Virginia s Health Insurance Challenge Alternatives for Consideration

Transcription

1 Virginia s Health Insurance Challenge Alternatives for Consideration November 2009

2 Objective of the Project Team Offer suggestions to positively influence the cost of providing health insurance for Virginia s State Employees 2

3 Background The Problem: Costs continue to increase for employees and the state Current & Recent Actions Co-pays increased JLARC Report COVA CARE (including HD/HP), Kaiser HMO, COVA Connect Our Focus: Lifestyle Choices of Virginia s State Employees 3

4 The Impact of Poor Lifestyle Choices Smoking and Obesity are the leading causes of preventable death Directly attributable to Obesity: 30% more hospital admissions Duration of hospital stay is 16.5% longer Major risk for chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension, stroke, and certain forms of cancer Smoking s impact goes way beyond lung cancer Lowers HDL (good) cholesterol Raises the risk of stroke by 150% Higher rates of cancer of the stomach, bladder, kidney, pancreas, and blood (leukemia) 4

5 Effecting Change Incentives are already used successfully in other government programs Safeway Inc. Incentive Plan ( Healthy Measures Employee Insurance Plan ) Targeted four lifestyle factors: Weight, Smoking, Cholesterol, and Blood Pressure Employees rewarded with $312 (in premium reduction) for not smoking (Company saves 1200/annum) Costs flat (0% increase) for four years as compared to 35% for state State Costs vs. Safeway Plan Effect $495.8 million difference $1,000,000,000 $900,000,000 $800,000,000 $700,000,000 $600,000,000 $500,000,000 $400,000,000 $300,000,000 FY 2006 FY 2007 FY 2008 FY 2009 Actual Annual Expenses Annual Expenses Held Flat 5

6 Safeway Plan Reward Healthier Choices Support Wellness Programs Reduced Employee Costs Reduced Agency Costs Positive Tangents 6

7 Challenges Employee Buy in What s in it for me? Resources to implement Time, people, budget Third Party Administration Opposition from influential groups 7

8 Let s get started Use Governor's Go Green initiative as a model to promote Employee Healthy Lifestyles Promote benefits of cost savings, pro-employee, pro-taxpayer Create Agency competition or challenges Provide incentives to agencies for meeting goals Provide incentives to employees for results (premium credits or cash) 8

9 Kitchen Sink 1. Incentives focused on non-smoking and obesity (BMI?) 2. Allow non-va health insurance providers to bid for Commonwealth contract 3. Leverage state medical universities to offer expanded services to state employees 1. Create a Pharmacy Benefit Manager thru state medical universities 4. Offer COVA Care options to wider government population (volume discounts?) 5. Provide incentives to contribute to an HSA/FRA 6. Expand pre-authorization requirements for drugs and procedures 7. Offer a managed care plan 8. What other companies are doing: 1. Reduce coverage for Chiropractic services 2. Charge Smokers more 3. Increase Specialist Co-Pays 9. Join a drug purchasing pool and cut out middle man 10. Audit TPA to ensure accurate costing 11. Value Based Insurance Design: 1. Lower co-pays for greater value services (preventative care?) 9

10 Questions 10

11 The Team Thanks You Jennifer Cavedo (Virginia Department of Agriculture & Consumer Services) Lance Franklin (Virginia Polytechnic Institute and State University) Anne O Meally (Virginia Lottery) Anil Purmasir (Virginia Retirement System) Jeff Ryan (Virginia Department of Motor Vehicles)

12 Sources & Acknowledgements WHO / Journal of the American Association Health Behavior News Service from the Journal of Health and Social Behavior World Health Organization Discovery Health Smoking s impact is not limited to lung cancer Wall Street Journal Washington Post Overweight? Smoker? Health bills hit hard DHRM Annual Report (Fiscal Year 2008) JLARC State Employee Compensation and Benefits Report, December 2008 ( 12