Association of Washington Cities Employee Benefit Trust

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Association of Washington CitiesEmployee Benefit
Trust

• Healthy Worksite Summit 2005
• Carol Wilmes
• Program Coordinator
• Employee Benefit Trust

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Association of Washington Cities Employee Benefit
Trust

• AWC member service Benefit Pool
• 280 participating employers
• 16,000 employees retirees
• 35,000 family members
• 7 areas of employee benefits

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National / Regional Plan Enrollment2000 Mercer
Trend Survey
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National / Regional Plan Enrollment2003 Mercer
Trend Survey
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AWC Cities EmployeesPartners in Prevention

• Support cities in implementing employee wellness
  programs
• Educate employees about adopting healthy
  lifestyles
• Help to create a city environment that supports
  employee wellness
• Evaluate programs utilization to measure
  effectiveness target programming

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AWC Wellness Works Health Promotion Strategy

• Supportive Environment
• Policies
• Resolutions
• Management Support
• AWC WellCity Awards

• Evaluation/Feedback
• Health Risk Assessment
• Claims Analysis
• Advisory Committee
• Program Evaluation

• Education
• Health Risk Assessment
• Behavior change counseling
• Wellness Campaigns
• Wellness Newsletter

• City Support
• City Programs
• Training/Consultation
• Resources
• Financial Assistance

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Preparing Our Employeesfor the Health Plan of
Tomorrow

• Economists predict current system non-sustainable
  
• Patients Rights Era to Consumerism Era
• Shared accountability
• Employees - Employers
• Provider community - Insurance carriers
• Transitioning perception of a health plan
• Today My health plan is my health to
• Tomorrow My health insurance policy is a
  family financial decision
• Education is Key!

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Healthy Decisions You CanMake a Difference!

A healthy city begins with healthy people.
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The Campaign What Will it Look Like?

• Train the Trainer Regional Sessions
• Trainers Manual
• CD with PowerPoints References
• Printed copy of PowerPoints
• Reproducible documents for employees
• Reproducible posters
• Wise Health Care Consumer Booklet
• Healthier At Home, AIPM
• Fall 2005 Ongoing

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Our Objectives

• Help you understand why health costs are so high
  and what it means to all of us
• What does it mean to be a wise health care
  consumer?
• Give you some tools and tips to make a difference

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Whats in it for You?

• Greater confidence
• Improve appropriateness of care
• Less risk
• More knowledge about health
• Greater control
• Lower out-of-pocket costs

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Why are Medical CostsGoing Up?

• Changing demographics
• Growing utilization patterns
• Rising drug costs
• Rising physician hospital fees
• State federal mandates
• Government cost-shifting (Medicare)
• New, more expensive technologies treatments

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AWC Medical Claims Trend

• Industry trends
• Regence Med 13.8
• Regence Rx 17
• Group Health 12.3
• AWC trend 12
• AWC Claims Cost
• Prescriptions 22
• Physicians 34
• Hospitals 31

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AWC Employee Benefit TrustRegence Medical
PlansRate Adjustment History1998 - Projected
2007
Sources The Segal Plan Cost Trend Survey was
utilized for Industry Trend. Employee Benefit
News, October 2002, quoting Hewitt Survey, was
used for projected trend.
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What do you think..

• An average hospital stay cost?
• An average physician visit cost?
• An urgent care center visit cost?
• An emergency room visit cost?
• An average prescription drug cost?
• An average dental visit cost?
• An average pair of glasses cost?

16,000 96 126 395 59 136 158
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If food were health care, and if prices had
risen at medical inflation rates since the
1930s

• 1 dozen eggs 45.83
• 1 pound apples 6.99
• 1 pound sugar 7.83
• 1 roll toilet tissue 13.83
• 1 dozen oranges 61.66
• 1 pound butter 58.33
• 1 pound bananas 9.17
• 1 pound bacon 69.99
• 1 pound beef shoulder 24.90
• 1 pound of coffee 36.67
• 10 item total 335.20

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Question.

• What determines how much health care is used?

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What is Wellness?
Wellness is the intentional choice of lifestyle
characterized by personal responsibility,
balance, and maximum personal enhancement of
mind, body,and spirit.
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The Theory Police Link Risk Health and Well-being

• Perception of Risk
• Judgments about Risk
• Influencing Others Judgments

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How much health care do you need?
Age Sense of responsibility for personal
health Clinical risk factors Current illness
and injury
Gender Personal health behavior Attitudes
about personal health and
health care use
Modifiable
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Factors Contributing to Illness Death

• Lifestyle--the everyday choices made about how we
  eat, drink, sleep, handle stress, exercise,
  drive, or smoke--is the single largest
  contributor to present day illness and untimely
  deaths.

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Health Risks and Cost Over Time
Annual Health Care Costs
Source Extrapolated from Yen and associates,
JOEM, 1998.
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Health costs 2001 2003All program participants
vs. non-participants
All-participant group includes Impact enrollees.
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Effects of Health Risks on Cost
Health Plan Cost
Percent Higher Annual Health Plan Costs
N 46,500X 3 yrs
Source Goetzel RZ, et. al. (1998, October). The
relationship between modifiable health risks and
health care expenditures An analysis of the
multi-employer HERO health risk and cost
database. JOEM, 40(10)843-54.
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Health costs 2001 2003Depression risk
Participants vs. IMPACTTM enrolled
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Question.

• What can you do to make a difference?

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You Can Become an Active Patient

• By becoming interactive with your doctor.
• Establish a relationship with a physician.
• Complementary relationship
• State that you desire to be an informed patient
• Establish a line of communication
• State symptoms clearly (prepare for your visit in
  advance)
• Clarification, Let me see if I understood you
  correctly,
• What are my options?
• Ask what to expect next

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Remember

• You are the Patient,
• Not the Physician

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What if you or a family member

• Had a serious health problem?
• Q. What would you do?

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Possible strategies..

• Ask questions
• If unable to ask questions, seek back-up
• Find out about other opinions early
• Educate yourself (e.g., web, books, professional
  organizations, support groups)
• When appropriate, ask about a case manager or
  social worker
• Constantly ask about options

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Prescription Drug Myths
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It Pays To Be Aware
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Prescription Drugs Be a Smart Aware Shopper

• Are there alternative treatments prior to Rx?
• Over-the-counter medications
• Generic availability
• Lower cost namebrand
• Interactions with other medications or remedies

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What if you or a family member

• Has a health problem arise and you are uncertain
  how serious it is.
• What would you do?

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What if..

• You are working in the garage and fall against a
  sharp piece of metal and cut your right lower
  arm. The cut is about 1 inch long and about an
  1/8 of an inch deep. The flow of blood is not
  great and seems to be stopping with slight
  pressure. The wound is straight and the sides
  seem to fit together evenly. However, your
  spouse is upset and you wonder if you should go
  to the emergency room. What would you do ?

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What safety concerns do you see?
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Keys to injury reduction

• National Safety Council Recommendations to Reduce
  Injuries
• Use safety equipment
• Strengthen safety belt laws nationwide to reduce
  traffic fatalities.
• ü Encourage companies and organizations to enact
  strict buckle-up policies for employees.
• ü Support the fall prevention efforts
• ü Install handrails, grab bars and night-lights
  in homes to reduce the risk of falls.
• ü Keep all medicine/cleaners out of sight in
  cabinets with child-proof latches to stop
  poisonings.
• ü Encourage every adult American to learn first
  aid/CPR.

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Your Prevention Plan

• Plan your personal approach to being a wiser user
  of the health care delivery system.
• Assess your family medical history your current
  health state.
• Prepare for the unexpected.
• Organize insurance information.
• Focus on wellness.

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Resources for a Wise Consumer

• Consult Your Medical Plan
• Employee Assistance Program
• Local resources (e.g., hospital, fire department,
  support groups)
• AWC Benefit Trust/Wellness Program
• Medical Plan (Regence Group Health)
• Staff advocacy

• Worksite Wellness
• Seasonal Campaigns
• HealthCheck Plus
• Health survey (HRA)
• Biometric Screening
• Personal report
• Telephone follow-up
• Self-Care Book

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Summary of main points

• Health care is a complex issue, but we all make
  choices
• The health plan is not your health.
• You have many resources for handling major and
  minor health problems
• You can make a difference as a health consumer.
• Take good care of yourself it makes a
  difference!

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Questions.
Carol Wilmes Program Coordinator Association of
Washington Cities carolw_at_awcnet.org www.awcnet.or
g [phone]