Isn’t it time someone created a healthier health plan? We thought so, too.
The Facts are Startling 50% of health care costs and premature death, illness and disability are due to health behavior-related conditions “ Health” and “health care” are only remotely related – 35% of all health care costs are wasteful or inefficient 75% of surgical procedures are elective and 1/3 of all elective surgeries are unnecessary Only 50% of high dollar claimants can be predicted from claims from one year to the next Sources: IFTF/CDC MBGH/Juran Institute Rand Corporation
$50 account allocation for online completion (limited to one/family each year) $200 added to account for mastering HealthModels for each enrolled family member Goals achieved with knowledge, skills and functional provider-patient relationship $100 added to account for enrollment for each eligible family member Participation in Personal Health Coach program Engaging with Personal Health Coach to identify goals, educate and manage their disease Identify, Improve Risk & Care Integrated & Incentivized Strategy Identify Health Risk Assessment Engage Personal Health Coach Enrollment Graduate Competency Mastery with Personal Health Coach
In 2007, the cost of heart disease and stroke is expected to exceed $210 billion in direct and indirect costs
$60 billion in health care spending attributed to high blood pressure
Major risk factors for heart disease
High blood pressure, high blood cholesterol, tobacco use, diabetes, physical inactivity and poor nutrition
American Heart Association/ CDC
Risk Factors – Controllable or Modifiable 1 American Heart Association 2 What Healthy People Know Reasonable portions; 5 or more servings of colorful fruits and vegetables, nuts and two whole grains daily; Fish twice per week; Mono- and polyunsaturated oils (olive or soybean) 2 Poor Nutrition 65% are overweight, 30% clinically obese Walk as if late for an appointment, Takes a minimum of 10 minutes for health benefit, Add 3 brisk 10 minute walks per day 2 Physical Inactivity About 21 million diabetics in US; 95% are Type 2 diabetes; 80% of Type 2 diabetes directly related to being overweight, obese (diabesity) Diabetes Quit before 30, no change in lifespan . . On average; On average, smokers live 10 years less 2 Tobacco Use Improved diet, exercise, quit tobacco use 1 High blood cholesterol Improved diet, exercise, quit tobacco use, moderate alcohol 1 High blood pressure
Increased levels of satisfaction with benefit plan and employment
Health Management – Personal Health Coach Observed strong correlation between offering incentives, enrollment and cost trend. -3.2% 6.0% Cost Trend 4.0% 2.0% Avg. Enrollment in PHC Program Incentives No Incentives -3.8% 7.1% Cost Trend > 3% Enrollment w/PHC < 3% Enrollment w/PHC
Health Management – Health Assessment Observed strong correlation between offering incentives and completion of health risk profile. There appears to be an emerging correlation between completion and cost trend. -1.2% -0.1% Cost trend 38.1% 1.2% Completion Rate Incentives No Incentives -2.3% -0.9% Cost trend > 50% Completion Rate < 50% Completion Rate
We are taking the complexity out of health care products through new Explanations of Benefits and Monthly Health Statements that are friendly, using plain language and defined from a consumer’s point of view.
increased knowledge in managing their health care Source: Lumenos 2005 Customer Satisfaction Survey 53 % 36 % 19 % 62 % more active involvement in health behaviors health improvement since joining Lumenos switched to a generic prescription drug … and a 93% satisfaction rate
Positively Impacting Costs $2,200 $2,400 $2,600 $2,800 Per Member Per Year 2004 Pre Lumenos 2005 Industry Trend 2005 With Lumenos + 8% – 9% $2,521 $2,723 $2,299