The Evolution of Your Plan for Health (YP4H) Gretchen Feldmann Strategy & Engagement Manager, Benefits firstname.lastname@example.org
YP4H Long Range Goals Optimize Wellness and Improve Productivity Maintain/Strengthen “Employer of Choice” Status Reduce Health Care Cost Inflation to Single Digits Demonstrates a culture of support that is in line with the university’s talent strategy Allows savings achieved through YP4H to be reallocated for faculty and staff salaries & other university initiatives
2 YP4H 2006-2009 Three Initiatives Focused on Controlling Cost Within the construct of YP4H, there are 3 health improvement initiatives aimed at reducing/controlling health care costs: We continue to increase YP4H brand awareness, and overall program participation and engagement. YP4H's primary focus is on helping faculty, staff and their family members reach their healthiest state by offering programs and incentives for identifying and acting on health related conditions, promoting cost-effective choices based on individual needs and taking control of health care spending. Faculty and Staff Engagement We provide high-touch, personalized programs to manage and decrease health risks. To motivate individuals to participate and complete programs, we offer incentives; premium reduction for completion of biometrics and PHA, and cash based incentives for completion of other health related activities including seminars, classes, and other specialty activities. Health Risk Identification and Management
We offer a health plan for individuals with limited household income. This plan is intended to help individuals reduce the financial barriers they may encounter with obtaining necessary health care.
In addition, individuals who actively participate in condition management programs are eligible for discounts on prescription drugs used to manage certain chronic conditions.
Reducing Barriers to Obtaining Health Care
3 Detailed Success—Health Risk Improvement and Trend¹ Continuously enrolled faculty and staff population achieved health improvement by either risk stabilization or actual improvement.² Greatest change occurred in 2008 with a 1% positive change in health risk Decreased trend by 3%. Represented approximately $3,000,000 in avoided cost³, unadjusted for regression and price increases. Percent of continuously enrolled populations by change in health risk status Stable or Improved OSU’s improvement in health among faculty and staff had a positive impact on overall costs. Declining Health ¹Trend—change in health care cost, year over year, calculated on a per employee or per member basis. ¹Health risk status—health state classification (low, moderate, high and extreme) derived from predictive modeling to assign a risk level that accounts for age, gender, and the degree to which the member has a chronic illness, using demographic and pharmacy data. ²Source: AonHewitt’s GPS study 2006-2009 ³Avoided cost—estimated savings from year over year change in population health risk and average cost per cohort.
Year-Over-Year Trend Average Per Employee Per Year (PEPY) cost trends from 2006 through 2010 are below national trend numbers National Trend 2007: 8.5% 2008: 9.0% 2009: 8.5% 2010: 7.5% $9,668 (10.7%) $8,730 (8.3%) $8,058 (2.4%) $7,868 (4.4%) $7,538 (4.5%) 10.9% 9.6% 5.2% 2.5% 6.8% 11.0% -0.1% 7.7% 6.0% 3.2%
5 Evolving Challenges Core enrolled OSU populations are aging; over 70% of remain with OSU year over year. Average age in 2009 for faculty and staff was approximately 47 years. Faculty/staff with chronic disease accounted for 38.1% of the population and drove over 66.0% of the cost in 2009. Prevalence of chronic disease is high with almost 12% of faculty/staff demonstrating more than one chronic disease. The dependent populations exhibit significant chronic and high cost disease. Aging will drive further growth in chronic disease prevalence.
YP4H 2.0 – Looking Ahead MISSION Empower our community, staff, and faculty to pursue a life of health and wellness through the concept of P4 medicine, which will enable a plan for health for each individual that is predictive, preventive, personalized, and participatory. VISION In alignment with our goal of achieving eminence through a high-performing, supportive culture, we will foster an environment that inspires individual well-being to create the healthiest university in the nation.
YP4H 2.0 – What Does It Mean? Provides the opportunity to re-engineer YP4H to engage more faculty/staff, encourage behavior change, and develop innovation. How can current programs/services be updated/enhanced to increase accessibility/participation and decrease barriers? How can healthy faculty/staff (who aren’t currently participating in YP4H) become engaged participants? How can Ohio State become a national PHM leader?
YP4H 2.0 – What Does It Mean? Encourages us to create a social norm focused on health/wellness. How can faculty/staff be encouraged to incorporate health/wellness behaviors into their work day? How can we create an environment where healthy behaviors are the norm and not the exception? Focuses on understanding the intrinsic drivers behind engagement. Why do some faculty/staff participate, and others choose not to engage? How can we utilize those “knowns” to create innovative engagement approaches?
YP4H 2.0 – What Does It Mean? Approaches engagement with a personalized model. YP4H can no longer be approached with a one-size-fits-all approach. How can we use segmentation data to approach different populations of faculty/staff? How can we provide personalized choices? How does YP4H 2.0 integrate with P4 Medicine? Connects engagement with education. How can we connect the dots between YP4H and health care cost? Faculty/staff need to understand the connectivity.
Health Care Strategies for 2012 and Beyond OHR – the Payer Optimize Plan Design and Funding
High performance/Accountable Benefit Design
Create a design structure focused on individual accountability by rewarding and penalizing for certain actions
Faculty and Staff must comply with certain requirements to receive a richer level of benefits and/or reduction in premiums
OSUMC – the Provider Transform Health Care Delivery
Integrate providers and health plan (care coordination)
Health management services to Central Ohio Employees
Exploring Health Exchange to further drive patient volume and diversify revenue sources
Creating a Balanced Health Care Strategic Framework OHR—the Payer Optimize Plan Design and Funding Provide plan design options aligned with incentives that promote health and appropriately associate member benefit costs with health choices OSUMC—the Provider Transform Health Care Delivery Provide personalized health care services in which members participate with providers in making health care decisions OSUHP—the Plan Improve Health Provide programs and services to help manage members’ care by reducing risk factors to optimize health and productivity Y H Organization Needs