

lowered Total Cholesterol by an average of 56 points.

1992

NORTH KARELIA

20 Year Project Outcomes

slide22

WEIGHT

Before and after program

BLOOD PRESSURE

High readings - before and after program

“Not” a weight-loss program

203

7

190

2

Start

Start

Finish

Finish

Average Weight Loss = 13 lbs

slide23

CHOLESTEROL CHANGE

Cartersville, GA

18.4%

Average

Decrease

Baseline

slide24

LIPID RISK PROFILE CHANGE

Cartersville, GA

35

Initial Program Participants

4

Remaining High Risk Participants

13

To Ideal Risk <200

slide25

2005-2006

U.S. Initiative

Cardiovascular

Risk Reduction

2005 screenings
96% Participation

3600 Participants Screened

Individuals Identified at “High Risk”

330 with Cholesterol levels of 240 or higher

41 Newly Diagnosed Diabetics

2005 Screenings
slide27

U. S. LOCATIONS

Pre-Program and Post Program

Pre-test - Number of Participants with Total Cholesterol >240

Post Program-test - Number of Participants with Total Cholesterol >240

cholesterol28
CHOLESTEROL

Identified & Addressed Root Cause – Cholesterol  240

Program Start

Program Finish

  • 240

16%

<150

08%

330

Completed RR Program

52

Participants “at risk”

200-239

50%

150-199

28%

slide29

BLOOD PRESSURE RISK

Number of Individuals “high risk” – Pre and Post Program

55

“at risk”

30

“at risk”

45%

Start

Finish

This was “not” a Blood Pressure Control Program

* Blood Pressures are highly variable from day to day – Diastolic Blood Pressure only

slide30

WEIGHT CHANGE

Average Weight – Pre and Post Programs

198.3

Average

193.5

Average

4.8lbs

Start

Finish

This was “not” a Weight Loss Program

64% of participants lost weight

slide31

ADDITIONAL FINDINGS

Respondents indicating the following areas have been positively affected

from participating in the Risk Reduction Program.

62%

48%

Productivity

More Positive Attitude

slide32

“However beautiful the strategy,

you should occasionally look at the results”

-Winston Churchill

slide33

2007 - 34% decrease

A CHANGE IN DIRECTION

Cartersville, Georgia

$25,140

Per Employee Per Year

At 12.0% increase per year

CVHI

2004

2006

2008

2010

2012

2014

2016

slide34

R

x

#1 Lipitor

#2 Zocor

#3 Plavix

COST AVOIDANCE

330 “high risk” at $125/mo.

$ 41,250 - per month - for life

ASSUMING: “all” at high risk would have been treated with pharmaceuticals..

slide35

COST AVOIDANCE

(1) By-Pass Surgery = $ 60,000+

(1) Angioplasty = $ 50,000+

(1) Stroke = $100,000+

slide36

COST IMPACT

TI Automotive, Cartersville, GA

slide37

COST IMPACT

TI Automotive, Corporate

slide38

COST IMPACT

TI Automotive, Corporate, 2004 - 2007

TI Automotive Average Annual PEPM Increase: 3.1%

Consumer Price Index Average Annual Increase: 3.2%

Kaiser Foundation Average Trend Increase: 7.9%

* TI Automotive data does “not” include annual plan changes made by employers to control costs

** Kaiser data includes annual plan changes made by employers to control costs

slide39

THE FACES

OF TI AUTOMOTIVE

slide40

My family & friends can’t believe that

my company is doing this for us!

-Joan

slide42

Thank God for TI.

I could never have done it with out the class!

-Beverly

slide43

City of Dalton, GA

319 Participants – 98%

Administration – Fire – Police – Public Works – Landfill – Trade Center – Parks & Recreation – Solid Waste

slide44

“Whether you think you can

or think you can’t.

You’re Right”

-Henry Ford