Koop Award Winner Medical Mutual of Ohio with Connie Beutel

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Koop Award Winner Medical Mutual of Ohio with Connie Beutel

  1. 1. Medical Mutual Employee Wellness Program: Implementation and Results June 8, 2011 ©2009 Medical Mutual of Ohio
  2. 2. Purpose and Mission Fundamental purpose: Improve the health and productivity of our population by modifying lifestyle behaviors that negatively impact well-being Medical Mutual Program Mission: “To provide the means and opportunities for employees to reach and maintain their best possible well-being” 2 ©2009 Medical Mutual of Ohio
  3. 3. Medical Mutual’s EmployeeProgramMakes a strong commitment to wellness ensuring that Medical Mutualwill meet and exceed strategic goals: Keep our healthy employees healthy Reduce the risks of the medium and high-risk employees Positively impact healthcare cost/trend Enliven and rejuvenate our corporate culture 3 ©2009 Medical Mutual of Ohio
  4. 4. Employee Program DirectionShift in Focus… From: Basic Awareness and Program Participation To: Concrete, Measurable Outcomes – Reduction in employee health risk – Economic Analysis 4 ©2009 Medical Mutual of Ohio
  5. 5. Company Demographics•Approx. 2700 employees •Years of Service: Less than 5= 32%•75% Female; 25% Male Over 5= 68% Over 10= 51% Over 20= 25% Employee Breakdown by Age 35% 30% 25% 20% 15% 10% 5% 0% 20-29 Year 30-39 Years 40-49 Years 50-59 Years 60-64 Years Over 65 Old Old Old Old Old Years Old 5 ©2009 Medical Mutual of Ohio
  6. 6. Medical Mutual’s Program Timeline 2004 2006 2003 2005 •Toledo Wellness •Web-based Healthy Center Opening•Corporate Wellness •Walking for Wellness Living ProgramsProposal approved •Roll-out ofby executive team •Weight Watchers •Cleveland Wellness REWARDS program Center Opening•Full implementation •Onsite Health •Lunch and Learnof health promotion Screenings •Education Modules Seminarspractices into day-to-day operations •Onsite Immunizations •Health club •Smoking Cessation membership Program•First Health •Enhanced employee reimbursementAssessment (HA) preventive benefits •Annual employee •Recipient of NBGH wellness survey Platinum Award and Local Healthy 50 •Nurse Line Award •Cleveland Cafeteria • Transition from Grand Opening – gift incentives to healthy menu choices healthcare premium discount 6 ©2009 Medical Mutual of Ohio
  7. 7. Medical Mutual’s Program Timeline 2007 2008 2009 2010•Onsite Mammography •Continual •Incentives for •SuperLoser WeightScreening Programming Preventive Care Loss Challenge Analysis/Evaluation •C. Everett Koop Award •Implementation of New•Pilot Program: Onsite •Weight Loss Fitness CenterBP Machines •Amer. Heart Assoc. Fit Challenge Management Team Company Award•Employee Assistance •Cooking •Implementation of •Rollout of OnsiteProgram Integration Demonstrations Telephonic/Online Hypertension Pilot •ROI Calculation Lifestyle Coaching•HA and HLPs Made •Quarterly Fitness •Measurement of •Fresh Produce Home Contests throughAvailable to Non- Delivery ProgramInsured Employees Obesity in the Wellness Centers Population •Rollout of SuperWell for •SuperWell for Life Web•Incentive Options •Rollout of Incentive Life Web site site EnhancementsAdded to REWARDS Tracking and •Analysis of CafeteriaProgram •Program Evaluation Fulfillment Program Food Purchases against Industry•HR Dept. Includes •Expansion of •Benchmarking with BenchmarksWellness Initiative in Employee Preventive NBGH and HERO •Smoking SurchargeCompany Survey Benefits Implemented 7 ©2009 Medical Mutual of Ohio
  8. 8. Wellness Program OfferingsPoint System allows us to heavily weight programs that we feel are most important for employees to utilize. Health Promotion Healthy Habits Education Weight Watchers-120 Health Assessment-400 Onsite Health Screening-300 Education Modules/Quiz-120 QuitLine Program-120 Goal Getter Program-300 Chiricosta SupeLoser Challenge-150 Virtual Health Guides-100 The Chef’s Garden Purchase-50 Flu Immunization-100 Dental Visit-50 Lunch & Learn Seminars-240 Lifestyle Coaching-100 Preventive Care Visit-50 Disease Management Program-100 Quarterly BP/ Weight Clinics-75 Fitness Join Company Fitness Center-50 Healthy Environment/Culture Join Community Fitness Center-50 Tobacco Free Campus Company Fitness Center Check-in-120 Healthy Cafeteria/Vending/Catering Options Quarterly Fitness Center Contests-40 Accessible Stairwells Fitness Evaluation-150 Coordination with Employee Assistance Program Physical Activity Cardio Log-120 Wellness Integrated into Orientation Sessions Walking Program-160 Visibility/ Accessibility of Wellness Team and Program Company Sponsored Fitness Walks-25 Comprehensive and Multi-Modal Communications Community Fitness Event Participation-25 Executive Team Communications 8 ©2009 Medical Mutual of Ohio
  9. 9. Employee Wellness Site 9 ©2009 Medical Mutual of Ohio
  10. 10. Participation Results ©2009 Medical Mutual of Ohio
  11. 11. Participation Analysis: Annual Growth Yearly Participation Cum ulative Participation 2+ Tim e Participants 3+ Tim e Participants 4+ Tim e Participants 12 0 % 92% 98% 10 0 % 92% 92% 9 4 %1% 9 86% 8 7% 82% 8 1% 8 1% 79 % 83% 76 % 73 % 75% 80% 68% 69% 6 1% 62% 57% 60% 49% 40% 20% 0 0% 2005 2006 2007 2008 2009 2005-2009 (N=2,549) (N=2,577) (N=2,500) (N=2,928) (N=2,835) (N=1,813) 11 ©2009 Medical Mutual of Ohio
  12. 12. Participation: Employee Healthcare CostsBy Rewards Points Earned•There is a strong correlation between participation intensity and averaged annual healthcare cost increases $5,000 $ 4,592 $ 4,565 Claims Payout Per Employee $4,500 $ 4,520 Average Annual $ 4,177 Healthcare Costs Increase $4,000 Points $ % $3,500 0-2000 (N=257) $581 28% $ 3,129 $3,000 $ 3,009 2000-3999 (N=242) $465 20% $2,500 $ 2,290 4000-5999 (N=244) $415 14% $2,000 $ 2,107 6000 + (N=954) $320 10% $1,500 $1,000 2005 2006 2007 2008 2009 12 ©2009 Medical Mutual of Ohio
  13. 13. Participation: Average Lost Workdays byRewards Points Earned • Fewer clean trends in lost workdays associated with program involvement. • Those earning greater than 4,000 points show less lost workday increases as compared with those earning less than 4,000 points. 3.0 3.09 2.5 2.28 Average Annual Lost 2.24 Workday Increases Lost Workdays 2.0 Days % 1.88 Points 1.7 1.5 0-2000 (N=257) 0.26 19% 1.38 1.36 2000-3999 (N=242) 0.49 51% 1.0 0.95 4000-5999 (N=244) 0.17 13% 0.5 6000 + (N=954) 0.18 11% 0.0 2005 2006 2007 2008 2009 13 ©2009 Medical Mutual of Ohio
  14. 14. Wellness Points/T1, T2 Risk Status Wellness Rewards Points (Cumulated 2005 ~ 2009) Time One Risk Time Two Risk Status Status N Average 0-2 0-2 871 8,801 3-4 112 8,037 5+ 15 7,659 3-4 0-2 188 8,953 3-4 223 8,503 5+ 39 7,023 5+ 0-2 20 7,442 3-4 78 8,684 5+ 86 6,905Among two time HRA Participants (2005/2006 vs. 2007/2008), N=1,632 14 ©2009 Medical Mutual of Ohio
  15. 15. Participation Analysis • Program participation remains high, with a cumulative participation of 98% • Repeat participation was especially high, with 94% of employees participating at least two years from 2005 through 2009. • In 2009, 75% of employees took part in at least one program. • Strong correlation between participation and averaged annual healthcare cost increases. • Correlation between participation and remaining low risk or moving to lower risk from T1 to T2 HRA. 15 ©2009 Medical Mutual of Ohio
  16. 16. Risk Analysis and Economic Results ©2009 Medical Mutual of Ohio
  17. 17. Risk Analysis:Shift in Risk Groups Risk 2004/2005 2007/2008 2009/2010 % Change Low Risk 61.1% 66.1% 68% 6.9% (0-2) Medium Risk 27.6% 25.3% 23.4% 4.2% (3-4) High Risk 11.3% 8.6% 8.6% 2.7% (5+) 17 ©2009 Medical Mutual of Ohio
  18. 18. Risk Analysis: Shift in Risk Measures•While improvement is evident in several measures, there is still a negative shiftin cholesterol (+1.9%), blood pressure (+2.4%) and weight/BMI (+3.0%). Time 1 High Time 2 High Risk Net Change % Risk % % Point* Physical Activity 13.4% 8.7% -4.7% Safety Belt Use 12.7% 10.4% -2.3% Life Satisfaction 5.8% 3.8% -2.0% Smoking 8.4% 6.6% -1.8% Job Satisfaction 5.5% 4.4% -1.1% Medication to Relax 0.9% 0.5% -0.4% Alcohol 1.4% 1.1% -0.3% Perceived Health 8.6% 8.3% -0.3% Illness Days 3.4% 4.4% 0.9% Existing Disease 12.9% 14.0% 1.1% Cholesterol 5.4% 7.3% +1.9% Targeted for Intervention Blood Pressure 34.1% 36.5% +2.4% Weight (BMI) 48.3% 51.3% +3.0% 18 ©2009 Medical Mutual of Ohio
  19. 19. Risk Analysis :Impact of Risk Categories on Medical Cost MED/HIGH RISK LOW RISK Medical Costs 2008 Healthcare Medical Costs $6965 Costs $2,879 +$2215 -$1522 +$3435 +$623MED/HIGH RISK LOW RISK 2009 Healthcare MED/HIGH RISK LOW RISK Medical Costs Medical Costs Costs Medical Costs Medical Costs $9180 $5543 $6314 $3502 N=1,599; MMO Employees 19 ©2009 Medical Mutual of Ohio
  20. 20. Excess Medical Cost Due to ExcessRisk Status $ 14 ,0 0 0 $ 12 ,5 7 9M $ 12 ,0 0 0ed $ 10 ,0 0 0 i E xc e s s C o s tc $ 8 ,0 0 0 B ase C o st $ 6 ,9 9 4 $ 9 ,0 9 0a $ 6 ,0 0 0 l $ 4 ,5 0 9 $ 3 ,5 0 5 $ 4 ,0 0 0 $ 1,0 2 0Co $ 2 ,0 0 0 $ 3 ,4 8 9 $ 3 ,4 8 9 $ 3 ,4 8 9 $ 3 ,4 8 9st $0s Lo w R is k N o n P a rt ic ipa nt s M e dium R is k H igh R is k ( 0 - 2 R is k s ) ( 3 - 4 R is k s ) ( 5 + R is k s ) Number of Risks *2010 HRA and 2009 Medical Costs 20 ©2009 Medical Mutual of Ohio
  21. 21. Excess Lost Work Days Due toExcess Risk Status 10.0 S 9.0 T 8.0 7.0 6.1 D 6.0 Base Cost Excess Cost 4.6 5.0 D 3.5 4.0 4.3 a 2.9 3.0 1.7 y 2.0 s 1.0 1.8 1.8 1.8 1.8 0.0 Low Risk Non Participants Medium Risk High Risk (0-2 Risks) (3-4 Risks) (5+ Risks) Number of Risks 21 ©2009 Medical Mutual of Ohio
  22. 22. Healthcare Cost/T1, T2 Risk Status Average Annual Healthcare Paid Time Two Time One Risk Risk Status Status Average N 2005 2006 2007 2008 2009 05-09 0-2 871 $2,070 $2,717 $2,558 $2,936 $3,687 $2,794 0-2 3-4 112 $2,348 $4,041 $4,566 $3,716 $4,467 $3,828 5+ 15 $6,495 $4,921 $6,696 $5,580 $5,309 $5,800 0-2 188 $2,956 $2,828 $3,080 $3,369 $3,721 $3,191 3-4 3-4 223 $3,777 $3,625 $4,046 $3,724 $5,132 $4,061 5+ 39 $2,900 $3,985 $6,276 $5,977 $5,728 $4,973 0-2 20 $2,510 $2,734 $5,453 $2,869 $4,593 $3,632 5+ 3-4 78 $6,536 $7,560 $7,201 $7,520 $9,583 $7,680 5+ 86 $5,555 $6,958 $7,144 $8,455 $11,905 $8,003 Among two time HRA Participants (2005/2006 vs. 2007/2008), N=1,632 22 ©2009 Medical Mutual of Ohio
  23. 23. Lost Work Days/T1,T2 Risk Status Average Work Lost Days (STD) Time One Time Two Average Risk Status Risk Status N 2005 2006 2007 2008 2009 05-09 0-2 746 1.13 0.86 0.67 1.18 1.08 1.85 0-2 3-4 103 2.20 0.54 2.24 3.17 2.54 2.50 5+ 13 2.68 8.85 0.00 1.37 0.00 3.20 0-2 162 1.62 2.66 0.56 0.71 1.74 2.41 3-4 3-4 194 2.11 2.20 0.88 2.36 2.15 2.94 5+ 36 2.71 0.00 0.89 3.87 4.86 3.92 0-2 18 1.55 2.56 2.00 2.14 0.00 1.05 5+ 3-4 71 4.47 3.39 2.66 6.32 5.56 4.42 5+ 72 4.07 5.79 10.26 4.64 8.41 6.63 Among two time HRA Participants (2005/2006 vs. 2007/2008), excluding women with 23 pregnancy claims N=1,415 ©2009 Medical Mutual of Ohio
  24. 24. Excess Cost by Risk/Condition Adjusted* Mean Risk Factor/ Prevalence Not Excess Disease State At Risk at Risk Cost Hypertension 37.4% $3,733 $3,387 $346 Cholesterol >=240 6.4% $3,578 $3,523 $55 Obesity (BMI>=30) 37.1% $4,757 $3,511 $1,246 Diabetes 6.8% $10,115 $3,524 $6,591 Coronary Artery Disease 6.2% $6,087 $3,827 $2,260 Asthma 11.4% $4,516 $3,899 $617 Smoking 6.1% $3,517 $3,429 $88 Depression 11.7% $5,641 $3,755 $1,886 None of the listed risks 28.6% $2,633*Adjusted for age, gender and all listed risksStudy population: N=2,047 (2009 HRA and 2009 Medical and Drug Paid Amount) 24 ©2009 Medical Mutual of Ohio
  25. 25. Studying Relationships… •BMI and Lost Workdays •BMI and Healthcare CostsThen Developing Strategic Initiatives 25 ©2009 Medical Mutual of Ohio
  26. 26. BMI vs. Lost Workdays Obese (BMI >30) 5 4.5 4 3.16 3 2.18 1.56 1.49 Days 2 1.17 1 0 <25 25-27.4 27.4- 30-34.5 35-39.9 40+ (N=355) (N=216) 29.9 (N=270) (N=187) (N=144) (N=197) BMI 26 ©2009 Medical Mutual of Ohio
  27. 27. BMI vs. Healthcare Costs Obese (BMI >30) $8 ,0 0 0 $6,871 $7,0 0 0 $5,374 Paid Amount $6 ,0 0 0 $5,0 0 0 $4,113 $4 ,0 0 0 $3,290 $3,227 $3,094 $3 ,0 0 0 $2 ,0 0 0 $1,0 0 0 $0 <25 25-27.4 27.4- 30-34.5 35-39.9 40+ (N=355) (N=216) 29.9 (N=270) (N=187) (N=144) (N=197) BM I 27 ©2009 Medical Mutual of Ohio
  28. 28. BMI InitiativesChiricosta Challenge• Six-Month Weight Loss/Get Healthier Challenge• CEO Endorsement and Ownership of Program• CEO Blogs and Communications• 1400 Participants• 6500 Pounds Lost 28 ©2009 Medical Mutual of Ohio
  29. 29. BMI Initiatives (cont’d)• Fitness Center Reimbursements• Onsite Fitness Facility Check-in Points• Onsite or Community Facility Membership Points• Fitness Center Contests• Cardio Log Entry Points• Walking Program• Company Sponsored Fitness Walks• Lunch and Learn Seminars• Education Modules• Healthy Choices: Cafeteria, Vending, Catering, Company Meetings• Cafeteria Promotions, Educational Displays• Healthy Cooking Demos 29 ©2009 Medical Mutual of Ohio
  30. 30. Benchmarking –How are we doing against national standards? ©2009 Medical Mutual of Ohio
  31. 31. Health Enhancement ResearchOrganizationHERO Scorecard ResultsThe scorecard is a tool designed to determine employee healthmanagement best practice. It can be used as an inventory, anindicator for program success and as a benchmarking tool."The greatest value of the Scorecard is in providing an inventoryof EHM best practices for consideration; your scores provide anindication of where you can identify opportunities to enhance yourprogram." 2008 2009Medical Mutual of Ohio Score 147 162Total possible points: 200National Average: 96 31 ©2009 Medical Mutual of Ohio
  32. 32. National Business Group on HealthWellness Impact ScorecardThe scorecard was developed to assist employers inunderstanding levels of achievement in improving health,the strengths and weaknesses of their programs and tohelp them benchmark against the programs of otheremployers. Overall Progress Total MMO’s Score Potential Points 2008 2009Company’s Efforts to Improve Health (Level 1) 50 43 50Employee Engagement (Level 2) 50 39 50Outcomes and Analysis (Level 3) 100 75 87.5Total 200 157 187.5 32 ©2009 Medical Mutual of Ohio
  33. 33. Cultural Analysis:Impact of Wellness ProgramWellness Program Survey Results – 94% of employees surveyed feel that the Wellness programs are making a positive impact on the culture at MMO. – 90% of employees surveyed feel that the Wellness programs are making a positive impact on their health. – 82% of employees responded that they are very satisfied or satisfied with the Wellness program. 33 ©2009 Medical Mutual of Ohio
  34. 34. Executive Summary and Analysis ©2009 Medical Mutual of Ohio
  35. 35. Executive Summary and Analysis• Participation in the wellness program showed a positive impact on healthcare cost trends for three consecutive study periods.• The low risk population continues to grow, a key achievement in our health management strategies.• Employees who earned more reward points had smaller healthcare cost increases and smaller lost workday increases than those who earned less points.• In general, an increased participation level (years of participation or number of wellness points) was associated with an increase in the percentage of individuals at low risk.• The wellness program had the most impact on percent risk reduction for those employees with risk factors for: physical activity, safety belt use, life satisfaction and smoking.• The number of employees at risk for weight (BMI), blood pressure, and elevated cholesterol increased over time and will remain a focus of programming and interventions. 35 ©2009 Medical Mutual of Ohio
  36. 36. Future of Wellness/Next Practices…1. Focus on the individual and how to impact: Personal buy-in and personal significance of change in health status Sustainable behavior Health in the context of life2. Moving the general public to healthier lifestyles Employer involvement in community health Role of the community in employee/family health Health as a social trend; social “movement”3. Standardization of program offerings, measurement, evaluation and performance metrics4. Continued focus on the influence and impact of corporate culture 36 ©2009 Medical Mutual of Ohio

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