Effectively Measuring Population Health Programs

Transcription

1 Effectively Measuring Population Health Programs Kevin Cowden, MS National Practice Health & Productivity Consultant May 6, Wells Fargo Insurance Services USA, Inc. All rights reserved.

2 Today's Agenda Effectively Measuring Population Health Programs Section I Section II Section III Section IV Section V What we do Health as a business driver Measuring the investment Framework to evaluate success Case examples 1

3 Population Health & Productivity Management Helping employers go beyond plan design to improve health, lower costs, and increase productivity WELLNESS CLINICAL PRODUCTIVITY Improve Health Status Lower Health Risks Partner With Carriers Identify Vendor Solutions Lower Health Care Costs Improve Clinical Outcomes Health Data Analytics Identify Clinical Intervention Strategies Increase Workforce Productivity Reduce Absenteeism / Presenteeism Health and Productivity Audit Integrated Solutions Oversight Align Strategy with Execution. Measure and Evaluate Measurement Cohort analysis Risk analysis Return on allocated resources Claims analysis Health risk analysis Culture audit Needs and interests Discovery Assess Your Population Needs Plan Design Solutions Wellness Solutions Condition & Case Management Solutions Life Cycle Virtual Health Solutions Implement Your Individualized Strategy Execution Solution identification RFP Management Project management Communications Multi-year Budget Incentive design Operation plan Compliance Customize Your Strategy Design Onsite Health Solutions Occupational Health Solutions Return-to-Work and Work Hardening Solutions 2

4 Health as a business driver The purpose of population health and wellness programs

5 What we know Employee health and well-being are strong determinants of productivity, morale, and retention There is a clear impact on business performance and share price in the case of public companies as well as on the bottom line 1. The health of an organizations population is inextricably linked to its long-term viability. Investing in employee health and well-being aligns with better business. 1 Fabius, Raymond, et. Al., The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a Culture of Health. JOEM. Volume 55, Number 9, September

6 Dollars The link between health and the bottom line $ $9, Portfolio Worth S&P 500 Initial $10,000 investment grew to $17,871 (Return of 78.72%) while the S&P 500 had a cumulative return of -0.77% Annualized return of the portfolio was 4.57% versus S&P 500 s -0.06% The portfolio outperformed the S&P 500 in 9 of 13 periods Average annual excess return of the portfolio over the S&P 500 was 4.67% Source: Fabius, Raymond, et. Al., The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a Culture of Health. JOEM. Volume 55, Number 9, September

7 Measuring the investment Shifting the paradigm

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9 Transforming how we define success Longstanding Contemporary Financially Driven Health and Medical Driven Past/Short Term Experience Return on Investment Production/Mission Driven Holistic Long-Term Effectiveness Value of Investment 8

10 Program goals and objectives Primary Secondary 1 2 Reduce Employee Health Risks 3 Improve Employee Productivity Reduce Health Care Costs Manage/Reduce Disability Improve Job Satisfaction Improve Profitability Promote Consumerism Recruitment & Retention Reduce Sick Days Reduce Presenteeism 1 Improve Morale 1. The cost of presenteeism has far surpassed the cost of absenteeism and accounts for 61% of an employees lost productivity. Presenteeism cost employers $2,000/employee/year on average. 9

11 What those with mature programs value Mature Program Senior Leaders Beginning Investor Manager/Directors Value Consumerism Focus on improving daily health decisions of employees Reduction of medical and disability claims cost Reduction of sick days Common Attributes Common Attributes More sophisticated analytic capabilities Desire to vary how they report value Limited data capture Financially focused To gain senior-leadership support Broaden your suite of metrics to demonstrate value! 10

12 Values by size and demographic Jumbo employers place importance on health care cost reduction and financial metrics Medium and large size employers place more importance on morale, energy levels, and relationships (suggests Value ) Those with older, tenured workforces place more importance on health care cost, sick days, and disability claims Younger workforces place more importance on productivity 11

13 Framework to Evaluate Success Guide to program measurement

14 Why we measure Program improvement Demonstration of outcomes Understand financial impacts Understand impact on employees Health Engagement Satisfaction 13

15 Operational guideline of outcome types Participation Program Type Mode of Delivery Means of Identification Qualification Engagement Productivity Time Away from Work Productivity Loss (WLQ) (HPQ) (WPAI) Satisfaction Conceptual Alignment Client (Purchaser) Participant Sampling and/or Survey Defined Standards Financial Cost Trend v. Peers Expected v. Observed Trend Chronic v. Non Chronic Trend Participant v. Non-Participant Matched Control Utilization (ER & Hospitalization) Reduced Lifestyle Related Risk Leadership Norms, Beliefs, Values Work Place Climate Programs Policies Procedures Health Impact Environmental Intellectual Social Spiritual Behavioral 14

16 Principles to rely on Customize your metrics based on what you feel is important and adds value Consider the assortment of costs which may be incurred Decide which calculations meet your needs Express results in a reasonable manner Be flexible in how you apply your methodology 15

17 Employee Health & Wellbeing Dimensions of Wellness Leveraging health as an input Inputs Value Prop. Output Emotional Performance & Outcomes Business Objectives Financial Spiritual Social Intellectual Mission & Vision Intellectual Social Capital & Assets Values Human Physical Occupational Guiding Principles Philanthropic Environmental 16

18 Case Examples

19 Large school district focus on diabetes 30,000 members (Including Retirees) 187 schools High retention with aging population 2,100 members identified as diabetic & 1,800 more pre-diabetic (19% cost) Low engagement Created a Diabetes Health Plan (DHP) in 2011 including decreased cost for prescription drugs, supplies and lower co-payments for MD visits Reduction in out-of-pocket costs tied to compliance with evidence based guidelines for diabetes care Program Participation 5% to 28% Improved Compliance 43% - 71% Average Cost 2014 $5,920 as compared to $13,700 What s Missing? 18

20 Healthcare system concentrates on chronic conditions 4,500 Health plan members Average age = 45 Escalating costs relative to chronic conditions Fast paced environment (12 hour shifts) Environment not conducive to appropriate lifestyle behaviors (diet, sleep, stress) Program Rx: Outcomes-based pop. health program Participants must meet 4 of 6 biometric thresholds Incentive = $3,000 PEPY premium discount Onsite health coaches and healthy vending added Onsite fitness, nutrition, tobacco programs Health Impact A1C: +537 LDL: +565 Diastolic BP: +776 BMI: +431 Net Paid PMPM Catastrophic: $ v Non-Catastrophic: $ v $ Employer Cost Share 89.5% % What s Missing? 19

21 Financial services firm emphasizes prevention 700 plan enrollees across 25 locations Average Age = 30 Issue Employee Engagement Program Rx: TPA with Wellness Exam with Biometrics Health Risk Assessment Age/Gender based preventive care Health Coaching Health Impact: Compliance Well Exam: 64% Lipid Panel: 73% Breast Cancer: 60% Colon Cancer 18% What s Missing What s Missing What s Missing? 20

22 Conclusion

23 Food for thought 7 Chronic conditions alone (cancer, heart disease, hypertension, mental disorders, diabetes, pulmonary conditions, and stroke) Cost the US economy more than $1 trillion per year Assuming current trend until 2023: would result in a 42% increase for a total of million cases $4.2 trillion in treatment costs and lost economic output 22

24 Recommendations Begin with the end in mind Be realistic in customizing YOUR measurements of success Be consistent Solicit assistance Communicate your results Celebrate your successes 23

25 Vision, value statement Engaging in a comprehensive effort to promote wellness, reduce the health risks of a workforce, and mitigate the complications of chronic illness can produce value over and above ROI. 24

26 Thank you for your participation Questions?

27 Disclosures Products and services are offered through Wells Fargo Insurance Services USA, Inc., a non-bank insurance agency affiliate of Wells Fargo & Company. Products and services are underwritten by unaffiliated insurance companies except crop and flood insurance, which may be underwritten by an affiliate, Rural Community Insurance Company. Some services require additional fees and may be offered directly through third-party providers. Banking and insurance decisions are made independently and do not influence each other Wells Fargo Insurance Services USA, Inc. All rights reserved. 26