EBMS’ value-based benefit strategy takes a holistic approach toward employee benefits. This strategy is focused first on the patient/employee, and second on how that impacts the overall financial health of your organization. The approach accomplishes the following:
1. Wraps a benefit design that supports prevention and wellness, with the ability to support the patient in the event of an unplanned or unexpected illness or injury. This is done through the wellness benefit available at first dollar, inclusion of a Health Reimbursement Account that can be carried over from year to year, reasonable out-of-pocket maximums, and generous in-network co-insurance.
2. Engages the employee through incentives, completion of an annual Health Risk Assessment (HRA), and additional funding by the employer into a Health Reimbursement Account or other qualified consumer directed account.
3. Empowers the employee through Disease Management and Wellness initiatives geared toward their personal needs, with targeted interventions from health coaches to educate and encourage compliance.
4. Provides greater access to care through an onsite-clinic. This model connects the provider with the pharmacist and care management team to close the loop between the benefit plan management and the services the patient is actually receiving.
5. Educates the members on the specific health concerns unique to your population. For example, following the completion of an HRA campaign, the group aggregate report might disclose your population to be at high risk for obesity and lung cancer. Through the addition of a smoking cessation program and wellness initiatives, your organization can see an immediate positive impact, with a reduction in your exposure to the illnesses tied to both of those behavior issues, and an increased productivity as members become more active and concerned with achieving good health.
Employee Engagement: Your Tool for Tackling Heath Care CostsDigital Measures
Everyone is concerned about increasing health care costs. This interactive session will review the various triggers that drive health care and insurance costs and cover the major communication and engagement strategies that companies use to reduce their trend. Case studies to be discussed include wellness, employee engagement and communication, benefit plan design and consumerism. Successful benefit incentive programs that support communication programs and have a quantifiable return on investment will also be discussed.
The Maternal Opioid Misuse (MOM) Model team held the first of two overview webinars on Thursday, November 8 from 12:00 p.m. - 1:00 p.m. EST. During this webinar, MOM Model team members presented a variety of information about the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Part D Payment Modernization Model team presented an overview webinar on Wednesday, February 6, 2019 from 1:00 p.m. to 2:00 p.m. EST. This is a repeat of the webinar held on Thursday, January 31 from 1:00 p.m. to 2:00 p.m. EST.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Employee Engagement: Your Tool for Tackling Heath Care CostsDigital Measures
Everyone is concerned about increasing health care costs. This interactive session will review the various triggers that drive health care and insurance costs and cover the major communication and engagement strategies that companies use to reduce their trend. Case studies to be discussed include wellness, employee engagement and communication, benefit plan design and consumerism. Successful benefit incentive programs that support communication programs and have a quantifiable return on investment will also be discussed.
The Maternal Opioid Misuse (MOM) Model team held the first of two overview webinars on Thursday, November 8 from 12:00 p.m. - 1:00 p.m. EST. During this webinar, MOM Model team members presented a variety of information about the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Part D Payment Modernization Model team presented an overview webinar on Wednesday, February 6, 2019 from 1:00 p.m. to 2:00 p.m. EST. This is a repeat of the webinar held on Thursday, January 31 from 1:00 p.m. to 2:00 p.m. EST.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
We at Boehringer Ingelheim know that there are many issues affecting health care in the United States. In this presentation Dr. Lee Sacks of Advocate Health takes a look at accountable care organizations (ACOs) and their role in health care reform. Understanding the Implications of Accountable Care Organizations for Patients and Providers, was a web conference given on July 31, 2012 and which we hope will provide offer an understanding of best practices among ACOs and tips for helping constituents adopt and participate in ACOs.
Aligning Clinical Practice and Process ImprovementiCareQuality.us
According to recent IOM reports, The Future of Nursing, Nurses can play a key role in the healthcare transformation process. Organizations such as the American Nurses Credentialing Center, the American Nurses Association and Magnet programs have supported and strengthened the mission to improve the nursing profession through education, advanced degrees and certifications. Central to the transformation process is self-regulation and accountability for clinical practice (Code of Ethics, ANA). The Peer Review process affirms the nurse's duty to being accountable for professional practice, competence in skills and knowledge in evidence-based care delivery. Thus, peer feedback promotes patient safety, reduces the likelihood of errors, and addresses the human factor element in patient care delivery to improve patient outcomes.
CFO Strategies for Balancing Fee-for-Service and ValuePhytel
Moving from fee-for-service to value-based care is not easy. However, leading health systems are all following a similar blueprint that enables the move to value-based care.
Download this whitepaper to learn how:
- Bon Secours Richmond - Closed 75,801 gaps in care within 12 months, generating $7 million in revenue for chronic & preventive care, while improving quality.
- Northeast Georgia Medical Center - Decreased HbA1C levels across uncontrolled diabetes by an average of 1.6 points within 120 days.
- Riverside Medical Center - Reduced unnecessary readmissions by 40% by using automation to reach and assess patients post discharge.
- Prevea Health - Increased care management productivity by 150% by automatically identifying high risk patients, and automating patient engagement.
Making the shift to value-based care is not easy. However, a growing number of healthcare organizations are finding success leveraging Lean process improvement and health IT to reduce waste, lower costs, and improve quality.
In fact, leading health systems like Bon Secours, Prevea Health, and North Mississippi Medical Center are using these principles to improve care management processes and achieve better patient outcomes.
We have assembled these strategies into a new whitepaper. You will learn:
- How key concepts of Lean thinking can be applied to healthcare
- Why high-performing practices are using Lean to enable care team members to provide better care
- The financial advantages of a team-based, population health management approach in a value-based reimbursement system
The New Healthcare Model - Collaboration is KeyIVCi, LLC
Heathcare reform is quickly changing the face of medicine. Join IVCi and Polycom for an informative webinar covering the power of collaboration in the delivery of healthcare.
In this presentation you will learn:
How Accountable Care Organizations (ACO) are redefining care coordination
The role visual collaboration can play in EHR roll-outs
Reduce unnecessary readmissions through better collaboration
What grant funding sources are available to drive these initiatives
Epstein Becker & Green, P.C., is a national law firm with a primary focus on health care and life sciences; employment, labor, and workforce management; and litigation and business disputes. Founded in 1973 as an industry-focused firm, Epstein Becker Green has decades of experience serving clients in health care, financial services, retail, hospitality, and technology, among other industries, representing entities from startups to Fortune 100 companies. Operating in locations throughout the United States and supporting domestic and multinational clients, the firm’s attorneys are committed to uncompromising client service and legal excellence.
In an article for Healthcare Executive, Don Seymour, Kevin Talbot, and Chad Stutelberg share their insight on developing compensation strategies that link executive and physician compensation models to acute care outcome-based payment methodologies.
In February 2013, the Office of Inspector General (OIG) released a report entitled Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements, in which they found that 26% of facilities fail to meet care planning and discharge planning requirements. Is your facility meeting federal guidelines for care planning?
Download the ABC’s of Care Planning presented by Beckie Dow, RN, RAC-MT for an overview of Care Planning in the Skilled Nursing Facility. Beckie discusses the important link between the MDS 3.0, the Care Area Assessments (CAAs) and the Care Plan.
Learn the essential components of a resident-centered care plan and how to develop a care plan that supports the clinical care that is provided to the patient. Beckie also discusses strategies for completing the CAAs more effectively and using the CAA process to create a more resident-specific care plan.
Learn How To:
1. Define the purpose of a Care Plan.
2. Define the purpose of the Discharge Care Plan and Summary.
3. Identify the correlation between the MDS 3.0 Assessment, the Care Area Assessments (CAAs), accurate RUG-IV Classification, and the Care Plan.
4. List three components of a Resident-centered Care Plan.
Medibank Managing Director speaks at Amercian Chamber of CommerceLaura Harris
Medibank Managing Director, George Savvides presented at the American Chamber of Commerce in Melbourne about Medibank’s approach to primary care and its integrated care pilots.
Decosimo's Shannon Farr and Anderson Busby's Amanda Busby co-presented this PowerPoint at the 2012 Tennessee Bar Association's Health Law Primer on October 3, 2012 in Brentwood, TN.
Presented by Steve Mills, IBM Senior Vice President, Group Executive, Software & Systems Group
Learn more: http://www.ibm.com/software/products/en/category/health-social-programs
We at Boehringer Ingelheim know that there are many issues affecting health care in the United States. In this presentation Dr. Lee Sacks of Advocate Health takes a look at accountable care organizations (ACOs) and their role in health care reform. Understanding the Implications of Accountable Care Organizations for Patients and Providers, was a web conference given on July 31, 2012 and which we hope will provide offer an understanding of best practices among ACOs and tips for helping constituents adopt and participate in ACOs.
Aligning Clinical Practice and Process ImprovementiCareQuality.us
According to recent IOM reports, The Future of Nursing, Nurses can play a key role in the healthcare transformation process. Organizations such as the American Nurses Credentialing Center, the American Nurses Association and Magnet programs have supported and strengthened the mission to improve the nursing profession through education, advanced degrees and certifications. Central to the transformation process is self-regulation and accountability for clinical practice (Code of Ethics, ANA). The Peer Review process affirms the nurse's duty to being accountable for professional practice, competence in skills and knowledge in evidence-based care delivery. Thus, peer feedback promotes patient safety, reduces the likelihood of errors, and addresses the human factor element in patient care delivery to improve patient outcomes.
CFO Strategies for Balancing Fee-for-Service and ValuePhytel
Moving from fee-for-service to value-based care is not easy. However, leading health systems are all following a similar blueprint that enables the move to value-based care.
Download this whitepaper to learn how:
- Bon Secours Richmond - Closed 75,801 gaps in care within 12 months, generating $7 million in revenue for chronic & preventive care, while improving quality.
- Northeast Georgia Medical Center - Decreased HbA1C levels across uncontrolled diabetes by an average of 1.6 points within 120 days.
- Riverside Medical Center - Reduced unnecessary readmissions by 40% by using automation to reach and assess patients post discharge.
- Prevea Health - Increased care management productivity by 150% by automatically identifying high risk patients, and automating patient engagement.
Making the shift to value-based care is not easy. However, a growing number of healthcare organizations are finding success leveraging Lean process improvement and health IT to reduce waste, lower costs, and improve quality.
In fact, leading health systems like Bon Secours, Prevea Health, and North Mississippi Medical Center are using these principles to improve care management processes and achieve better patient outcomes.
We have assembled these strategies into a new whitepaper. You will learn:
- How key concepts of Lean thinking can be applied to healthcare
- Why high-performing practices are using Lean to enable care team members to provide better care
- The financial advantages of a team-based, population health management approach in a value-based reimbursement system
The New Healthcare Model - Collaboration is KeyIVCi, LLC
Heathcare reform is quickly changing the face of medicine. Join IVCi and Polycom for an informative webinar covering the power of collaboration in the delivery of healthcare.
In this presentation you will learn:
How Accountable Care Organizations (ACO) are redefining care coordination
The role visual collaboration can play in EHR roll-outs
Reduce unnecessary readmissions through better collaboration
What grant funding sources are available to drive these initiatives
Epstein Becker & Green, P.C., is a national law firm with a primary focus on health care and life sciences; employment, labor, and workforce management; and litigation and business disputes. Founded in 1973 as an industry-focused firm, Epstein Becker Green has decades of experience serving clients in health care, financial services, retail, hospitality, and technology, among other industries, representing entities from startups to Fortune 100 companies. Operating in locations throughout the United States and supporting domestic and multinational clients, the firm’s attorneys are committed to uncompromising client service and legal excellence.
In an article for Healthcare Executive, Don Seymour, Kevin Talbot, and Chad Stutelberg share their insight on developing compensation strategies that link executive and physician compensation models to acute care outcome-based payment methodologies.
In February 2013, the Office of Inspector General (OIG) released a report entitled Skilled Nursing Facilities Often Fail to Meet Care Planning and Discharge Planning Requirements, in which they found that 26% of facilities fail to meet care planning and discharge planning requirements. Is your facility meeting federal guidelines for care planning?
Download the ABC’s of Care Planning presented by Beckie Dow, RN, RAC-MT for an overview of Care Planning in the Skilled Nursing Facility. Beckie discusses the important link between the MDS 3.0, the Care Area Assessments (CAAs) and the Care Plan.
Learn the essential components of a resident-centered care plan and how to develop a care plan that supports the clinical care that is provided to the patient. Beckie also discusses strategies for completing the CAAs more effectively and using the CAA process to create a more resident-specific care plan.
Learn How To:
1. Define the purpose of a Care Plan.
2. Define the purpose of the Discharge Care Plan and Summary.
3. Identify the correlation between the MDS 3.0 Assessment, the Care Area Assessments (CAAs), accurate RUG-IV Classification, and the Care Plan.
4. List three components of a Resident-centered Care Plan.
Medibank Managing Director speaks at Amercian Chamber of CommerceLaura Harris
Medibank Managing Director, George Savvides presented at the American Chamber of Commerce in Melbourne about Medibank’s approach to primary care and its integrated care pilots.
Decosimo's Shannon Farr and Anderson Busby's Amanda Busby co-presented this PowerPoint at the 2012 Tennessee Bar Association's Health Law Primer on October 3, 2012 in Brentwood, TN.
Presented by Steve Mills, IBM Senior Vice President, Group Executive, Software & Systems Group
Learn more: http://www.ibm.com/software/products/en/category/health-social-programs
Team based care model for better productivityJessica Parker
In an old-fashioned practice model, the physician is solely responsible for most, if not all of the work undertaking of his facility, which also involves charge entry, to medical billing and coding till the time of claims reimbursements.
Three Keys to a Successful Margin: Charges, Costs, and LaborHealth Catalyst
How can cost management and complete charge capture protect and enhance the margin?
In this webinar, we will look at 2024 margin pressures likely to impact your organization’s financial resiliency. This presentation will also share how organizations can move from Fee-for-Service to Value; bringing Cost to the forefront.
Staff from the CMS Innovation Center and the Center for Medicare and CHIP Services hosted a webinar that provided an overview of the Strong Start initiative and the application process and requirements for the Medicaid funding opportunity.
More at: http://innovations.cms.gov/resources/StrongStart_overview.html
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Imagine a healthcare system where people live long, healthy lives, receiving quality, affordable care, with clinicians nationwide collaborating to improve outcomes. That's Accountable Care! Learn the benefits of becoming an ACO in this insightful eBook.
Running Head QUALITY IMPROVEMENT PLAN 1QUALITY IMPROVEMENT .docxtoltonkendal
Running Head: QUALITY IMPROVEMENT PLAN 1
QUALITY IMPROVEMENT PLAN 12
Quality Improvement Plan; Mayo Clinic
Introduction
Quality in the healthcare organisation is of paramount importance. This is not only for the purpose of ensuring that more customers are attracted to the business but also to make sure that the services being offered comply with the standard that are required for medical practitioners. Quality in mayo clinic is realised through various ways in accordance with the services that are offered. Each personal work strives to ensure that quality medical services are offered. Mayo clinic is a healthcare facility that offers medical services at a fee. People who attend the facility come with the hope of getting quality services they are paying for; this is the driving force of the facility- to ensure that quality services are offered.
With the above being said, the purpose of this paper is to evaluate quality improvement for conflict in mayo clinic caused by diversity of cultures.
Description of the environment and the departments of mayo clinic
Mayo clinic is located in different parts of the United States of America, with over 3300 physicians, researchers and other professionals sharing expertise to empower its clients. Being among one of the renowned healthcare organizations, mayo clinic is not without its own weaknesses. Many of these weaknesses as presented in the SWOT analysis were obtained from the interview conducted in this environment (Bauer, Kermott, Millman, & Mayo Clinic, 2017). The objective of this healthcare organization is to provide quality services in order to attract more customers seeking for services. Therefore, seeking quality plans to counter the possible weaknesses arising in the departments is inevitable.
In order to embrace the tradition of providing quality in all areas, such as the effectiveness of Medicare program, mayo clinic utilizes the department ad centres for research (Bauer, Kermott, Millman, & Mayo Clinic, 2017). Irrespective of the various challenges this healthcare organization go through, its belief that quality improvement is an endless task makes it moving. The research department and centres always endeavour to identify every possible gap in health care provisions going on in the different departments as a foundation of solution seeking.
The services offered in mayo clinic ranges from consumer services to business services. For the former, this healthcare organization offers health living programs, book and related programs, health letter for future reference, gift shop and mayo clinic voice apps which helps the customers to get health services in a convenient way using technological means (Bauer, Kermott, Millman, & Mayo Clinic, 2017). On the other hand, business services offered by this healthcare organization include medical laboratory services and Global business solutions.
In regard to the equipment being used at mayo clinic, the belief is that provision of care to patie ...
1. EBMS, Inc.
Value Based
Benefit Strategy
2005-2009
2. Contents
Introduction 3
Challenges and Reactions 4
Yearly Plan Analysis 5
Program Initiatives
Chronic Condition/Disease Management 10
Wellness 11
miCare Clinic 12
Plan Summary 17
Results 18
EBMS Core Values
Excellence
Passion
Innovation
Commitment
Integrity
EBMS Value Based Health Plan Initiative
Maximize member benefits at the least cost, significantly impacting
both the personal and fiscal health of our organization.
EBMS Mission Statement
EBMS is an innovative benefit administration and management
company. We are dedicated to providing superior quality and
cost-effective, personalized services.
3. Introduction
EBMS developed an integrated, value-based health strategy as a
potential solution to the health care financing crisis. Value – the
clinical benefit achieved for the money spent – had been absent from
any former solutions EBMS developed to solve rising healthcare costs.
Instead, the dialogue focused on two trends in benefit design – cost
containment and quality improvement – which often created a conflict
of incentives for members.
Much like other employers, EBMS increasingly enrolled beneficiaries
in disease management programs designed to improve patient self-
management, often by intervening to enhance compliance with specific
medications. However, at the same time EBMS negated these efforts
with increased copayments and greater cost-sharing, creating financial
barriers that discouraged the use of recommended services needed to
keep members compliant.
When individuals are required to pay more for their healthcare, it is
well known that they buy less – of both essential and excessive therapies
alike. A value-based health strategy adjusts out-of-pocket costs on an
assessment of the clinical benefit to the specific patient population and
aligns financial incentives to encourage the use of high-value care.
3
4. Challenges
EBMS’ Billings, MT corporate office employs 260 of 320 employees;
the remaining sixty employees are spread throughout satellite offices in
Portland, OR and Aurora, CO, with remote employees, home-based,
in Salt Lake City, UT. Like many of the organizations for whom
EBMS administers health benefit plans, maintaining a benefit plan that
encourages the personal health of employees and the financial health of
the organization has become a challenging balancing act.
Until 2006, EBMS used similar strategies many of employers in the
United States still use today. If costs increased, EBMS increased
deductibles, co-pays, and employee contributions to offset those
increases. Though this strategy allowed EBMS to stay in front of the
costs, EBMS continued to average a 9% increase each year between
1999-2005, with peaks as high as 24%. It became apparent that for
EBMS to shift the paradigm, a change in strategy was needed.
Reactions
Transforming EBMS’ benefit culture would require significant energy
and resources from EBMS leaders. Once established, however, EBMS
was confident this energy would permeate throughout the organization
and eventually shift the benefit philosophy from cost management to
consumer (employee) engagement. Any culture change takes time;
EBMS stayed realistic in expectations and began with subtle changes.
4
11. Wellness
* Though EBMS offers wellness education and activities to all
employees, the data is only reflective of plan members.
11
12. EBMS values innovation. But innovation comes with a certain amount
of risk. EBMS regularly tests concepts on our own benefit plan before
rolling them out to clients. In 2005, EBMS began exploring the
concept of on-site, employer sponsored clinics. These clinics would be
operated for the sole use of the covered employees and dependents of the
employer. This model, though not a new concept for large companies,
had not been widely tested until the early 2000’s for smaller companies.
In April, 2006, after forming miCare, LLC, EBMS opened an on-site
clinic at its Billings, MT corporate office.
12
13. Model
Employees and their dependents drive the care they receive. Rarely
do these decisions relate to the cost of the care provided, only the
expected outcomes from the care/treatments received. The miCare
clinic model brings the following:
• Clinic space at location of employer’s choice.
• Clinic funded by employer, managed by miCare.
• Services offered:
– Routine medical care
– Laboratory testing-all results are electronically loaded
into the Electronic Medical Record and available within
24 hours
– Physical examinations
– Preventive screenings
– Health education, consultation, and wellness (nutrition
counseling, cholesterol screening, prenatal programs)
– Basic adolescent and child care, including back-to-
school and sports physicals
– Chronic disease management
– Case management
– Dermatology
– Prescriptions
– Annual Health Risk Assessment
• Twenty minute appointments with no waiting, scheduled online
or telephonically by the patient at a time convenient for them.
• Labs and office visits are offered at no cost to the employee
because the employer can access these services at the wholesale
(direct) costs. There is no provider or facility in the middle to
mark up costs.
• Clinic is staffed with a Family Practitioner, a mid-level Nurse
Practitioner or Physician’s Assistant, and a Medical Assistant or
LPN. Malpractice insurance is carried by the practitioners, and
miCare provides general liability coverage.
13
14. Costs
Costs are broken down into two categories:
1. Fixed Administrative Costs - miCare charges a flat administrative fee
per employee per month. This fee covers:
a. Electronic Medical Record
b. Communications
c. 24 hour Nurse Call Line
d. Coordination of Services/Development of New Services
e. Recruitment and Staff Management
f. Supply Management
g. Reporting
2. Variable Expenses-Remainder of costs are passed through monthly
to the employer. There is no mark up of the charges.
a. Staff contracted hourly rates will include prorated costs for
malpractice insurance
b. Supplies
c. Medications
d. Lab tests outside of the Annual Health Risk Assessment
14
15. Savings Engine
Lab tests are contracted through LabCorp, a national laboratory
services provider. miCare directly contracts with LabCorp at a rate
that is comparable with what they provide to practitioners within
the same community. miCare completed an evaluation of lab
tests within the Yellowstone County community and discovered
that there is a significant savings opportunity when lab services are
obtained through miCare.
15
16. Savings Engine (cont.)
miCare is a licensed pharmacy for all medication types except Controlled
Substances. Prescription medications are provided pre-packaged. Upon
prescription by a Practitioner, the miCare Pharmacist dispenses the labeled
medication. During evaluation, it has been determined that a plan can save
up to 65% off of standard Pharmacy Benefit Manager savings.
16
17. EBMS Value-Based Summary
In summary, EBMS created a holistic approach toward its benefit
plan with a strategy that focused first on the patient/member, and
second on the financial health of the organization. The approach
accomplishes the following:
1. Supports the health and well being of the member by wrapping
a benefit design that supports prevention and wellness, with the
ability to support the patient in the event of an unplanned or
unexpected illness or injury. This is done through the wellness
benefit available at first dollar, the Health Reimbursement
Account that can be carried over from year to year, reasonable
out-of-pocket expenses, and generous in-network co-insurance.
2. Engages the member by incentivizing completion of an annual
Health Risk Assessment and additional funding by EBMS into
the Health Reimbursement Account.
3. Empowers the member through Disease Management and
Wellness initiatives geared toward their personal needs, with
specific coaching and guidance to encourage compliance.
4. Encourages members to receive appropriate care by offering an
onsite practitioner, which allows for timely, convenient patient
care and support at no cost. In addition, the practitioner
works closely with the benefit plan to close the loop between
benefit plan management and the services the patient is actually
receiving.
5. Educates members on needs which are specific to their personal
health status. EBMS found that obesity and nicotine use were
issues among our population. Through smoking cessation and
wellness initiatives, EBMS has seen a positive impact, and a
reduction in illnesses tied to both of those behavior issues.
17
18. EBMS Health Plan Savings
2006-2009
Projected Average
Plan Trend * :
2006-2009 PEPM Expense - Projected* vs. Actual 9%
2006-2009
$600
Actual Average
Plan Trend:
$500 1.99%
$400
$300
2006 2007 2008 2009
YTD**
2005 Baseline Costs: $422.92 PEPM
*Based on a 9% annualized expected trend
**2009 YTD reflects 1/1/09 - 6/30/09
18