UnitedHealth Wellness Helping people lead healthier lives
Why Wellness? Influence health behaviors Identify high risk health needs Increase productivity Reduce absenteeism Improve employee satisfaction Manage escalating health care costs 2
Did you know 80% of all heart disease, stroke, type 2 diabetes and up to 40% of cancer could be prevented if people ate healthier, exercised and stopped using tobacco. 1 Adult obesity has doubled, while childhood obesity has tripled, in the past 25 years. 1 If obesity prevalence were the same now as in 1987, our annual healthcare costs would be $200 billion less each year. 2 1. World Health Organization (WHO), Preventing Chronic Diseases: A Vital Investment (Geneva: WHO, 2005). 2. Thorpe KE, Florence CS, Howard DH, Joski P. The Impact of Obesity on Rising Medical Spending. Health Aff (Millwood) 004: Web Exclusive; w4-480-486. 3
Did you know Individual employees may be the most important factor in improving quality and cost efficiency 10% Access 20% 20% Genetic Environmental 50-85% Behavior Factors that affect health are principally behavioral. 50-85% of all diseases are associated with modifiable health risks and are therefore preventable. Helping individuals become aware of their modifiable health risks and engaged in their personal health can be a great way to affect change Source: IFTF, Center for Disease Control and Prevention 4
Elements of Effective Wellness Programs Customers with a High Impact Wellness Programs: Assess Population and Create Awareness Provide Personal Health Record Sponsor Biometric Screenings Conduct Direct to Employee Education Conduct Program Promotional Campaigns Conduct Wellness Promotional Campaigns Offer Worksite Solutions Integrate Wellness into Corporate Infrastructure Develop and Execute Strategic Plan Incent and Reward Participation Measure Outcomes 5
UnitedHealth Wellness : Core Products Fully Insured and ASO 100+
Everything begins with the Health Assessment 52 questions 15-20 minutes to complete Available in English and Spanish Available online and paper* Integrated with Online Health Coaching and Care Coordination Integrated with Personal Health Record Individual profile report with goalsetting *Additional fee applies. 7
Personalized content and tools on myuhc.com Messages of encouragement Online Health Coaching information Health reminders Educational articles 8
Online Health Coaching Online health coaching programs Diabetes lifestyle Exercise Heart health lifestyle Nutrition Smoking cessation Stress Weight loss 5-week incremental programming Tailored to the individual based on Health Assessment Based on readiness to change and level of participation Calculators, tools and trackers 9
Newsletter Healthy mind, healthy body e-newsletter 2.3 million users enjoy content based on five topics that they choose including: Healthy living and well-being Family and children s health Men s health Women s health Asthma Cancer Diabetes Healthy back Heart health Members can register online at www.uhc.com/myhealthnews 10
Personal Health Record Employees can manage their own health information online at myuhc.com Integrated with claims history Member information: Medical history Physician office visits Lab test results Prescription medications Identify possible drug interactions 11
Online Health Coaching Programs Five-week, evidence-based behavior change programs Diabetes Exercise Heart health Nutrition Weight loss Smoking cessation Stress management 12
Online Tools, Calculators and Trackers Tools include: Symptom Checker Risk Assessment Quizzes Waist to Hip Calculator Calcium Calculator Adult Food Pyramid Cost of Drinking Calculator Children s Food Pyramid Cost of Smoking Calculator 13
Healthy Pregnancy Program Healthy Pregnancy Program No cost to members Identification of special needs or risks 24-hour toll-free access to experienced OB nurses Participants receive: Coupon Book Journey Through Pregnancy book Breast pump discount Enhanced website: www.healthy-pregnancy.com Award-winning online pregnancy owner s manual: http://mypregnancymanual.com/uhc 14
Preventive Care Reminders Scheduled preventive mailings* for the following immunization or screenings: Breast cancer screening Cervical cancer screening Diabetes screening Immunizations Colorectal screening Cardiovascular risk UnitedHealthcare reminds members through: 1. Personal Health Statements 2. Personal Message Center on myuhc 3. Home mailings 4. Member services * Member mailings to individuals who are missing care based on claims history 15
SM NurseLine Services NurseLine s goal is to empower individuals to choose the most appropriate level of care for their situation. Nurse advice (triage) General health information Condition education Member services/provider referrals Health information library 16
UnitedHealth Allies Discount Program Available to all UHC members via myuhc.com Discounts for wellness services not typically covered through medical plan: Fitness Centers Spa Services Massage Therapy Laser Vision Correction Weight Loss Programs Tobacco Cessation Programs Home Exercise Equipment Much More! 17
UnitedHealth Wellness : Buy Up Programs ASO Only, 750+ Members
Health Rewards Clinical Incentive Solutions Program Clinical Incentive options align with the health continuum Staying Healthy Getting Healthy Living with Illness Preventive screenings Annual physical Mammography Prostate Cancer Colon Cancer Worksite Wellness Know Your Numbers Adult Flu Online Health Coaching Standard Wellness Coaching Health Assessment QuitPower Healthy Weight Healthy Pregnancy Program Disease Management Diabetes Asthma Heart Failure CAD 19
Telephonic Wellness Coaching A Solution Today s Health Care Expenditures: Reached $1.9 trillion in 2004 and expected to reach $4 trillion by 2015. 75% of these costs can be prevented, delayed or curtailed through lifestyle modifications 1 Weight: 66% of US adults are either overweight or obese. 1 Each year weight issues/obesity causes at least 300,000 excess deaths and ~ 9% of annual US medical costs 2 Tobacco: 21% of US adults use tobacco - the single most preventable risk factor for death and disease, resulting in 438,000 deaths annually and costing over $167 billion a year 3 Stress, Exercise & Nutrition: About 105 million US adults have high cholesterol (>200mg/dL), over 80% do not have it under control. About 50 million US adults have high blood pressure and another 45 million are pre-hypertensive. About 70% of those with high blood pressure do not have it under control. 4 Modifiable lifestyle changes such as exercise, weight management, stress management and proper nutrition may assist individuals with reducing overall health risks that lead to costly chronic health conditions 5 Diabetes: US adults with diabetes has doubled in the last 15 years, reaching 14.6 million in 2005. 6.2 million have it but don t know it and 54 million are pre-diabetic. The total cost of diabetes in the US is $132B (2002 dollars). Lifestyle modifications contribute significantly to prevention and control, including properly managing blood sugar levels, blood pressure and cholesterol 6 1) Health, United States, 2006; US Department of Health and Human Services, http://www.hhs.gov/ 2) Center for Disease Control, Sustaining State Programs for Tobacco Control Data Highlights 2006, http://www.cdc.gov/ 3) Finkelstein et al, Health Affairs Web Exclusive, May 2005 4) Center for Disease Control, National and State Perspectives 2004, http://www.cdc.gov/ 5) Agency for Healthcare Research and Quality, Dec 2004, http://www.ahcpr.gov/ 6) 6) CDC, Diabetes At-A-Glance 2007, http://www.cdc.gov/ 20
Telephonic Wellness Coaching - Criteria Program Weight Management Risk Criteria BMI of 25 Exercise Does the member exercise less than 2 times per week? Nutrition Does the member self report high cholesterol or a fair to poor perception of current health? Tobacco Cessation Daily use of tobacco products Stress Management Feels tense, anxious, or depressed and stress has impacted health in the past year Heart Health Lifestyle Systolic BP 140 or Diastolic BP 90 Indicates has high BP & is on medication Cholesterol 240 or HDL < 40 High LDL Indicates has high cholesterol & is on medication Indicates has heart problems, but no heart failure Diabetes Lifestyle Indicates that he/she has diabetes and BMI > 25 21
QuitPower Advanced Tobacco Cessation Program Our Advanced Tobacco Cessation Program Supports your efforts to control health care expenditures through decreased medical costs and improve productivity at the workplace. Provides employees with the tools, resources and coaching support they need to achieve optimal cessation outcomes. Combines online cessation program capabilities in conjunction with print materials, a personalized wellness coach and Nicotine Replacement Therapy (NRT). 22
QuitPower Advanced Tobacco Cessation Program QuitPower focuses on a member s unique smoking cessation needs - coaches use specific measurable and attainable goals such as: Establishing a smoking quit date. Provide encouragement, and reinforcement. Continual education on the harmful physical effects of tobacco and the benefits of tobacco cessation. Helping members recognize common tobacco triggers. Implementing the most appropriate OTC NRT. A follow-up call 6 months after program completion for additional support and encouragement to maintain a tobacco-free life and to collect final program outcomes. Referrals to other UnitedHealthcare programs if appropriate NurseLine, Disease Management and other Health and Wellness resources, tools and programs. 23
QuitPower Advanced Tobacco Cessation Program Nicotine-based therapies can increase chances of successful tobacco cessation. NRT increases the odds of tobacco cessation 1.5 to 2 times. Nicotine-based therapies are available as transdermal patch or gum. Wellness coaches screen for individual member NRT contraindications, answer questions/concerns, help ensure correct usage, then it is ordered and sent directly to the member s home. Source: BMJ Group, 2007. Brunnhuber et al. Putting Evidence into Practice: Smoking Cessation. 24
QuitPower Advanced Tobacco Cessation Program The QuitPower program brings several distinct advantages to employees: Two additional outbound support calls (compared to our competitors) to aid them with maintaining a tobacco-free life. Consistent coaching by an assigned, dedicated wellness coach for each member enrolled. Integration with the University of Michigan online health assessments. Proactive telephonic outreach to drive participation and realization of benefits. Integrated online and telephonic experience. Unlimited inbound calls. Program self-referral for members who do not engage in the on-line health assessment. 25
UnitedHealth Wellness: Employer tools
Worksite Flu Shots Provide: 44% reduction in physician visits for upper respiratory illnesses in healthy working adults. 57% reduction in lost workdays. Estimated $46.85 saved per every vaccinated employee. $23.50 per participant 2009 price. Adult Flu Vaccination clinics are offered as a buyup option to UHC customers. Clinic minimums require at least 40 participants. Source: Nichol KL, Lind A, Margolis KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med. 1995;333:889-893. Rothberg MB, Rose DN. Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis. Am J Med. 2005;118:68-77. Prevention and Control of Influenza. Recommendations of the Advisory Committee on Immunization Practices. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/rr55e628a1.htm. Accessed July 2006. 27
Onsite Health Screenings Know Your Numbers provides onsite preventive screening services that supports individuals with identifying common health risk factors that may be tied to costly chronic conditions if left untreated. Know Your Numbers includes: Total Cholesterol and HDL Blood pressure Glucose Body mass index Integrated with PHR and HA Outcome aggregate reporting 50 participant minimum $45 per participant, all-inclusive 28
On-Site Education Programs Our Care24 programs offer over 50 health & well-being topics that educate your employees about the importance of maintaining good health. Professional trainers will focus on issues such as: Wellness and You Taking Care of Health Balancing Work and Home Smoking Cessation Stress Management Healthy Eating on the Run Aging Well 29
Communication tools Communication Resource Center (CRC) Health and wellness articles & e-mail content Downloadable communication templates, toolkits, brochures, fliers, check stuffers, and posters Customized newsletters using the Build a Custom Newsletter capability Workplace wellness template work plans Turnkey workplace program solutions 30
Tools for Wellness CD format Getting started tools and templates Employee engagement resources: Turnkey solutions Workplace wellness campaigns Promotional tools and health fair materials 31
Turnkey Programs Complimentary programs that can be administered when you re ready! 32
Lose & Win Weight Loss Program Train the trainer model Onsite support group 8 week program UnitedHealthcare provides the training and ongoing support for facilitator UnitedHealthcare provides all of the program material on a CD. Facilitator guide Participant guide Power Point presentations Weekly health tips 33
Lose & Win Weight Loss Program Understand the benefits of weight loss Determine a healthy weight range Understand the key components of weight loss Review portion sizes Learn everyday ways to move more Discuss the importance of tracking Set realistic and achievable goals 34
Employer Reporting Health Assessment: Completion report Summary report* Comparison summary Online Health Coaching: Completion report Summary report** Utilization Reports: myuhc registrations *Requires 50 completions **Certain sections of the report may require minimum participation or have limitations to maintain HIPAA compliance * Available with buy-up health reward incentive administration programs. 35
2008 Well Deserved Award Winners Case Study
Well Deserved Award Winners About the study: 94 customers participated in 2008 Over 150,000 members in Well- Deserved client group and 620,000 members in the control group Summary Results Utilizing the Consumer Activation Index: Higher level of activation among Well- Deserved customers Activation was higher in each member life stage segment Overall CAI score of the Well Deserved applicants was 3% higher for Private Sector customers and 5% higher for Public Sector customers 37
Well Deserved Award Winners Results 38
Well Deserved Award Overview UnitedHealthcare Key Account and Public Sector customers were invited to submit applications for the Well Deserved Wellness Award. Applications were screened and scored based on evaluation of the customer s efforts to instill and support employee awareness and ownership of their behavioral impact on their own personal health. The consumer activation scores and claims costs of the top scoring Well Deserved applicants were compared to the balance of the UHC Key Accounts and Public Sector book. Customers most engaged in a corporate Wellness Program experienced greater consumer activation among members in each of the life stages and lower allowed costs per member per month than their peers for the period ending June 2008. 39
Elements of Effective Wellness Programs Customers with a High Impact Wellness Programs: Assess Population and Create Awareness Provide Personal Health Record Sponsor Biometric Screenings Conduct Direct Employee Education Conduct Program Promotional Campaigns Conduct Wellness Promotional Campaigns Offer Worksite Solutions Integrate Wellness into Corporate Infrastructure Develop and Execute Strategic Plan Incent and Reward Participation Measure Outcomes 40
Summary of UnitedHealth Wellness Programs
UnitedHealth Wellness Standard Programs for All Customers Health Assessment Online via myuhc.com English or Spanish Integrated with Care Management Provides personal health profile Paper option available for additional fee Online Health Coaching Programs designed to motivate and encourage the adoption of healthy behaviors Programs include: exercise, weight, nutrition, stress, tobacco cessation, diabetes Lifestyle, heart health lifestyle Personal Health Record Individual management of health care utilization Pre-populated with limited medical and pharmacy claims Health and Wellness Publications Care24 and/or Nurse Line SM 24/7-365 access to nurses or master s level counselor Health education Medical Triage On-site educational programs Preventive Care Reminders Direct-mailed reminders to individuals Reminders include: childhood immunizations, colorectal, adolescent immunizations, women s health, diabetes and coronary artery disease Health Discount Program Discounts on health and wellness related products and services Discounts range between 5-50% Popular discounts include: Jenny Craig, Global Fit TM gym discounts, tobacco cessation, fitness apparel, lasik surgery and more. Available on myuhc.com Healthy Mind, Healthy Body e-newsletter Monthly email distribution Bi-annual hard copy distribution Individual selection of up to five health topics 42
UnitedHealth Wellness Buy-up Programs for Fully Insured or ASO Customers Biometric Screening On-site biometric screenings by certified screening technicians to support workplace wellness efforts Screening package includes: cholesterol, HDL, cardiac ratio, glucose, blood pressure, BMI, and body fat Results integrated into the Personal Health Record located on the health and wellness page of myuhc.com Instant personal results coupled by certified screening technician Requires a pre-registration of 50 participants per location and an 60-day minimum set-up/promotion lead Free registration options: online, telephonic, or paper Free employer communication and promotion toolkit Free employer aggregate results report Adult Influenza Immunization Clinics On-site delivery of influenza vaccine to adults 18 years and older by registered nurses to support workplace wellness Requires a pre-registration of 40 participants per location and 60-day minimum set-up/promotion lead Free employer communication and promotion toolkit *Minimum participation required. Additional fee available to all UHC customers on UNET platform (not available to customers on Prime) 43
UnitedHealth Wellness Buy-up Programs for ASO Customers Standard Wellness Coaching Telephonic or mail-based coaching support for one of seven lifestyle programs located on myuhc.com Dedicated coach throughout program duration 3-5 outbound coaching call model with certified wellness coach Unlimited inbound calls Free employer communication and promotion toolkit QuitPower Advanced Tobacco Cessation Telephonic coaching support by a certified wellness coach Dedicated coach throughout program duration 5-8 Outbound call model Free over-the-counter (OTC) nicotine replacement therapy (NRT) (patch or gum) Unlimited inbound calls Self-referral option Free employer communication and promotion toolkit Health Rewards - Clinical Incentive Management Program Spans the continuum of care- Staying Healthy, Getting Healthy, Living with Illness- to reward behaviors that make the most sense based on selfreported health risks via the online Health Assessment and/or claims history. Employer-funded rewards can be provided in a variety of forms including: gift cards, health reimbursement accounts, etc. *Available to ASO customers with 750 members for an additional fee 44
UnitedHealth Wellness Buy-up Programs for ASO Customers Healthy Weight Program Non-surgical approach with general and weight specific assessments Targets moderate and high risk individuals with BMI>25 10 call coaching model with unlimited inbound telephonic support Access to website content, tools, trackers and webinars on weight loss topics Integrated with existing wellness, disease management and psycho-social programs Designed to support and motivate individuals to achieve 5%-10% weight loss Healthy Back Program Lifestyle intervention and condition management program to deliver savings by improving self-care and addressing care-seeking patterns for those with chronic back conditions Use of telephonic nurse outreach, online tools, videos and other interactive education materials Fully integrated with other disease management programs and promotes use of UnitedHealth Premium Designation Program providers Educates participant on the important role the primary care physician, chiropractors and physical therapists play in managing back pain Member gains confidence in managing back pain episodes, they improve self-care skills and receive guidance in navigating the healthcare system *Available to ASO customers with 750 members for an additional fee 45