Trends in Employer Health Care Andrew Sennett Market Sales Executive
Environment Health care cost continue to climb. Without substantive change, experts say, health care cost will continue to increase at 8-9% per year. Health care reform does not address health care cost. Federal and state efforts to reform health care will continue to influences the market, mainly addressing access to coverage yet failing to solve health care cost issues or adverse population health. The overall health of our population is declining. As a national we are less healthy. The main concern centers around eight health risks and behaviors including poor diet, physical inactivity, smoking, and lack of health screenings. These risks drive the incidence and impact of the 15 most common chronic conditions, which in turn accounts for 80% of the total cost for all chronic conditions illness worldwide. The impact of these 15 conditions on an employer s medical spend typically exceeds 65% of total cost. Source: Aon Hewitt, 2012 Health Care Survey
8 Human Behaviors that impact our health Source: Aon Hewitt, 2012 Health Care Survey
Employer s Reactions Source: Kaiser 2014 Employer Health Benefits Survey
New Trends Source: Towers Watson/NBGH 2013/2014 Employer Survey on Purchasing Value in Health Care
Examples of Wellness Programs offered by employers Weight loss programs Biometric screenings Gym membership discounts or onsite exercise facilities Smoking cessation programs Lifestyle or behavior coaching Classes in nutrition Web-bases resources for healthy living Flu shots and other vaccinations Employee Assistance Program (EAP) Wellness Newsletter
Examples of Wellness Programs offered by employers Offering financial incentives for participating in a wellness program Lower premiums Reduce cost sharing Higher health reimbursement arrangement or HSA contributions Gift cards, travel merchandise, or cash The Affordable Care Act (ACA) allows employers to increase the size of their financial incentive for completing wellness programs Under new rules, firms can increase an employee s premium contribution up to 30% of the cost of the plan for not completing wellness programs provided the wellness program is reasonably designed and there are alternatives for employees who cannot meet the standard.
Things to consider when implementing a wellness program Walk don t run Take small steps Cultural Environment Employee Needs Trusted Partner Long term goals
Employer Based Clinics Onsite or Near-Site an employer location Shared clinics among employers Most employee have access; Some provide access to dependents Price to use No cost (Part of benefit package) or small copay (cost share) May include any of the following Acute Care Prevention / Primary Care Wellness Care Occupational Health Other Services like Chiropractic, Behavioral Health, Pharmacy Typically staffed by an advance practicing provider (NP or PA) Hours vary based on volume and are customized to the population
How to Employer Based Clinics work? Employers pay staffing and supplies for the employer clinic Insurance is not billed Employer see the use of the onsite/near-site clinics as successful strategy in addressing the following key objectives Increasing access to health care Controlling health care costs Improving employee health and engagement Ultimately productivity Extension of primary care office
Things to consider when implementing an Employer Clinic Location Onsite or Near-site Multiple locations? Services? Staffing Needs Who will deliver: Local Health Care Provider? 3 rd Party Vendor? Employer?
Value Based Purchasing: High Performing Network Moving away from paying on volume Moving towards payments based on quality and efficiency Source: Towers Watson/NBGH 2013/2014 Employer Survey on Purchasing Value in Health Care
Aurora Consumer Access Initiatives Same Day access within PCP schedules Expanded Walk-in Clinic access with expanded hours 24/7/365 Aurora Quick Care- Integrated within Aurora EHR (reduced cost ) Time Starved Family hours in most PCP clinics Aurora E Health- E Advice and E Visits access through MyAurora Urgent Care Reservations- Helping Hands Program Onsite- Financial Counselors will help with application Better Together- Partnership with key heatlhcare partners throughout Eastern Wisconsin to improve access to needed health care services.
Questions More Information Andrew Sennett Market Sales Executive Aurora Employer Solutions 262-767-6378 262 210 1891 Andrew.sennett@aurora.org