Interactive Question and Answers Session</li></li></ul><li>Webinar, Panelists<br /><ul><li>John Kahle, SVP & Chief Wellness Officer for Intercare Health Solutions</li></ul>John Kahle provides the leadership necessary to ensure that the benefits plans offered by Intercare continually enhance employee health and workforce productivity. He is an expert in the design and implementation of wellness programs and funding options that effectively control benefits costs while supporting a more value-based approach to employee benefits. <br /><ul><li>Bob Goodman, Benefits Manager for Manatee County</li></ul>Bob Goodman has developed an innovative employer program that not only engages the employee but their dependents with innovative plans designs and member incentives. This is the first Government plan that has produced reductions in GASB 45 and their programs have won many prestigious awards. <br /><ul><li>David Hom, President, Care Management Services for SCIOinspire Corp.</li></ul>David Hom is an internationally-recognized expert in the field of Value-based Benefits and Employee Wellness. He joined SCIOinspire after more than 25 years with Pitney-Bowes Corporation, where he was responsible for introducing their leading-edge programs in value-based wellness, which resulted in bending the rate of health care inflation by 50% for over a decade.<br />
Webinar Definitions<br />Definition of Wellness<br />Terminology used in this presentation: Members, Employees, Patients<br />Webinar Audiences: Health plans, employers, vendor community, providers<br />
Health Plan Challenges<br />Health Plan Challenges<br />Solutions<br />Member<br />Engagement<br />Solutions<br />Healthcare Reform<br /><ul><li>Universality
Accountability for cost containment</li></ul>Care Analytics and Reporting<br />Engaging Members and Providers<br /><ul><li>Member Engagement to promote responsibility</li></ul>Data/Analytics<br />Driven Transformation Solutions<br />Payment Integrity<br /><ul><li>Payment Errors
Overpayments, fraud, and abuse</li></ul>Opportunity to Transform<br />Payment Integrity<br />Solutions<br />Care and Wellness Management Effectiveness<br /><ul><li>Improving quality and lowering the demand for healthcare services
Clinical and financial effectiveness and ROI</li></ul>Business Process/ Cost Optimization<br />Legacy Cost Structures<br /><ul><li>Leveraging new technologies
Holistic view of data to make it actionable</li></li></ul><li>Member Engagement, Legislation Impact<br />Areas of Opportunity<br />Burden of cost containment falls on Health plans to maximize the effectiveness of their care dollars<br />Health plans have to innovate to differentiate themselves – and innovative member engagement is a key area of differentiation<br />Wellness programs will be driven by tax incentives for Employers<br />Up to 30% of the premium can be used for wellness incentives beginning in 2014<br />Improving overall health of the membership/employees will be a key differentiator for both health plans and employers <br />Effective member engagement to improve member health <br />Efficient outreach will need to be developed<br />
Headwinds of Healthcare<br />30%<br />58%<br />59%<br />31%<br />67%<br />9%<br />Member Satisfaction<br />Lack of Employee Engagement<br />Insufficient<br />Incentive<br />Health Management Budget<br />Medical Trends<br />Health Habits<br />TowersWatson /NBGH Survey Report “Purchasing Value in Health Care,” 2010<br />Headwinds of Healthcare<br />Key Data Points, 2010<br />
Elements of Wellness<br />Targeted communications<br />Plan designs to drive compliance<br />Senior management engagement <br />Integrated suite of services<br />Other incentives to reinforce behavior changes<br />Culture of health<br />
The “So What Questions”<br />Key Questions<br /><ul><li>How should health plans maximize their care dollars and reduce their administrative costs?
How effective are the programs today to improve member engagement?
How do you think the mid market employer will react to Healthcare Bill?
As an employer, does your insurance company provide data that you can act on?</li></li></ul><li>Member Engagement Solution, Sample Workflow<br />Optional Connections or Referrals<br />
The “So What Questions”<br /><ul><li>Will this solution framework work?
What are barriers to implementing this type of outreach based on a “Gap in Care”
Response from members using text messaging or other web base methodologies
What is the impact of HIPAA/Privacy?</li></ul>Key Questions<br />
Improved Member Engagement, Positive Snowballing effect<br />
The “So What Questions”<br />Key Questions<br /><ul><li>Are these benefits real?
Should Physicians and Hospitals offer this as a service to their patients?
Will the patient value the message if it comes from these sources?</li></li></ul><li>SCIOinspire<br />Just InTime™ Wellness, Overview<br />Library of Content and Video<br />On Member Portal<br />JITW<br />Personalization Engine<br />Customized Member Content<br />Employer’s HRA <br />Medical<br />Claims <br />Biometrics<br />Customized web content based on Alert<br />Pharmacy<br />Claims<br />Lab values<br />Alerts Configuration<br />Outbound IVR<br />Optional Connections or Referrals<br />Text Msg<br />Call Center<br />Member<br />Internet<br />Mail<br />email<br />HIPAA Compliant Alert Message:<br />
The “So What Questions”<br />Key Questions<br /><ul><li>Are there short and long term savings, and how do you measure the savings?
Will a Life or a Disability carrier provide discounts to employers who implement wellness programs?
Does member engagement really matter?</li></li></ul><li>Interactive Q&A Session<br />Please use the messenger on your screen <br />to submit your questions<br />