We decided to start with the New Basics!

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2 What employees think of healthcare Confusing Uhh, What?... Frustrating I give up! We decided to start with the New Basics!

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 Increasing cost of health care Active & Retiree Costs increasing Rising burden of disease in our population Aging population Confusing health care system Underutilization of Preventive care Complex Benefit Designs Budgetary constraints Rising Employee Frustration Something had to change 4

5 City of Dallas Challenge: Engaging Leadership 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? 5

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 Leveraging Technology Promoting The Resources Available 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 program *UnitedHealth Premium Tier 1 physicians have received the Premium designation for Quality & Cost Efficiency, or Cost Efficiency and Not Enough Data to Assess Quality 7

8 Leveraging Technology Promoting The Resources Available The Results? 3,500 Individuals Shop for Healthcare Services on line 20,000 Mobile Application Hits 1,000 Coaching Engagements 80,000 Hits on our Wellness Portal! *UnitedHealth Premium Tier 1 physicians have received the Premium designation for Quality & Cost Efficiency, or Cost Efficiency and Not Enough Data to Assess Quality 8

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 9

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 physicians to help them manage their conditions. 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

11 Right Care, Right Place, Right Provider Where do I go for Treatment Problem: Emergency Room utilization rising fast (and cost rising faster) Solution: Implemented 3 Strategies to help reduce ER over utilization: Promoted Appropriate Place of Service and advertised Urgent Care Centers Advertised free Onsite Clinic Contracted with Urgent Care facility to expand urgent care facility options 11

12 Support Our Employees Engage Chronic Disease Population Problem: How do we get employees with chronic diseases to make optimal healthcare decisions? Identify Attract Deliver Report 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 United HealthCare Services, Inc. All rights reserved. Do not distribute or reproduce without express permission of UnitedHealth Group.

13 Support Our Employees Helping Them Make Better Decisions Right Provider Right Care 3% Reduction in ER Utilization 14% Increase in Preventive Care Utilization in Members over 40 8% Decrease in Diagnosis of Diabetics with Complications 9% Decrease in Diagnosis of Hypertension 12% Decrease in Diagnosis of Intervertebral Disc Disorders Right Medication Right Lifestyle Generic Utilization has Increased from 77% - 82% 3% Increase in Hypertension Medication Compliance 2.6% Increase in Diabetic Medication Compliance United HealthCare Services, Inc. All rights reserved. Do not distribute or reproduce without express permission of UnitedHealth Group.

14 Support Our Employees Leveraging Multiple Strategies Promotional communications Mailed program invitations Biometric monitoring event invitations Health assessments Program referrals Provider referrals Wellness Program Incentive United HealthCare Services, Inc. All rights reserved. Do not distribute or reproduce without express permission of UnitedHealth Group.

15 Keep Healthy Employees Healthy Meet Them Where They Are Problem: With an emphasis on our cost drivers, we can t lose sight of keeping our entire workforce healthy 50-75% of costs Lifestyle habits and health decisions Solutions: 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 15

16 Keeping Employees Healthy Participants completing health risk assessment Employees who earned all 250 Wellpoints Retirees < 65 who took the health assessment Individual activities tracked Met biometric targets Completed online programs Participated in educational offerings 16

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 Measure Medical Net Paid (per employee per month excluding RX) % Change -6.88% High Cost Claims -10.7% Emergency Room Utilization -2.65% Preventive Care (Over 40) +14.3% Inpatient Admissions -13.6% 18

19 Questions? 19