The opinions expressed in this presentation are those of the speaker. The International Foundationdisclaims responsibility for views expressed and statements made by the program speakers.

Administrative Strategies

Jay CastellanoInterim Benefits ManagerCounty of San Mateo

Redwood City, California

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Introductions

• Name• Organization you represent• Numbers of employees/

retirees/dependents• Total years in employee benefits• Location of your most frequent

vacation “get away”

1-2

Administrative StrategiesAgenda

• Introductions• Learning Objectives• Five Forces

– Develop Key Strategic Objectives– Improve Staff Competencies– Satisfy Customer Expectations– Use Information Systems Effectively– Develop Effective Communication Plans

• Summary and Closing• Questions and Discussions

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CAPPP® is intended to have a strategic and policy focus.

Why is this relationship between strategy/policy and administration?

1-4

Public Plan Policy—Administrative Practices

• Presentation—Broad strategic objectives• Handouts—Specific key examples

– Internal Revenue Code/Glossary/Websites– Supporting Documentation– http://hr.smcgov.org/employee-benefits– IFEBP website: Value-Based Health Care

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Administrative Practices—Learning Objectives

• Discuss key forces driving benefits• Distinguish between passive vs. proactive

administrative practices

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Administrative Practices—Learning Objectives

• Develop key strategic objectives• Improve staff competencies• Satisfy customer expectations

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Administrative Practices—Learning Objectives

• Use information systems which:– Evaluate plan design/performance– Bind stakeholders in improvement processes– Measure effectiveness of risk reduction

interventions – VBHC—Six Articles

• Develop effective communication plans

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Administrative Practices—Learning Objectives

• Write participant improvement objectives

“Success is not a matter of chance, it’s a matter of choice.”

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Exercise 1

Key Changes—Administration Today vs. 1980

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Administrative Practices—Passive vs. Proactive

• Transactional/Passive– Eligibility – Invoicing – Complaint resolution

“We are made wise not by the recollection of our past, but by the responsibility for our future”

George Bernard Shaw

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Administrative Practices—Passive vs. Proactive

• Strategic/Proactive– Workforce Diversity– Legal/Compliance Issues– Financial Requirements– Political/Labor Relations– Technology

“The future ain’t what it used to be” Yogi Berra

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Develop Key Strategic Objectives

Improve StaffCompetencies

Use Information Systems Effectively

Develop Effective Communication Plans

Satisfy Customer Expectations

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Administrative Practices—Five Forces—Overview

I. Growth in number/type of benefitsII. Increase in legislative/legal activityIII. Explosion in financial costIV. Downsizing the public sectorV. Growth in information technology

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Administrative Practices—Five Forces

I. Growth in number/type of benefitsChild Care CenterSick Child CareTelecommutingJob SharingRetirement PlanningCafeteria Benefit PlansHealth and Fitness ProgramsHRAs/HSAs/VEBAs

Dependent Care AssistanceElder care benefitsFlexible Work ArrangementsEmployee Assistance ProgramLegal ServicesFinancial ServicesCatastrophic LeaveHousing Assistance

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Administrative Practices—Five Forces

II. Increase in legislative/legal activity Mental Health Parity ActNewborn and Mother’s Health

Protection ActMedicare Prescription Drug,

Improvement, and Modernization Act

Health Savings AccountsAffordable Care ActSupreme Court DecisionElection

ERISAADEATEFRADEFRACOBRATax Reform ActOBRA ‘89FLSA

FMLAPension SimplificationSmall Business Job

Protection ActBalanced Budget ActGASB 10GASB 43/45HIPAA

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Administrative Practices—Five Forces

III. Explosion in financial cost

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Explosion in Financial Cost

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Explosion in Financial Cost

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Administrative Practices—Five Forces—Cost Control Options

• Modify Design– Premiums/Co-Pays/Coverage

• Modify Network– Upsize Purchase/Downsize Provider

• Modify Financial Structure– Self-Fund/Pre-Pay/Minimum Premium

• Modify Health Status of Participants– Reduce Risk/Improve Health/Use Care Wisely

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Administrative Practices—Five Forces

IV. Downsizing the public sector

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Administrative Practices—Five Forces

V. Growth in information technology

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Improve Staff Competencies

Develop Effective Communication Plans

Satisfy Customer Expectations

Use Information Systems Effectively

Develop Key Strategic Objectives

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Develop Key Strategic Objectives

• Strategic planning– Develop broad objectives– Identify options– Assure stakeholder inclusion– Create systems to support objectives

• Concept of VBHC

“A long, awkward sentence that describes management’s inability to think clearly.”

Scott Adams, Dilbert

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Develop Key Strategic Objectives

• Identify Areas of Strategies– Legal/legislative responsiveness– Plan design and financing– Information strategies– Communication strategies– Staff competencies

“If you don’t know where you’re going you may end up somewhere else.”

Yogi Berra

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Develop Key Strategies—Legislative Reform

• Health Reform (Affordable Care Act) – Key Elements– Impact on Employer Provided Coverage– Regulatory Updates

• Timetable for Implementation• Health Reform Repeal Efforts

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Develop Key Strategic Objectives

• Example of Strategies– Health plan objectives– Dental plan objectives– Work-Life objectives

“Vision without action is a daydream. Action without vision is a nightmare.”

Japanese Proverb

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Develop Key Strategic Objectives

• Transform Administration into Administrative Strategies

• Begins with Strategic Objectives• Requires a “Sea Change” in Thinking

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Break—10 Minutes

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Develop Key Strategic Objectives

Use Information Systems Effectively

Develop Effective Communication Plans

Satisfy Customer Expectations

Improve StaffCompetencies

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Improve Staff Competencies—Overview

• Create standards/expectations• Hire/evaluate on standards/expectations• Train/build skills• Involve outside partners

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Create Standards/Expectations

• Visible/explicit customer service expectations

• Example of standards/expectations– Components of Customer Service– Visual Integration of Service– County’s Ten Commandments– Tips on Developing

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Hiring/Evaluating

• Review customer service expectations• Address questions/issues• Link accountability to expectations

– Sample Performance Measures

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Training/Skill Building

• Commitment to Education– Dealing with Difficult People– Effective Interpersonal Skills– Face-to-Face with the Customer– Achieving Professional Excellence in a

Supporting Role

“The educated differ from the uneducated as much as the living do from the dead.”

Aristotle

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External Partners

• Contractors/providers• Exchange standards/expectations• Establish incentives• Contract renewal/RFPs

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Develop Key Strategic Objectives

Improve Staff Competencies

Use Information Systems Effectively

Develop Effective Communication Plans

Satisfy Customer Expectations

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Satisfy Customer Expectations

The most successful way to provide good customer service is to be thoughtful in the

design and delivery of service—Proactiveness

The second most successful way to provide good customer service is to practice

effective case management—Responsiveness

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Satisfy Customer Expectations

“I think customer service is a really brilliant system designed to keep customers from ever getting service. . . The most hated group in any company is the customer.”

Dave BarryPulitzer Prize Winning HumoristMiami Herald

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Proactiveness—Overview

• Elements of proactiveness– Instill low tolerance for poor service– Practice good customer service skills– Customize response to special cases– Follow-through

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Proactiveness

• Meet with customers regularly• Communicate request for low tolerance

– New employee hiring/training– Multiple year plans– Posters/workplace advertising– Surveys/meetings

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Proactiveness

• Observe/model desired behavior• Review difficult problems/solutions

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Responsiveness—Case Management

• Special cases—Special responses

“Seek first to understand, then to be understood.”R. Covey

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Responsiveness—Case Management

• Follow-through– Communicate action steps/timeframes– Obtain commitment from others– Communicate status/changes– Agree on closure

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Responsiveness—Case Management

• Integrating systems– Benefits/Risk/Retirement/Employee Relations

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Customer Feedback Systems

• Determine frequency of feedback• Target users at time of use• Design—Survey/focus group

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Exercise 2

• Single most significant change in customer service/responsiveness

• Identify process (5 key steps)

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Break—10 Minutes

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Develop Key Strategic Objectives

Improve Staff Competencies

Develop Effective Communication Plans

Satisfy Customer Expectations

Use Information

Systems Effectively

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Information Systems—Overview

• Link information systems to strategy• Assess information needs (VBHC)• Identify recipients of information• Include external partners• Incorporate HIPAA guidelines

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Information Systems and Strategy

• Frequency of review of information• Method of gathering/distributing• Determining analysis methodology

– Anecdotal/empirical– Internal/external– Over time/comparative

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Assessing Information Needs

• Assess current/prospective needs• Define information parameters• Use information to act

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Information Recipients

• Senior management/policy makers• Labor representatives• Employees/retirees

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External Partners

• Discuss information expectations• Establish provider accountability for

information• Develop partnership strategies

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HIPAA Guidelines

• Overview of Systems• Integration with External Partners• Communication to Participants

– Participant Rights– Participant Responsibilities

1-54

Resources

• ACA Central– www.ifebp.org/acacentral– Compendium of resources

• ACA University– www.ifebp.org/acau– 24/7 ongoing education

• Webcasts/Support materials—Videos, podcasts, survey results/Q&A with industry experts

• Health Care Reform Survey– www.ifebp.org/research– Benchmarking plan changes

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Risk Reduction Programs

• Long term cost containment• Financially/statistically significant trends• Responsiveness to interventions• Effective methods to target participants

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Develop Key Strategic

Objectives

Improve Staff Competencies

Use Information Systems

Effectively

Satisfy Customer

Expectations

Develop Effective Communication

Plans

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Communication Plans—Overview

• Employees/retirees• Policy makers/senior management• Labor organizations• External partners

“The greatest problem with communication is the illusion that it has been accomplished.”

George Bernard Shaw

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Communication—Employees

• Think ERISA• Simple/straightforward• Use of electronic media• Use of social media• Rapidity of changes require more

communication

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Communication—Policy Makers

• Communicate overall strategies• Link actions to strategies• Communicate often• Rapidity of changes require more policy

discussion

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Communication—Labor Organizations

• Share/don’t hoard information• Wed to strategies/outcomes not to specific

programs/actions• Provide ongoing forums to participate• Co-sponsor communications

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Communication—External Partners

• Communicate overall strategies• Link external partner to strategies• Identify co-responsibilities• Co-sponsor communications

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Content:Involve Others in Process/Solutions

Spectrum of Change

Issue/Problem

Research/DataGathering

DevelopOptions

Evaluate/Recommend

DevelopActionPlan

Survey-Internal/External

Communicate/Implement

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Content:Involve Others in Process/Solutions

Spectrum of ChangeWhy Change is Difficult/Often Fails

Issue/Problem

Research/DataGathering

DevelopOptions

Evaluate/Recommend

DevelopActionPlan

Survey-Internal/External

Communicate/Implement

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Communication and Technology

• Intranet/Internet opportunities• Strategies for intranet communication• Strategies for social media• Obstacles and options

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Exercise 3

• List three key learnings• List three things that you will do

(differently) as a result of attending this session

WHO… WILL DO WHAT… BY WHEN?1.2.3.

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Questions and Answers

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KEY TRENDS IMPACTING HEALTH PLANS

Overall increase in health cost has introduced, over time, preferred provider networks, inclusive provider networks, point-of-service designs and, more recently, the defined contribution models of health care design (chiefly HSAs).

Increased prescription drug costs and patient demand for specific prescriptions have prompted the creation of formularies, multiple tier prescription drug co-pay models and third party prescription drug services with bio-pharmacological customized drugs on the horizon.

The introduction of federal and state health insurance mandates, most recently including health care reform (the Affordable Care Act) have required employers to modify their designs in compliance with these changes.

The number of retirees and length or retiree life have placed financial stress on Medicare and employer-offered retiree plans and prompted the introduction of HMO retiree products (Medicare Risk / Medicare + Choice).

Changes in family composition including domestic partners, children of domestic partners, grandchildren and other newly defined “dependents” have forced employers and health insurers to offer coverage to an extend group of individuals.

The introduction and proliferation of medical technology including application of population-based medical procedures, less invasive micro-surgery and pharmacological / biological / genetic applications have reduced inpatient hospital care and driven many medical procedures to outpatient surgery with reduced cost and improved recovery time.

Rise in medical consumerism whereby individuals expect to have a greater voice in their health care and utilize internet resources to research general information, specific diseases. Also, this trend includes increasing desire for patients to communicate with physicians and other health plan providers over the internet.

Electronic media have streamlined administrative processes, re-defined reporting responsibilities (from provider to health plan, health plan to provider, health plan and provider to employer).

Increasing terminations of managed care options in rural and less profitable areas constrict the available design options, particularly for retirees, and reverse trends of establishing nationwide managed care networks.

Expanded employee choice and responsibility for design options and selections including variety of design, variety of options within designs (POS, Defined Contribution) variety of benefit and co-pay options (multiple tier prescription drug models) and corresponding variety of cost consequences.

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Read the brief (/medicaid/issue-brief/the-aca-and-recent-section-1115-medicaid-demonstration-waivers/)

The Affordable Care Act andRecent Section 1115 MedicaidDemonstration Waivers(/medicaid/issue-brief/the-aca-and-recent-section-1115-medicaid-

demonstration-waivers/)

(/medicaid/issue-brief/the-aca-and-recent-

section-1115-medicaid-demonstration-waivers/)

Related brief: Medicaid Expansion Through

Premium Assistance: Arkansas, Iowa, and

Pennsylvania’s Proposals Compared (/health-

reform/fact-sheet/medicaid-expansion-

through-premium-assistance-arkansas-and-

iowas-section-1115-demonstration-waiver-

applications-compared/)

Related brief: State Fiscal Conditions and

Medicaid: 2014 Update (/medicaid/issue-

brief/state-fiscal-conditions-and-medicaid-

2014-update/)

View report (/medicaid/report/medicaid-in-a-historic-time-of-transformation-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2013-and-2014)

Medicaid in a Historic Time ofTransformation: Results from a50-State Budget Survey(/medicaid/report/medicaid-in-a-historic-time-of-transformation-

results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-

years-2013-and-2014)

See More (http://kff.org/topic/medicaid/)

The Virginia Health Care Landscape(http://kff.org/medicaid/fact-sheet/the-virginia-health-

care-landscape/)

Health Coverage and Care for Youth in theJuvenile Justice System: The Role of Medicaidand CHIP (http://kff.org/medicaid/issue-brief/health-

coverage-and-care-for-youth-in-the-juvenile-justice-

system-the-role-of-medicaid-and-chip/)

Financial and Administrative AlignmentDemonstrations for Dual Eligible BeneficiariesCompared: States with Memoranda ofUnderstanding Approved by CMS(http://kff.org/medicaid/issue-brief/financial-alignment-

demonstrations-for-dual-eligible-beneficiaries-

compared/)

the latestthe latest

States and the ACAMedicaid Expansion(/medicaid/state-indicator/state-activity-around-

expanding-medicaid-under-the-affordable-care-act/)

state datastate data

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Read Report (/medicaid/report/money-follows-the-person-a-2013-survey-of-transitions-services-and-costs/)

35,400 (/medicaid/report/money-follows-the-

person-a-2013-survey-of-transitions-services-and-

costs/)

Number of Money Follows the Person

participants in 40 states.

key numberkey number

Getting into Gear for 2014: Shifting NewMedicaid Eligibility and Enrollment Policies intoDrive (/medicaid/report/getting-into-gear-for-2014-

shifting-new-medicaid-eligibility-and-enrollment-

policies-into-drive/)

Medicaid in a Historic Time of Transformation:Results from a 50-State Medicaid BudgetSurvey (/medicaid/report/medicaid-in-a-historic-time-

of-transformation-results-from-a-50-state-medicaid-

budget-survey-for-state-fiscal-years-2013-and-2014/)

Medicaid: A Primer (/medicaid/issue-

brief/medicaid-a-primer/)

the essentialsthe essentials

See the issue brief(http://www.kff.org/medicaid/issue-brief/financial-alignment-demonstrations-for-dual-eligible-beneficiaries-compared/)

(/medicaid/issue-brief/financial-alignment-

demonstrations-for-dual-eligible-beneficiaries-

compared/)

CMS has approved financial or administrative

alignment demonstrations that will affect over

1.3 million dual eligible beneficiaries in 11

states.

data spotlightdata spotlight

Where does your state stand? (/medicaid/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/)

See state reports (/state-profiles-uninsured-under-aca/)

How the Uninsured WillFare Under the ACA inEvery State (/state-profiles-uninsured-

under-aca/)

(/state-profiles-uninsured-under-aca/)

state reportsstate reports

Setting the RecordStraight: Medicaid'sImpact on Access,Outcomes and Quality(/medicaid/issue-brief/what-is-medicaids-impact-on-

access-to-care-health-outcomes-and-quality-of-care-

setting-the-record-straight-on-the-evidence/)

Read the brief (/medicaid/issue-brief/what-is-medicaids-impact-on-access-to-care-health-outcomes-and-quality-of-care-setting-the-record-straight-on-the-evidence/)

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Cumulative Increases in Health Insurance Premiums, Workers’ Contributions to Premiums, Inflation, and Workers’ Earnings, 1999-2013

57%

119%

182%

56%

117%

196%

14%

34%

50%

11%

29%

40%

0%

50%

100%

150%

200%

250%

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Health Insurance Premiums

Workers' Contribution to Premiums

Workers' Earnings

Overall Inflation

SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April to April), 1999-2013; Bureau of Labor Statistics, Seasonally Adjusted Data from the Current Employment Statistics Survey, 1999-2013 (April to April).

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* Estimate is statistically different from estimate for the previous year shown (p<.05).

SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013.

Average Annual Premiums for Single and Family Coverage, 1999-2013

$16,351*

$15,745*

$15,073*

$13,770*

$13,375*

$12,680*

$12,106*

$11,480*

$10,880*

$9,950*

$9,068*

$8,003*

$7,061*

$6,438*

$5,791

$5,884*

$5,615*

$5,429*

$5,049*

$4,824

$4,704*

$4,479*

$4,242*

$4,024*

$3,695*

$3,383*

$3,083*

$2,689*

$2,471*

$2,196

$0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 $18,000

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999Single Coverage

Family Coverage

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66% 68% 68%

66% 66% 63%

60% 61% 59%

63% 59%

69%*

60%* 61% 57%

55% 57% 58% 58% 55%

52%

47% 49%

45%

50% 47%

59%*

48%* 50%

45%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All Firms

Firms with 3-9 Workers

Percentage of All Firms Offering Health Benefits, 1999-2013

*Estimate is statistically different from estimate for the previous year shown (p<.05).

NOTE: Estimates presented in this exhibit are based on the sample of both firms that completed the entire survey and those that answered just one question about whether they offer health benefits. The percentage of firms offering health benefits is largely driven by small firms. The large increase in 2010 was primarily driven by a 12 percentage point increase in offering among firms with 3 to 9 workers. In 2011, 48% of firms with 3 to 9 employees offer health benefits, a level more consistent with levels from recent years other than 2010. The overall 2011 offer rate is consistent with the long term trend, indicating that the high 2010 offer rate may be an aberration.

SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2013.

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Featured Topics

ACA CentralHealth Plan DesignEmployer and IndividualResponsibilityInsurance Marketplace andExchangesMultiemployer and PublicEmployee Plan IssuesSmall Business IssuesTimelines and GeneralResourcesViewpoints of OutsideOrganizations

Value-Based Health Care

Financial Wellness andRetirement Security

Pension Reform Central

FASB DisclosureRequirements

GASB Pension Standards

Codification of FASBAccounting Standards

Flu Resources

Form T-1

HIPAA Privacy and SecurityRevisions

What is a MultiemployerPlan?

Health Plan Design

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Small Business Issues

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Employer and Individual Responsibility

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Multiemployer and Public Employee Plan Issues

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Insurance Marketplace and Exchanges

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Timelines and General Resources

View

Viewpoints of Other OrganizationsMultiemployer | Public Employee | Corporate

The Affordable Care Act Comprehensive health care reform, known as the Affordable Care Act (ACA), was enacted with the passage of two new laws:the Patient Protection and Affordable Care Act (PPACA), signed into law on March 23, 2010 and the Health and EducationReconciliation Act of 2010, signed on March 30, 2010. What the final bill means to private and public employers,multiemployer health and welfare plans, small businesses and others continues to be revealed via regulations.

Keep an eye on this site for news updates and regularly updated resources (choose your topic of interest below). TheInternational Foundation will help you make sense of it all.

Home > News > Featured Topics > ACA Central

ACA Central

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• Small employer tax credit (March 2010)

• Creation of Early Retiree Reinsurance Program (established June 2010)

• Annual limit restrictions for “essential health benefits” (plan years after September 2010)

• Adult child coverage required to age 26 regardless of marital status, residency or school attendance; applies to grandfathered plans if child does not have access to other coverage before January 2014 (plan years after September 2010)

• Lifetime benefit limit restrictions for “essential health benefits” (plan years after September 2010)

• Elimination of preexisting condition exclusions for covered children under age 19 (plan years after September 2010)

• Preventive care coverage requirements (does not apply to grandfathered plans; plan years after September 2010)

• Health care plan rescission restriction: health care coverage cannot be terminated except in cases of fraud (plan years after September 2010)

• Installation of internal and external appeals process (does not apply to grandfathered plans; plan years after September 2010)

• Simple cafeteria plans can be established by small employers; these plans offer a safe harbor from nondiscrimination rules (January 2011)

• Penalty for nonqualified health savings accounts withdrawals, increase in excise tax from 10% to 20% (January 2011)

• Elimination of reimbursement of over-the-counter drugs without a prescription for flexible spending accounts, health savings accounts or health reimbursement arrangements (tax years beginning January 2011)

• Employer W-2 Form reporting requirements for cost of health care coverage (tax years beginning January 2012)

• Uniform explanation of coverage requirement: employer required to provide participants a summary of benefits and coverage explana-tion prior to enrollment (open enrollment periods or plan years after September 2012)

• Fee per covered individual charged to health plan sponsors and insur-ance companies to fund the Patient-Centered Outcomes Research Institute (PCORI) (policy or plan years ending after September 2012, fee is first due July 2013, fee will end in 2019)

• Flexible spending account annual employee contribution limit capped at $2,500 (January 2013)

• Additional Medicare payroll tax: for high-income individuals (January 2013)

• Medicare Part D retiree drug subsidy loses tax-exempt status (January 2013)

• Employee notice of coverage options in exchanges (before October 2013)

• Individual health care coverage mandate or penalty tax for no coverage (January 2014)

• Elimination of annual limits in health plans except for annual limits on specific covered benefits that are not “essential health benefits” (January 2014)

• Plans must limit annual participant out-of-pocket maximum to the limit imposed on health savings account-compatible high-deductible health plans (does not apply to grandfathered plans; plan years after January 2014)

• Qualified health plans offered through a state exchange and insurers in the small and individual markets must include “essential health benefits” and meet a specified actuarial benefit value (does not apply to grandfathered plans; January 2014)

• Creation of health exchanges, marketplaces that allow individuals and eligible employers to purchase health insurance (January 2014)

• Elimination of preexisting condition exclusions for all participants (January 2014)

• Waiting period limitation, maximum of 90 days (January 2014)

• Increases in maximum wellness incentives, from 20% to 30% of the cost of coverage, with possibility of increase to 50% (January 2014)

• Fee charged to health insurance issuers and certain plan administrators on behalf of self-insured group health plans for transitional reinsurance program (years 2014-2016)

• Large employers with 50 or more employees must offer coverage to full-time employees (30 hours or more per week) or pay penalty; coverage must be affordable and meet minimum standards (voluntary compliance January 2014; enforcement delayed until January 2015)

• Large plan auto enrollment requirement: plans must automatically enroll all new full-time employees and continue enrollment of current employees (after final regulations are issued)

• Nondiscrimination rules apply to insured plans (after final regulations are issued)

• Quality of care reporting requirement to Department of Health and Human Services and enrollees: annual report on whether plan fulfills quality requirements (after final regulations are issued)

• Excise tax on high-cost group health plans: tax imposed on value of “excess” coverage (January 2018)

PDF-713MK130696

Affordable Care Act (ACA) Implementation Time Line

www.ifebp.org/acau

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020

1120

1220

13

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4TB

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1820

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San Mateo County Human Resources

Strategic Plan FY 2011 - 2014

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HR Strategic Approach - Meeting the Challenge

Mission Through strategic partnerships and collaboration, the Human Resources Department recruits, develops and retains a high performing and diverse workforce and fosters a healthy, safe, and productive work environment for employees, their families, departments, and the public in order to maximize individual and organizational potential and position San Mateo County as an employer of choice.

Values The Human Resources Department demonstrates the following values:

• Promote Honesty, Integrity, and Trust: We honor our commitments and conduct business in a manner that promotes fairness, respect, honesty, and trust.

• Celebrate Teamwork: We encourage the diversity of thoughts, experiences, and backgrounds and celebrate participation and partnership in all of our endeavors.

• Encourage Communication: We solicit the input of others and strive for transparency and inclusiveness.

• Focus on Our Customers: We have a passion for service and are committed to knowing our customers’ business, anticipating their needs, and exceeding expectations.

• Embrace Change and Innovation: We are open to possibility and foster creativity and risk-taking to support continuous improvement.

• Champion Employee Development: We are committed to maximizing the potential of every individual and to support and promote the County as a learning organization.

• Model Leadership: We lead by example and advocate equitable treatment in our behaviors, policies, and practices.

• Produce Quality Results: We believe those we serve deserve excellent service, a safe, productive, and healthy work environment, and quality results.

Goals The HR Strategic Plan is focused on six overarching goals:

• Value, Encourage, and Support a Diverse Workforce;

• Continually Improve Individual and Organizational Effectiveness;

• Anticipate and Meet the Changing Needs of the Workforce / Family;

• Champion Career and Professional Growth;

• Create and Enhance Strategic Partnerships; and

• Enhance Services Through Technology.

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Employee Benefits / Wellness and Work-Life Programs

Purpose The Employee Benefits Division administers the County’s comprehensive benefits and work-life programs, provides benefits education and problem resolution to employees, retirees and family members and manages an award winning wellness program to attract and retain employees, optimize health and productivity and promote a healthy and supportive work environment.

Goals We accomplish our mission by focusing on the following goals:

1. Provide benefits administration services that meet the needs of employees, retirees and their families within budgeted constraints in order to enhance an employee’s quality of life and to help recruit and retain top employees, resulting in 90% of customers rating the services provided as courteous, accurate and responsive.

2. Offer wellness and work-life programs that improve employee health and well-being and promote a healthy work environment.

Services We manage the following programs and services for our customers:

Medical Insurance Dental Insurance Vision Insurance Life Insurance Short-Term Disability COBRA Deferred Compensation Flexible Spending Accounts Employee Assistance Program Voluntary Time-Off Program Catastrophic Leave Program Child Care Center Workplace Mediation Retiree Health Benefits Wellness & Work-Life Programs

Priorities GOAL(S) PRIORITIES FY 2011 FY 2012 FY 2013 FY 2014

1 Implement online benefits enrollment system. 1, 2 Expand use of technology in providing education

and training to employees.

2 Collaborate with Health Plans and/or Medical Groups to improve health status, health outcomes, and/or health care utilization.

1 Implement new hire benefits orientation module. 2 Leverage vendor and community partnerships for

expanded work-life and wellness trainings.

2 Implement recommendations from the Countywide Wellness Committee.

2 Implement Countywide Wellness Policy.

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GOAL(S) PRIORITIES FY 2011 FY 2012 FY 2013 FY 2014

2 Provide Work-Life education programs to assist working parents in effectively managing work-family demands and responsibilities.

Performance Measures FY 2009

Actual FY 2010 Actual

FY 2011 Projection

Year 1

FY 2012-14 Target

Years 2-4 Workload

Number of participants in sponsored Wellness and Work-Life Programs and activities

2,109 2,731 2,500 2,500

Number of covered lives under the County’s medical plans

--- --- 15,881 15,800

Number of Calls (data development) --- --- --- ---

Quality/Efficiency Percent of customer survey respondents rating overall satisfaction with services as good or better - Active Employees - Retirees - Wellness/Work-Life

84% 88% 93%

82% 92% 86%

90% 90% 90%

90% 90% 90%

Outcome Percent of customer survey respondents reporting increased health knowledge, increased skills, competency and/or intended health behavior change as the result of participating in a sponsored wellness or work-life training

--- --- 90% 90%

Percent of customer survey respondents reporting successful lifestyle change(s) at least 30 days after attending training class

--- --- 50% 50%

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County Home > Human Resources Department > Employee Wellness > All Classes & Events > Health & Wellness

Belly Dancing

Blood Pressure Check UpLearn the basics about blood pressure, what’s normal (what’s not), plus areview of the latest recommendations to keep your blood pressure as low aspossible. more>>

Brain and Mood FoodWill eating fish make you smarter? Can chocolate consumption really putyou "in the mood"? What foods and nutrients can keep your brain young,reducing forgetfulness and increase reaction time? Join our registereddietitian for answers to these questions and to learn what science has tosay about the ways food can alter our mood and brain function. more>>

Cholesterol ~ Healthy Heart BasicsThis class is designed for anyone who wants to know the basics about heartdisease. We'll review and describe the risk factors for heart disease,metabolic syndrome and hypertension. You'll also get up to speed on all ofthe lab tests and blood pressure readings so that your next checkup reallymakes sense! more>>

Cholesterol ~Launching Your Diet for a Plaque AttackThis class is all about food -- yum -- but which ones lower your risk of heartdisease and which ones raise it? Join us for this nutrition-focused class andyou'll learn what food substitutions make the greatest impact on yourcholesterol and blood pressure numbers. We'll review the blood pressurelowering DASH Diet, the best way to include more omega-3 fats, and howto read a label to make sure it's the highest in fiber to launch the strongestplaque attack! more>>

Cholesterol ~Managing Heart DiseaseLet's move from knowing about cholesterol and heart disease tosuccessfully managing it! This class is for anyone who knows a little bitabout cholesterol, hypertension and heart disease, but needs to take theirmanagement of it to the next level. We'll review the best ways to reducechronic complications from these diseases, spend time analyzing your labresults and review many types and proper use of medications. Please bringa copy of your recent screening results! more>>

Crock Pot Cooking

Last year our registered dietitian bought a crock pot, and apparently she’sin love! With a year of experimentation, she’s realized that the crock pot isthe easiest way to make a meal when you’re too busy to cook.

Feeling too busy to cook? Then please join us for this practical seminar tolearn the tricks of the trade from a happy crock potter. You’ll learn simplesteps for putting a healthy meal on the table before you leave for work!Sound too good to be true? Come, find out for yourself!

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Sign in to LMS to register for aclass

Technical Advisory, PleaseRead...

We are currentlyexperiencing some technicalglitches with the Health andFitness division web site. Ifyou come to a page thatseems blank, pleaserefresh (F5) your screento load the content.

We are working to correctthis issue. Our apologies forany inconvenience.

Sound too good to be true? Come, find out for yourself!

Visit LMS for more information! To register for training get verbal orwritten permission from your supervisor to attend this program on Countytime. Register online using County LMS ~ you are pre-approved, noelectronic supervisor approval is required. You’ll be sent an e-mailconfirmation and reminder notice. http://www.co.sanmateo.ca.us/LMSmore>> 1-93

Summary Table of Measures, Product Lines and Changes 1

HEDIS 2014, Volume 2

SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES

HEDIS 2014 Measures

Applicable to:

Changes to HEDIS 2014 Commercial Medicaid Medicare

General Guidelines for Data Collection and Reporting

Changed all coding table references to value sets.

Added a requirement to exclude members with a hospice benefit from MA HEDIS reporting in General Guideline 7.

Updated deadline dates in General Guideline 9.

Updated the measures eligible for rotation in General Guideline 14.

Updated submission dates and plan-lock date in General Guideline 35.

Revised General Guideline 39 to reflect the updated requirements for supplemental data.

Clarified requirements in General Guideline 40.

Clarified that laboratory claims and data can only be used for codes in the Lab Panel Value Set (which only contains CPT codes) or for codes in value sets that contain LOINC codes in General Guideline 46. As a result of converting coding tables to value sets, fewer codes are eligible for use when reporting laboratory data in HEDIS 2014. Specifically, the following tables from HEDIS 2013 were split into multiple value sets and only some of the value sets contain LOINC codes: COL-A, CHL-B, CHL-D, CDC-K, MPM-A, PPC-C and PPC-E.

Added General Guideline 47 and renumbered subsequent guidelines.

Revised General Guideline 49 to reflect the presentation of codes in the value sets (formerly General Guideline 48).

Revised General Guideline 52 to reflect how UB TOB codes will be listed in the value sets (formerly General Guideline 51).

Guidelines for Calculations and Sampling

Revised the requirements for Drawing the sample prior to the reporting year for claim-dependent denominators.

Revised Table 1: Sample Size Information for Hybrid Measures.

Updated step 5 in the Systematic Sampling Methodology for HEDIS 2014 reporting.

Effectiveness of Care

Guidelines for Effectiveness of Care

Revised the requirements for ―Which services count?‖ when reporting Effectiveness of Care measures.

Adult BMI Assessment Removed coding tables and replaced all coding table references with value set references.

Clarified that ranges and thresholds do not meet numerator criteria.

______________

Current Procedural Terminology © 2013 American Medical Association. All rights reserved.

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ACA Regulatory UpdatesMay 22, 2014 | 3:00-4:30 p.m. EDT

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HRA/HSA Options Under the Affordable Care ActRecorded April 24, 2014

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The New Employer Shared Responsibility Rules (“Pay or Play”): Time for ActionRecorded March 18, 2014

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Individual Premium Tax Credits: Who Gets Them, How Much are They, Impact on EmployersRecorded February 20, 2014

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Ann E. Murray [view bio]PartnerMcKenna Long & Aldridge LLPSan Diego, California

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Your 2014 Health Care Reform To Do List—Prepare or Pay!Recorded January 16, 2014

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Mental Health Parity: The Final Regulations are HereRecorded December 5, 2013

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Recorded November 7, 2013

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New Rules for Health Reimbursement Arrangements—Plan SponsorsNeed to Take Action NowRecorded November 7, 2013

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The Affordable Care Act: Implications for Wellness ProgramsRecorded September 30, 2013

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Health Care Reform Strategy: Your Next MoveRecorded September 23, 2013

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Is the Time Right for Private Exchanges?Recorded August 15, 2013

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Countdown to 2014: An Update on Health Care Reform andImplementationRecorded July 25, 2013

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The New PCORI Fee—What You Need to KnowRecorded July 2, 2013

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Health Insurance ExchangesRecorded June 25, 2013

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What You Need to Know About Exchange NoticesRecorded June 24, 2013

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Update on ACA Regulations and GuidanceRecorded May 30, 2013

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The Latest on Health Care ExchangesRecorded April 2, 2013

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Communicating Health Care Reform to Plan ParticipantsRecorded April 2, 2013

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Preparing for Health Care Reform in 2014Recorded April 2, 2013

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New Pay or Play Regulations (December 28, 2012)Recorded January 23, 2013

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Integrating Value-Based Health Care Into the Exchange StructureRecorded at the 2013 Health Care Management Conference

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Additional Features:

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LIVE Q&A with Webcast presenters

Real-time access to other participants through instant messaging chat, e-mail and social networks

A dynamic exchange of best practices and tips of successful implementation

A wealth of resources including breakout labs with content specific to varying roles including multiemployer, publicemployee and corporate benefit plans, discussion forums, downloadable reports, white papers, videos and more.

ACA University Ongoing EducationOpen through December 31, 2014

Registrants have access to the full ACA University virtual environment throughout the year. Click here for a list of virtual features.

Educational sessions at this program qualify for CEBS continuing professional education (CPE) credit.

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Featured Topics

ACA Central

Value-Based Health CareWhat Is VBHC?

Getting Started

Success Stories

Financial Wellness andRetirement Security

Pension Reform Central

FASB DisclosureRequirements

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What is a MultiemployerPlan?

What Is VBHC?

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Additional ResourcesWhite Paper | Glossary | Focus Group Findings | Initial VBHC Survey | Second VBHC Survey

What is Value-Based Health Care?Value-based health care (VBHC) is a health care managementstrategy focusing on costs, quality and, most importantly,outcomes. Its goal is to create a culture of health within anorganization by removing barriers and encouraging participantsto pursue healthy lifestyles that ultimately lead to a healthyworkforce. VBHC involves collaboration among plan sponsors,participants and providers to pursue high-quality and high-value care while reducing the need for high-cost medicalservices

Select any of the topics in the illustration on the right for a brief description.

Home > News > Featured Topics > Value-Based Health Care

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by | Paul Hackleman

Gathering and Using Data for Value-Based Health Care Initiatives—

About the Series

Introduction to Six-Part Series

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january 2012 benefits magazine 25

Unless health plan sponsors have accurate information, they can’t be sure that health care dollars are being spent effectively and that initiatives designed to keep participants healthy are working. Getting the right data and knowing what to do with it is critical, as a series of upcoming articles will explain.

Over the next six months, Benefits Magazine will feature a series of articles on gathering and us-ing data to implement value-based health care (VBHC) initiatives and measure their out-comes. Improving health and controlling cost

has never been more important. Despite the passage of health care reform legislation, health care costs continue to rise at an unsustainable pace. Plan sponsors—employers and multi-employer funds—retain primary responsibility for employee, retiree and dependent health care and its cost. This responsi-bility is unlikely to change any time soon. Plan sponsors need to take action.

It is fundamentally important to understand that data is the building block of information. But data is not information any more than the alphabet is literature. Well-reviewed and under-stood, data evolves into information—the basis for program development, refinement, administration and evaluation.

Without information, plan sponsors are incapable of de-veloping specific strategies that address their own workforce populations. Without information, plan sponsors are unable to evaluate the effectiveness of any initiatives in address-ing health improvement or cost. And without information, plan sponsors are unable to impact the overall health care trends that are absorbing an ever-greater proportion of their resources and plan participants’ individual costs. Optimally, information leads to action.

Taking action by implementing VBHC strategies depends heavily on the quality and type of data available for review and evaluation. While plan sponsors may identify gen-

eral health care and diagnostic trends that drive cost, they have little likelihood of designing successful VBHC pro-grams without a clear understanding of employer-specific or fund-specific utilization and how it impacts their employees’ health, overall productivity and use of health care, disability and retirement system services.

Data and the information it illuminates are key to (1) de-veloping risk reduction/health improvement initiatives and (2) determining whether specific interventions are achiev-ing the desired outcomes. As a result, investing time and re-sources in data definition and organization are essential.

But data design and development are time-consuming. They require a commitment of organizational resources over a period of time. This is especially difficult when budgets are strained and resources are scarce.

In this environment, how can plan sponsors develop prac-tical, workable data systems to identify and design VBHC ini-tiatives that impact health? How can their efforts be supported by practical shortcuts they can employ to achieve results more quickly, with lower expenditures? If providers are currently not providing or sharing sufficient data, how can plan spon-sors expect to identify initiatives that will reduce their costs and workers’ costs? What practical steps can employers take to elevate the quality of data they receive and review? These are important questions plan sponsors must ask and answer.

In February 2010, the International Foundation of Em-ployee Benefit Plans launched a two-year initiative on value-based health care. The initiative seeks, among other things, to help plan sponsors answer these questions. One of the

Reproduced with permission from Benefits Magazine, Volume 49, No. 1, January 2012, pages 24-28, published by the International Foundation of Employee Benefit Plans (www.ifebp.org), Brookfield, Wis. All rights reserved. Statements or opinions expressed in this article are those of the author and do not necessarily represent the views or positions of the International Foundation, its officers, directors or staff. No further transmission or electronic distribution of this material is permitted. Subscriptions are available (www.ifebp.org/subscriptions).

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critical steps is focusing on data design, development and delivery.

The Foundation’s Value-Based Health Care Initiative

In 2008, the Foundation formed an ad hoc Value Based Health Care Com-mittee to develop a strategic plan to help plan sponsors implement VBHC strat-egies that encourage cultures of health and help control cost. During the first several years, the committee sought to develop a comprehensive definition of value-based health care and identify a road map the Foundation could use in broadening the number of multi-employer and public funds that adopt VBHC strategies and initiatives.

The 2010 launch of the two-year ini-tiative was the Foundation’s first major step in providing a comprehensive guide to VBHC strategies. A preliminary benchmark study of what plan sponsors are doing in the area of VBHC initia-tives was completed and the key results were made available free to Foundation members in spring 2011.

Additional steps following the benchmark survey included a

• Report of focus group findings at the 56th Annual Employee Ben-efits Conference in 2010

• Followup benchmark study to measure progress in implement-ing initiatives

• Glossary of terms• Series of case studies of multiem-

ployer and public plans.These additional steps were intended

to provide practical templates plan sponsors can follow in transforming their health plan oversight.

Dr. Dee W. Edington, University of Michigan professor and author of Zero Trends: Health as an Economic Strategy,

and members of his staff have been key players in the Foundation’s overarching initiative. They produced a white paper that is intended to be a living document, continuously updated with practical tools for plan sponsors. A master report will tie together the phases, steps and projects generated in this initiative.

Next month, Benefits Magazine will begin a series of articles on developing data systems to support specific pro-gram interventions.

Team of AuthorsA group of authors that includes

medical professionals, third-party ad-ministrators, public sector and multi-employer benefits managers and con-sultants is collaborating to write as well as review the articles. The team includes

• JohnW.Barton, chief executive officer of Health Services Benefit Administrators (HSBA), Inc., Livermore, California. He previ-ously was a benefits consultant specializing in health care for multiemployer plans with Mercer Human Resource Consulting where he was a worldwide part-ner and national practice leader for health and group benefits. Barton is a member of the Foun-dation’s Health Care Manage-ment and Coalition Committee.

• ClaireBrockbank,owner of Segue Consulting Inc., a health care strat-egy and business development firm. Since 1996, Segue has worked with international, national and lo-cal clients to get more value from their health care business relation-ships. Brockbank’s clients include public and private sector entities, employers, health care organiza-tions, manufacturers and technol-

ogy firms with an interest in the health care sector. She also works closely with the National Business Coalition on Health.

• LewisE.Devendorf,who re-cently retired as a partner at Mer-cer Human Resources Consult-ing, where he was a senior consultant and executive sponsor to Mercer’s health and benefits carrier relations program. Deven-dorf was a member of Mercer’s national health and benefits man-agement team. Previously, he was executive director of two health plans operating in New York and Connecticut and director of op-erations of a group model HMO in the West.

• PaulHackleman, principal with SST Benefits Consulting, where he has advised public sector and Taft-Hartley funds since retiring in 2008 as benefits manager for San Mateo County, California. He serves as a trustee for the San Mateo County Employees’ Retire-ment Association (SamCERA) in Redwood City. Hack leman serves as a voting director of the Foundation and is vice chair of the Public Employees Board and a member of the Health Care Management and Coalit ion Committee.

• SusanManning, director of health management programs at HSBA, Inc. A registered nurse, certified case manager and certi-fied chronic care professional, Manning is responsible for over-sight of a self-funded multiem-ployer plan client’s chronic dis-ease management program. She also serves as a clinical consul-

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value-based health care

tant for the plan’s mobile biometric screening (well-ness) program. Manning consults for five additional self-funded plans through Chronic Disease Solutions.

• LarryMcNutt, a certified public accountant who serves as administrator of the Carpenters Trusts of Western Washington in Seattle, Washington. He has more than 30 years’ experience in Taft-Hartley fringe benefit administration. McNutt is a past president of the Northwest Association of Administrators.

• GeneH.Price, administrator of the Carpenter Funds Administrative Office in Oakland, California and chair of the Foundation’s Health Care Management and Co-alition Committee. He serves on the Foundation’s board of voting directors.

• JohnRiedel,president at Riedel & Associates Consul-tants, Inc. (RACI). RACI provides health and produc-tivity management services for self-insured employers and employer coalitions, health plans, hospitals, dis-ease prevention and disease management providers, and pharmaceutical companies. Riedel also helped de-velop HPM Clinic, a comprehensive health and pro-ductivity management training program, in collabora-tion with the American College of Occupational and Environmental Medicine and the Integrated Benefits Institute.

In addition, William J. Einhorn, administrator of the Teamsters Health and Welfare and Pension Trust Funds of Philadelphia and Vicinity, and Margaret C. Lemkin, Ph.D., will help review the articles. Einhorn serves on the Founda-tion board of voting directors and is a member of the Com-mittee on Training and Education. Lemkin serves as an ad-visory member of the board of directors and is a member of the Health Care Management and Coalition Committee. She chaired the ad hoc VBHC Committee.

Goal of ArticlesThe goal of the articles is to provide practical, actionable

steps plan sponsors may take to• Improve data collection• Establish a process for analyzing health plan utilization

to address participant health, risk reduction opportu-nities and plan expenditures

• Develop specific VBHC strategies and initiatives based on the newly developed data elements

• Monitor strategies and initiatives to determine their

effectiveness in improving participant health and avoiding or minimizing costs.

Summary of ArticlesEach article will begin with an assessment of the chal-

lenges facing plan sponsors in assembling key information to identify cost trends and behavioral factors that drive overall plan expenditures. The articles will include case examples of plan sponsors that have faced similar challenges and success-fully identified the data necessary to make decisions about interventions likely to improve health and reduce cost. Here is an overview of the six upcoming articles:

1. Characteristics of Health Plan Utilization will focus on current characteristics of health plan utilization for most plan sponsors to set the table for a discussion in later articles about how that utilization should define VBHC initiatives. The old 80-20 rule that 80% of par-ticipants represent 20% of annual health plan expenses and 20% of participants represent 80% of costs is prob-ably true. But it is also clear that a much smaller 3-7% of participants drive 30-50% of annual utilization. The more successfully plan sponsors can identify areas of high utilization, the more likely they are to develop spe-cific programs targeted to improve health. Knowing whether high utilizers are employees, retirees or depen-dents or concentrated in certain occupational classifica-tions of participants is critical in targeting individuals whose health will most benefit from interventions.

2. Characteristics of Plan Sponsors will acknowledge how data is different based on plan sponsor characteristics includ-ing size, geographical dispersion of participants, num-

learn more >>EducationHealth Care Management ConferenceMarch 19-21, Savannah, GeorgiaFor more information, visit www.ifebp.org/healthcare.Wellness and Disease ManagementFor more information, visit www.ifebp.org/elearning.

From the BookstoreZero Trends: Health as a Serious Economic Strategyby Dee W. Edington. 2009. University of Michigan.For more details, visit www.ifebp.org/books.asp?8884.

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ber and type of providers, structure of insurance (fully insured, self-funded) and other factors. This article will reference several specific data sets (which will be avail-able on the Foundation’s website) as a starting point for developing high-quality information capability. Not surprisingly, the data needs are not confined to health plans alone. It is no less important to understand dis-ability and retirement costs. It is critical to think about overall worker productivity. In essence, this article will explore the numerous interrelated areas that define a culture of health.

3. Characteristics of Medical Providers will discuss the various providers of services (physicians, health care facilities, pharmacy providers, etc.). It will focus on how information related to those services is captured and communicated. It will also highlight how that im-pacts coordination of data for purposes of analysis, es-pecially if information is received separately from mul-tiple providers. This article will also focus on service disparity between providers that impact both outcomes and cost and how plan sponsors can use that data to direct patients to providers that offer a combination of superior outcomes and lower cost.

4. Summary of Key Data Elements will list essential data ele-ments plan sponsors should obtain across the spectrum of multiple programs, how those data elements can be established as performance standards in agreements and contracts and how, if data providers are currently pro-viding little or no data, plan sponsors can establish pro-

cesses for improving overall data collection. The Foun-dation’s website will provide a comprehensive list of desirable data elements developed for this project, where readers may access them directly from each article.

5. How Data Can and Should Define VBHC Strategies will be a summary of the ways in which plan sponsors can develop ongoing processes to assure they are regularly reviewing data, using that data to develop risk reduction interventions and potential plan design modifications, and monitoring intervention effectiveness. This article is intended to help plan sponsors “put it all together.” This article will also address the question of how risk reduc-tion and health promotion initiatives may be evaluated and monitored and how rewards program information can compliment participation and data collection.

6. How Small Employers and Funds May Use Data to De-velop Risk Reduction Strategies. The first five articles are intended to provide broad utility for larger plan sponsors irrespective of sector (public, corporate, mul-tiemployer or Canadian). The authors realize that the strategies promoted in these articles may be less suit-able for smaller employers. Larger plan sponsors often have more financial and human resources to address data issues and promote collaboration with other health plan stakeholders. They have greater leverage with other health care partners (third-party adminis-trators, health insurance providers, medical profes-sionals). This last article will be specifically targeted to smaller plan sponsors that might have difficulty pursu-ing the strategies outlined in the first five articles. It will provide concrete strategies and steps small em-ployers/funds may take to obtain data, avoid Health Information Portability and Accountability Act viola-tions and use that data to develop VBHC strategies.

Organization of ArticlesThe articles are intended to provide an overview of spe-

cific data requirements and examples of plan sponsors that have used data in designing programs that seek to improve health and reduce cost. Articles will include links to the Foundation’s website (www.ifebp.org/Resources/News/Top-icsInDepth/ValueBasedHealthCare/HCdata.htm) to illus-trate more specific and detailed information for interested readers. Each article will also emphasize the key two or three steps plan sponsors should consider.

Paul Hackleman, a principal with SST Benefits Consulting, advises public sector and Taft-Hartley funds since retiring in 2008 as benefits manager for San Mateo County, California. He

received his B.A. degree from Callison College, University of the Pacific, Bangalore, India Univer-sity; and his M.A. degree from the University of Chicago. Hackleman has published three books: Public Employee Benefits: From Inquiry to Strategy, Deferred Compensation/Defined Contribution: New Rules/New Game and Defined Contribution Decisions: The Education Challenge.

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