innovation and data-driven strategies in corporate healthcare · 2018. 11. 6. · source: coventry,...
TRANSCRIPT
Innovation and Data-Driven Strategies in Corporate Healthcare
November 14, 2018
Karen Amato R.N., CCM, CPDMVice President, Director of Health Risk Solutions
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n Learn how population data insights can help inform targeted solutions to improve employee health, productivity, and medical trend.
n Review emerging and innovative healthcare delivery, tools and technologies that are changing the approach of disease/condition management.
n Explore the impact of stress on the workforce and what employers are doing to mitigate.
n Review the shift in well-being programs to drive employee engagement and performance.
Objectives
Lockton Companies |3
Healthcare inflation is driven by price increases, not
utilization (new medical and pharmacy technologies).
Specialty medications are the fastest growing driver
of high cost.
Severity and frequency of catastrophic claims continue to increase.
Specific Cost Drivers
High-risk claimants have chronic conditions (such as coronary artery disease, diabetes, hypertension, smoking-related illness and obesity) but also include maternity, behavioral health and orthopedic conditions.
High-cost claimants are associated with specialty medicines, cancers, back conditions, trauma, premature births and complications of hospitalization and surgeries.
High-cost claimants~2% of the total population drives 50% of the costs.
High-risk claims~20% of the total population drives 80% of the costs.
The drivers of medical cost
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Source: Lockton Infolock.
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Understanding impact of chronic conditions
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5
$10,991$12,811
$28,192
$16,556
$13,857$12,720 $12,602
$19,646
Asthma Back pain Coronaryartery disease
(CAD)
Diabetes High bloodpressue
Highcholesterol
Neck pain Osteoarthritis$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
Allo
wed
am
ount
PPP
YChronic conditions drive cost
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Lockton’s Infolock book of business
Costs represented here include comorbidities.*PPPY – Per Patient Per Year
Improving chronic conditions positively affects population health, productivity and health plan financials.
Source: Lockton Infolock®, 2018
Lockton Companies |6
Health and productivity
Source: Coventry, 2010- Most current study.
$1,500
$9,750
$1,400
$1,400
$1,400
$750
$19,000
$19,000
$9,875
$10,500
$1,000
$2,500
$11,750
$14,000
$9,675
$10,000
$10,500
$2,000
$5,850
$9,750
$2,500
$3,000
$1,750
$1,000
$5,500
$10,000
$1,400
$1,400
$1,400
$750
Depression
Obesity
Diabetes
Hypertension
Smoking
No Comorbidity
Contusions/lacerations Sprains/strains Musculoskeletal disease Fractures Burns
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Median 12 month medical allowed amountby complicating condition and injury classification
No comorbidity
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The most common musculoskeletal conditions include: n Osteoarthritisn Back/neck pain
n Bone fracturesn Injuries n Inflammatory conditions
(i.e.) rheumatoid arthritis
Low back pain is the leading cause of
disability worldwide.
n Musculoskeletal conditions are the second largest contributor to disability globally.
n These conditions include more than 150 diagnoses relating to muscles, bones, joints, tendons and ligaments.� Often characterized by persistent pain and
limitations in mobility, dexterity and functional ability.
n The impact on individuals suffering from these conditions can include: � Lowered ability to be productive at work.� Decline in overall mental and motional well-
being.� Feeling isolated as a result of physical
limitations.
Source: World Health Organization, 2018
Musculoskeletal conditions
Lockton Companies |8
The business case for population health management
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Greater productivity
Lower risks
n Reduced absenteeism.
n Improved performance.
n Improved health outcomes.
n Personal insights and accountability for health.
n Cost-efficient plan design.
n Improved consumerism.n Less turnover.
Lowercosts
Most employers consider healthcare costs a challenge to the bottom line. The benefits of a population health strategy present a solution to this challenge.
Lockton Companies |9
Hot topics in population health management
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Targeted disease-specific management
Second medical opinion
Specialty medications
Centers of excellence
On-site clinics
Chronic conditions
Financial wellness
Precision medicine
Health and productivity
Executive physicals
Behavioral health
Pharmacogenomics
Diabetes
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Focused interventions
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Well-being solutions
n Population health programs.
n Culture of health.
n Incentive design.
n Employee communications.
Access to care solutions
n Assistance for members to find the right provider.
n New ways of interacting with the right provider.
Targeted care solutions
n Identification of high-risk, high-cost, high-complexity members.
n Interventions that improve the health outcomes of designated members.
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Access to care solutions
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On-site health solutionsn Convenience.
n Cost control.
n Geographic concentration.
n Productivity improvement.
Telemedicine
n Reduce ER overutilization.
n Offset urgent care expense.
n Efficiency for common ailments and behavioral health.
Cost transparencyn Increase health
engagement.
n Allow members to control their own costs.
n In tandem with HDHP and cost shifting.
Patientadvocacyn Assistance with
navigating complexities of healthcare system.
n Focus on quality of care.
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Targeted care solutions
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Disease managementn Apps, technology-based
monitoring systems.
n Customized real-time interventions.
n Cardiac health.
n Diabetes.
n Mental health.
n Back disorders.
Case managementn Catastrophic care
management.
n Renal care/dialysis.
n Cancer care.
n Rehabilitation.
n Home-care solutions.
n Specialty Rx case management.
Second opinion solutionsn High-cost claimants.
n High-risk claimants.
n High-complexity patients.
n High-uncertainty medical situations.
Other targetedsolutionsn Specialty Rx provider
carveout.
n Targeted chronic condition management.
n Narrow network.
n Centers of excellence.
Increasingly employers have expressed interest in adding as a carved-out solution.
66% of employers have medical decision support/second opinion services in place.
71% of employers plan to offer by 2019.
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Well-being solutions
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Population health programsn Health risk assessment.
n Biometric screening.n Health coaching.
n Health education. n Group challenges.n Preventive care.
Culture ofhealthn Mission and vision.
n Well-being committee.n Corporate policies.
n Holistic, including financial well-being.
n Enhancements to work environment.
n Middle management accountability.
Incentivedesignn Morale-based.
n Participation-based.n Progress-based.
n Outcomes-based.n Tobacco cessation.n Compliance
considerations.
Employee communicationsn Program branding.
n Varied channels.n Multi-media.
n Management support.
Lockton Companies |14
Shifting to well-being
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Employers are increasingly offering programs that address behavioral/mental, financial and social health.
Source: Fidelity 9th Annual Employer-Sponsored Health and Well-Being Survey, 2018
31%
25%
21%
17%
10%
7%
1%
28%
60%
72%
77%
90%
92%
98%
Purpose in life or "spiritual contentment"
Social connectedness
Community involvement
Job satisfaction/stress
Financial security
Emotional/mental health
Physical health
Yes Considering for the future
Lockton Companies |15
Financial stress
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7%
8%
9%
9%
11%
12%
14%
30%
34%
31%
34%
30%
36%
38%
63%
58%
61%
57%
59%
52%
48%
Problems with spouse/partner
Problems with coworkers/colleagues
Stress over cost of healthcare
Family issues
Dealing with debt payments
Stress over financial situation
Worry about future
A great deal Moderately Not at all
Workplace productivity suffers
when workers are under financial
stress.
Source: Lockton Financial Wellness Survey, 2018
Lockton Companies |16
Financial wellness: How employers can help
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Respondents stating certain programs and resources that would be ‘very helpful’ to decrease financial concerns.
Source: Lockton Financial Wellness Survey, 2018
31% 31%
26% 25% 24% 24% 24% 24% 23%20%
17%19%
14% 14%
10%
15%13%
15%
N/A
7%
Meeting with afinancial
professional
Help creatingfinancial plan
Helpeliminating orconsolidating
debt
Medicareadvice
Help planningfor healthcare
costs
Budgetingadvice
Stressmanagement
education
Investmenteducation
Advice onbenefitsselection
Informationabout HSAs
2018 2016
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Autism services•Torchlight, Rethink
College savings/student loan/financial •LEAF, Gradvisor, UBS; Ion Tuition, SoFI; Hello Wallet
Condition management•Livongo, Abacus, Hello Heart, Hinge Health
Genetic testing•Color Genomics, 23andMe, Viome
Infertility / maternity•Progyny, Ovia, Mango Health, Milk Stork
Weight loss / metabolic syndrome•Retrofit. Omada, Newtopia
Accolade•Total population health
Benevity•Charity giving
Care @ Work•Enhanced care.com model, family services
Consumer Medical•Advocacy, second opinion, medical research
Joyable •Digital mental health solutions
Sleepio•Sleep and behavioral health impact
Trending Benefits
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By vendor By vendor category
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Stress in the workplace
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37% of working adults report experiencing chronic stress at work.
Top 5 factors contributing to work stress:
1. Low salaries.2. Lack of opportunity for growth or
advancement.3. Too heavy of a workload.4. Uncertain or undefined job
expectations.5. Unrealistic job expectations.
Chronic stress leads to negative health outcomes:
n Anxiety and depression.n Difficulty with memory and
concentration.n Digestive issues.n Headaches.n Heart disease.n Sleep problems.n Weight gain.
Source: American Physiological Association Work and Well-being Survey, 2017.
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Stress management and resilience
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Employers reporting these emotional/mental health programs will be in place the following year, or considering for the future.
Source: Fidelity 9th Annual Employer-Sponsored Health and Well-Being Survey, 2018
45%
53%
71%
62%
79%
54%
62%
70%
75%
82%
Happiness programs
Teletherapy
Resiliency training
Mindfulness classes or training
Coaching/relaxation programs
2018 2017
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Stress by generation
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Source: American Physiological Association, 2017.
Younger generations report higher average levels of stress and are more likely to say stress increased in the past year.
5%
13%
25%
30%
79%
88%
93%
88%
18%
25%
36%
38%
Mature
Boomers
Gen X
Millenials
Stress increased in past year
Engage in stress management
Not doing enough to manage stress
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The dimensions of well-being
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Physical
Emotional
Intellectual
Social
Spiritual
Environmental
Occupational
Financial
Employers should think holistically and focus on all dimensions of
well-being.
Source: HHS Substance Abuse and Mental Health Services Administration
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Our Goal | To be the best place to do business and to work© 2018 Lockton, Inc. All rights reserved.
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Karen AmatoVP, Director of Health Risk Solutions
Lockton N.E. [email protected]