Mary Brainerd, CEO, HealthPartners spoke at a Minnesota High Tech Association (MHTA) CEO Briefing on June 23, 2010.

1. Minnesota High Tech Association
June 23, 2010

2. HealthPartners Mission
To improve the health of
our members, patients and
the community.
2

3. HealthPartners
• Consumer-governed, not-for-profit
• Health plans, medical group, hospitals
• Health and dental plans
– 1.25 million members

4. HealthPartners Approach
The Triple Aim
To simultaneously optimize…
The Health of a defined population
The Experience of the individual Per capita Cost for the population
4
4

5. How are we organized?
Members / Patients / Community
Contracted
Health Plan Care Delivery Foundations Networks
Medical & Dental Clinics - Medical
Pharmacies - Specialty
Research
- Hospital
Medical Hospitals Foundation - Pharmacy
- Regions
Dental - Westfields - Dental
- Hudson Institute for
Pharmacy Strategic
Medical Education Partnerships
Home Care & Hospice
Health Riverway Clinics (IME)
Promotion North Suburban Clinics - ICSI
N. St. Paul Transitional Care - MNHIE
Philanthropy
Central Minnesota - MNCM
PNBC - Other WI
partnerships
Administrative support such as: Legal, IS&T, Communications, HR & Finance

6. Health Care Reform
• Coverage for 35-40 million more Americans
• Insurance practices/requirement for coverage
• Health care changes
• $1 trillion price
• Tax increases (50%)
• Medicare cuts (50%)

7. Real Health Care Reform
• Support healthy life choices
• Coordinated care/focus on that triple aim!
• Payment reform to support value
• Use health information technology to improve
results
• Measure and publicly report quality and cost
• Partner with consumers in making choices –
health, care, cost, quality
• Adopt innovate approaches that add value
• Reduce administrative burden

8. Support Healthy Lifestyles
• Healthy living = longer life and better quality of
life.
Also, lower health care costs.
• Four lifestyle behaviors could impact 25% of
health care costs:
– Healthy diet (5 servings fruits/vegetables/day)
– Regular exercise
– Not smoking
– Moderate alcohol use/avoiding risky use

9. Obesity Trends* Among U.S. Adults
BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System

10. Obesity Trends* Among U.S. Adults
BRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
No Data Behavioral Risk Factor Surveillance
Source: CDC <10% 10%–14% System

11. Obesity Trends* Among U.S. Adults
BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4”
person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System

12. Obesity Trends* Among U.S. Adults
BRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System

13. Obesity Trends* Among U.S. Adults
BRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data 10% 10%–14%
No Data Behavioral Risk Factor Surveillance
Source: CDC <10% 10%–14% System

14. Obesity Trends* Among U.S. Adults
BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: CDC Behavioral Risk Factor Surveillance System

15. Obesity Trends* Among U.S. Adults
BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System

16. Obesity Trends* Among U.S. Adults
BRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System

17. Obesity Trends* Among U.S. Adults
BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System

18. Obesity Trends* Among U.S. Adults
BRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System

19. Obesity Trends* Among U.S. Adults
BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System

20. Obesity Trends* Among U.S. Adults
BRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: CDC Behavioral Risk Factor Surveillance System

21. Obesity Trends* Among U.S. Adults
BRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System

22. Obesity Trends* Among U.S. Adults
BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System

23. Obesity Trends* Among U.S. Adults
BRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System

24. Obesity Trends* Among U.S. Adults
BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: CDC Behavioral Risk Factor Surveillance System

25. Obesity Trends* Among U.S. Adults
BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System

26. Obesity Trends* Among U.S. Adults
BRFSS, 2002
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System

27. Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System

28. Obesity Trends* Among U.S. Adults
BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Source: CDC Behavioral Risk Factor Surveillance System

29. Obesity Trends* Among U.S. Adults
BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System

30. Obesity Trends* Among U.S. Adults
BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System

31. Obesity Trends* Among U.S. Adults
BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System

32. Obesity Trends* Among U.S. Adults
BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: CDC Behavioral Risk Factor Surveillance System

33. Adherence to Healthy Lifestyle
Behaviors and New Disease
Difference in 2-year incidence of new disease between people
who adhere to 0 or 1 and 3 or 4 healthy behaviors (%)
High Blood Heart
Pressure Cholesterol Cancer Back Pain Disease Diabetes
-15 -17
-24
-43 -45
Source:
HealthPartners Health
-66 Assessment database, 2007
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34. Change health care itself
Coordinated care/triple aim
focus

35. • Proactive
• Prevention focused
• Chronic illness care coordinated
• Templates, tools and teams
35

36. TRIPLE AIM: Health-Experience-Affordability
Health-Experience-
100%
1.006 HealthPartners Clinics 38%
97%
98%
0.986 33%
95%
Total Cost Index
0.966
25%
0.946 90%
17%
0.926
85%
0.9105
0.906 9%
4Q04 1Q05 2Q05 3Q05 4Q05 1Q06 2Q06 3Q06 4Q06 1Q07 2Q07 3Q07 4Q07 1Q08 2Q08 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09
Total Cost Index % patients with Optimal % patients “Would
Diabetes Control* Recommend” HealthPartners
(compared to statewide average)
* controlled blood sugar (per ICSI guideline A1C changed Clinics
< 1 is better than network average from < 7 to < 8 in 1st quarter 2009), BP & cholesterol, AND
daily aspirin use, AND non-tobacco user

37. Affordability: (Statewide)
Affordability:
HealthPartners Clinics
1.0100
1.00
1.0000
0.9900
0.9800
Total Cost Index
0.9700
0.9600
0.9500
0.9400
0.9300
0.9200
0.91
0.9100
0.9000
4Q04
1Q05
2Q05
3Q05
4Q05
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
Total Cost Index (compared to statewide average)
< 1 is better than network average

38. Total Cost of Care
• A method to measure the overall
performance of a medical group relative
to other groups.
• Includes all costs associated with
treating a patient’s condition:
– Professional, facility inpatient and
outpatient, pharmacy, lab, radiology,
any other ancillary services

39. Health: (Optimal Diabetes Control- Total)
Control-
HealthPartners Clinics
40%
38%
35%
Optimal Care Percent
30%
25%
20%
15%
10%
9%
5%
4Q04
1Q05
2Q05
3Q05
4Q05
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
3Q09
4Q09
% Patients with Optimal Diabetes Control* *controlled blood sugar, BP &
cholesterol (per ICSI guidelines A1C changed from < 7 to < 8 in 1st quarter 2009)daily
aspirin use AND non-tobacco user

40. Saves 364 Hearts, 68 Legs &
625 Pairs of Eyes Each Year

41. Experience: (Would You Recommend)
HealthPartners Clinics
100% 98%
97%
90%
80%
Percent
70%
60%
50%
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
3Q09
4Q09
Measure: % of HPMG patients surveyed who answered “Yes, definitely” and “Yes, probably” to
"Would you recommend this office to your family and friends?"

42. TRIPLE AIM: Health-Experience-Affordability
Health-Experience-
1.006 HealthPartners Clinics 38%
100%
97%
98%
0.986 33%
95%
Total Cost Index
0.966
25%
0.946 90%
17%
0.926
85%
0.9105
0.906 9%
4Q04 1Q05 2Q05 3Q05 4Q05 1Q06 2Q06 3Q06 4Q06 1Q07 2Q07 3Q07 4Q07 1Q08 2Q08 3Q08 4Q08 1Q09 2Q09 3Q09 4Q09
Total Cost Index % patients with Optimal % patients “Would
Diabetes Control* Recommend” HealthPartners
(compared to statewide average)
* controlled blood sugar (per ICSI guideline A1C changed Clinics
< 1 is better than network average from < 7 to < 8 in 1st quarter 2009), BP & cholesterol, AND
daily aspirin use, AND non-tobacco user

43. Payment Reform to Support
Value
• Take the emphasis off fee-for-service
• Pay for value (triple aim)
• Move to Total Cost of Care approaches
• Re-evaluate fee-for-service weights and
payment levels
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44. Leveraging Technology
• Use the electronic medical record to
improve care
Disparities Initiative
H1N1 Outreach
• Online patient services: 221,000 patients
(10.5 millions test results)
• m.HealthPartners.com (already 10,000 per
month)
44

45. Partner with Consumers
• Decision support – better information
about care choices
• Measure and publicly report quality and
cost
– Minnesota Community Measurement
– www.HealthPartners.com: Cost
Comparison Tools
• Support healthy choices

46. Reduce Administrative Costs
• Reduce administrative burdens
– Paperless Plan – No paper Explanation of
Benefits necessary
– Electronic Enrollment
– Online billing, payment and record
maintenance
– Electronic provider payment
Electronic claims submission – 90%
Auto adjudication – 85%

47. HealthPartners Advantage
• Consumer-governed, not-for-profit status
• Low administrative costs 5.4%
+
• Responsible margin 2.3%
___________
Better value for customers

48. Real Health Care Reform
We’ll advocate for it.
We’ll be an example of it