P1253296559bJUXH

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King Countys Health Reform Initiative
Collaborative solutions to the health care
crisis SCI - July 31, 2008
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Health care environment

• 13,000 employees
• 30,000 plan members
• Strong Labor Unions 95 separate bargaining
  units
• Dwindling tax base, rising public expectations
• Comprehensive medical, dental, vision
• 2012 Health costs double under status quo to
  300 Million

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Health reform strategy

• Address both demand and supply side market
  failures
• King Countys efforts with employees reduce
  demand for health care by improving employee
  health
• King County works with Puget Sound Health
  Alliance to improve the quality of care in the
  region, reducing costs that come from ineffective
  treatment

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Health Reform Initiative
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Healthy IncentivesSM benefit design

• Focused on individual employees and family
  members
• Wellness Assessment
• Individual coaching to change risk factors
• Disease management resources
• 24/7 Nurse line
• Quit Smoking programs
• Workplace programs

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Healthy IncentivesSM - how it works
Did you take the wellness assessment by January
31 AND complete your individual action plan by
June 30?
NO
Did you take the wellness assessment by June 30?
NO
YES
YES
SILVER
GOLD
BRONZE
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Healthy IncentivesSM Design
Out-of-pocket level (KingCareSM) Annual deductible Co-Insurance
Gold 100/person 300/family 10 network/ 30 non-network
Bronze 500/person 1,500/family 20network/ 40 non-network
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Supportive Environment
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Supportive Environment

• Eat Smart, Move More, Stress Less, Quit Tobacco,
  Get a Flu Shot
• Gym Discount Program
• Weight Watchers at Work
• Healthy Workplace Funding Initiative
• Healthy snacks in vending machines
• Onsite flu shots
• Onsite workout facilities
• Education newsletter, website, poster campaigns
• Organizational support
• Health Leadership Forum
• Management training
• Health Promotion Leadership Committee

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Results
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Results
WELLNESS ASSESSMENT PARTICIPATION - 2006 2007
60
58
51
50
44
40
38
2006
30
2007
20
10
5
4
0
Low
Moderate
High
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Results
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Results
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Results
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Results At-Risk Health Behaviors
Aggregate All Respondents Risk Factor Change (2006-2008)
Alcohol Use -1.1
Depression -2.5
Injury Prevention -5.0
Mental Health -5.6
Nutrition -9.0
Physical Activity 2.8
Sun Damage Behavior -5.9
Smoke Behavior -3.8
Stress Behavior -5.1
Source Thompson Reuters
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Results At-Risk Health Behaviors
Aggregate All Respondents Risk Factor Change (2006-2008)
BMI Risk -2.7
Cholesterol -7.2
Blood Glucose 2.7
Systolic BP -2.5
Diastolic BP -1.6
p-value lt0.05, using McNemars chi square test
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Results
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Puget Sound Health Alliance

• King County Health Advisory Task Force Quality
  Value
• Alliance formed December 2004
• Public and private employers, unions, clinics,
  hospitals, consumers, health plans, and more
• gt160 organizations, gt50 individuals
• gt1.5 million covered people (not counting health
  plan enrollees)
• Focus 5-county socio-economic region

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Puget Sound Health Alliance

• Major Initiatives
• Community agreement on evidence-based treatment
• Better information about health care
• Public reports comparing quality and efficiency
• Useful information for decision-making
• Encourage use of health information technology
• Aligned incentives to reward quality care
• Better results than any one organization, group
  or individual can achieve by themselves

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Puget Sound Health Alliance

• Community Check-up Report
• 14 volunteer clinic systems
• 150 clinic locations
• 21 performance measures
• Data on 70 percent of the insured, non-Medicare
  population in the region

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Puget Sound Health Alliance
Prevention Services in the Five-County Region
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Lessons

• Early lessonssuccess built on
• Comprehensive strategy that includes supply and
  demand-side
• One full year of outreach and education before
  the wellness assessments/individual action plans
  began
• Large enough financial incentive
• Collaborative process with the unions

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Questions? http//www.metrok
c.gov/employees/hri_toolkit