Population Risk Management: Implementing Effective Health & Productivity Strategies

Transcription

1 Population Risk Management: Implementing Effective Health & Productivity Strategies Kevin Cowden, MS National Practice Consultant, Health & Productivity November 10 th, Wells Fargo Insurance Services USA, Inc. All rights reserved.

2 1 Today's Agenda Overview of the Wells Fargo Engagement Model Health as a business driver Emerging Trend: Onsite Clinics as a Solution in the Public Sector Assessing onsite clinic feasibility for your organization Case examples Closing remarks Questions Section I Section II Section III Section IV Section V Section VI Section VII

3 2 The value proposition The Health and Productivity practice at Wells Fargo Insurance helps employers go beyond plan design to improve health, lower costs, and increase productivity.

4 3 Engaging our customers We help our clients understand and improve the performance of their benefits programs through discovery, analysis, actionable recommendations, and execution. Implementation and Execution Discovery Annual Stewardship Recommended Actions Analysis

5 4 Identifying the appropriate solutions Corporate Culture Plan Design Value-Based Pricing Methods Onsite and Clinical Solutions Utilization of Technology Reference Based Pricing Direct Contracting

6 Health as a business driver The purpose of population health and wellness programs

7 One chart tells the story Cumulative Increases in Health Insurance Premiums, Workers Contributions to Premiums, Inflation, and Workers Earnings, % 200% 150% Health Insurance Premiums Workers' Contribution to Premiums Workers' Earnings Overall Inflation 158% 221% 203% 138% 100% 88% 50% 0% 75% 20% 17% Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), ; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, (April to April). 42% 31% 56% 42% 6

8 7 What we know 7 Chronic conditions alone cost the US economy more than $1 trillion per year Administrative costs Excessive spending Wasteful spending Inappropriate consumption/utilization

9 The unsustainable cost Annual Family Health Insurance Premiums Compared to Annual Household Income (Actual , Projected ) $90,000 $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $ Family premium Household income Source: DeVoe JE, Dodoo MS, Phillips RL Jr., and Green LA Who will have health insurance in the year 2025? Robert Graham Center 8

10 The business value Dollars $17, $9, Portfolio Worth S&P 500 Initial $10,000 investment grew to $17,871 (Return of 78.72%) while the S&P 500 had a cumulative return of -0.77% Annualized return of the portfolio was 4.57% versus S&P 500 s -0.06% The portfolio outperformed the S&P 500 in 9 of 13 periods Average annual excess return of the portfolio over the S&P 500 was 4.67% Source: Fabius, Raymond, et. Al., The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a Culture of Health. JOEM. Volume 55, Number 9, September

11 Bottom line Employee health and well-being are strong determinants of productivity, morale, and retention There is a clear impact on business performance and share price as well as on the bottom line 1. The health of an organization s population is inextricably linked to its long-term viability. Investing in employee health and well-being aligns with better business. 1 Fabius, Raymond, et. Al., The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a Culture of Health. JOEM. Volume 55, Number 9, September

12 Emerging trend Onsite clinics as a solution in the public sector

13 12 Factors driving the resurgence of onsite 1 Primary Care Shortage 3 Poor Clinical Compliance 5 Stressful Employee Workloads Shortage of 40K by 2020 Healthcare reform adds 32MM to system Medicaid to cover 16MM by Hurried, Distracted Providers 5-10 min. avg. appointment Focused on symptoms versus cause NEJM puts noncompliance rates at 50% 4 Increasing Employee Out of Pocket Cost Hesitancy to seek care due to affordability Employees less willing to leave work site and take time for care 6 System Inefficiencies Procedure duplications, preventable mistakes, unnecessary treatments and prescriptions, technological inefficiencies

14 13 Pressure close to home To maintain current rates of utilization, Florida will need an additional 4,671 primary care physicians by 2030, a 38% increase compared to the state s current (as of 2010) 12,228 PCP workforce.

15 14 Florida compared to the region and nation Implications: 4,671 additional PCPs required by 2030 (38% of the current workforce) Florida s current PCP ratio of 1,537:1 is greater than the national average of 1,463:1 Increased need for PCPs is reflective of: Increased utilization due to aging population Population growth Greater population of insured due to the Affordable Care Act (ACA)

16 15 What it means for employees and employers THE END OF THE LINE STARTS HERE Access to service hindered Wait time increases Productivity is lost NO TRESSPASSING PCP Practices are full and not accepting new patients LEGIONS OF PREVIOUSLY UNINSURED ENTER AN ALREADY BLOATED HEALTHCARE SYSTEM EVERY DAY

17 Feasibility assessment Is an onsite clinic appropriate for your organization

18 17 Quick stats High-performance health program Onsite clinic growth anticipated to increase 15% to 20% year over year Evidence suggests that on-site health centers offer a ROI as high as $3 to $6 for every dollar spent Onsite pharmacies are reported to reduce medication costs by 10 to 60 percent Employees who use onsite health centers reportedly save 2 to 4 hours per visit compared to traveling off site Approximately 25% - 30% of large employers now provide onsite health services. Up 50% since 2000 Onsite clinics can deliver employee health care services 2 to 3 times more costeffectively than offsite

19 18 A new model for healthcare delivery Going beyond primary care Basic Primary Care Additional Offerings Onsite Pharmacy Health Promotion & Wellness Labs Immunizations Work Comp Integration Onsite Clinic Disease Management Nutritionist Physical Therapy Occupational Therapy Pre Employment Services Travel Medicine Telehealth Disability Integration EAP Claims Dictate Ancillary Services

20 19 Are you an appropriate candidate? Considerations Key Decision Points Prevalence by Industry Candidates Improve access Enrich quality of care Boost clinical compliance Enhance outcomes Redirect care to appropriate settings Reduce lost time/absence Moderate trend, lower spend Retention, recruitment, and morale Eligibility? Charge for service? What services? Clinic location? Buy, Build, Lease? Staffing needs? IT Infrastructure Risk management Regulatory and compliance Healthcare 60% Government 32% Manufacture 30% Retail 20% Transportation 18% Services 15% Financial 10% 500 < PCP Shortage Geographically disperse employees High ER utilization Low utilization of preventive care High unscheduled absences High retention, low turnover Higher avg. employee age

21 Case examples

22 School System After first year 21

23 Manufacturer After nearly 10 years 22

24 Closing remarks

25 24 Growing Consensus The health of the workforce is inextricably linked to workforce productivity. Health & Productivity Continuing current health care strategies is not a sustainable option. Employers can manage the health-related productivity of the workforce. The impact of a healthier, more productive workforce is quantifiable. Evidence-based medicine needs to incorporate functional impacts on productivity, as well as, health.

26 Questions Thank you for your time

27 Products and services are offered through Wells Fargo Insurance Services USA, Inc., a non-bank insurance agency affiliate of Wells Fargo & Company. Products and services are underwritten by unaffiliated insurance companies except crop and flood insurance, which may be underwritten by an affiliate, Rural Community Insurance Company. Some services require additional fees and may be offered directly through third-party providers. Banking and insurance decisions are made independently and do not influence each other Wells Fargo Insurance Services USA, Inc. All rights reserved. 26