Caterpillar Presentation - ACOEM · 2019. 2. 7. · CATERPILLAR CONFIDENTIAL: Green Caterpillar Inc. Global Enterprise – Nearly 95,000 employees – Nearly 300 operations in 40

Integrating Health Promotion and Healthcare Quality

Paul Hodgins MD MPHCaterpillar Inc.

Corporate Health Achievement Award 2007

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MAKING PROGRESS POSSIBLE

Making Progress PossibleCATERPILLAR CONFIDENTIAL: Green

Caterpillar Inc.

World’s largest manufacturer of construction and mining equipment, diesel and natural gas engines and industrial gas turbines

Technology leader in construction, transportation, mining, forestry, energy, logistics and electric power generation

#1 or #2 for each industry we serve with a 2010 goal of market leadership for every major product group on every continent

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Caterpillar Inc.

Caterpillar Inc., established in 1925 with merger of Holt and Best tractor companies

First diesel tractor model built in October 1931 in East Peoria, Illinois

Cat machines served in World War I and II

World headquarters in Peoria, Illinois

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Caterpillar Inc.

Global Enterprise– Nearly 95,000 employees– Nearly 300 operations in 40 countries– Over 500 products sold in every country

Fortune 100 Company / Fortune 500 Global Company– Sales and revenues of $41.5 billion for 2006– Sales and revenues of $50 billion projected by 2010– Profit per share of $5.17 in 2006 vs. $4.04 in 2005– Invested over $1.35 billion in research & development in 2006

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Excavators

Track-typetractors

Trucks

Wheel loaders

Engines

Backhoe loaders

Motor graders

Paving products

Compact construction equipment

Caterpillar Products

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Caterpillar Services

Cat Logistics– Integrated supply chain services to more than 48 companies

in 28 countriesCat Financial

– Offers financing alternatives for Cat equipmentCat Remanufacturing

– Recycling end-of-life components to same-as-new condition

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Healthcare cost per covered life

2002 2003 2004 2005 2006 2007 2008 2009 2010

National Industry Employer HC Inflation PMPY - IndexedGoal – Total CPI Inflation from 2002 PMPY

Actual + Projected – (2002-2005 Actuals), 2006 PMPY



0 %

30 %

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Cost sharing

Employer

Employee

2005Healthcare Costs

90%90%

10%10%

2006 Healthcare Costs

75%75%

25%25%

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Healthcare cost per covered life

2002 2003 2004 2005 2006 2007 2008 2009 2010





0 %

30 %

Quality strategy will eliminate the gap

Quality strategy will eliminate the gap

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Poor quality drives costs

Inconsistency

– Misuse, Overuse, UnderuseRewards for re-work and volume, not outcomes and qualityDelays in implementing effective new treatmentsLack of quality dataHuge opportunity for savings and engagement

Rand study concluded 33% of

U.S. healthcare spend is waste

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Integration of care

Improve quality, value and productivity through innovation and partnershipParticipation of all stakeholders

– Patients: Consumerism– Payers: Plan Design– Providers: Quality and Efficiency

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Integration of care

Aligning visionsSix sigma methodologyPharmacy and medical claims dataExisting networkHealth Promotion Programs

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SupportiveSymptomaticPreclinicalPreventionPromotionMaintenance

TerminalDiseaseHealth

An Integrated Care Delivery Model

Identify, prioritize and implement opportunities along a continuum of a disease state

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Health Risk Assessment

All payrolls and includes spouses and retireesOver 80% employee participationTargeted feedbackData warehouseFollow-up recommendations

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Health Promotion Website

Health risk calculators for diabetes, heart disease, cancerActivity CenterNutrition Center / Chef’s CornerTobacco cessationOn-line HRAHealth topicsNewsletters

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Health Screening Exams

Hourly, Salaried and ManagementEmployees counseled on risk factorsLeave with recommendation sheetMetrics drive health promotion focusBiometrics entered in data warehouseDrives disease management and local wellness initiatives

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An Integrated Care Delivery Model

Quality Provider metrics/ feedbackStandards of care determinationAddress efficiency, effectiveness, reduce re-workLean manufacturing principlesDevelopment of integrated programsEnd of life decision-making

BenefitsPlan design

Outcome metrics

Health PromotionTargeted HRA

Tailored feedback

Predictive modeling

Evidence-based guidelines

Follow-up reminders

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Six Sigma Projects

Initiated projects which will integrate health promotion and healthcare deliveryProjects focus on:

Data / MetricsClinical Best Practices / ResearchShared Decision-MakingCommunications / Behavior ChangeQuality

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Desired State

Incentives are aligned and driving healthy behaviors– Providers paid for educating members, supporting prevention

and maintaining wellness– Members encouraged (premium reductions) to live a healthy

lifestyle

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Goals

1. Reduce the incidence of targeted conditions:

Colorectal cancerAtherosclerosis

2. Improve quality of care delivered3. Improve efficiency4. Seek patient and physician feedback5. Metrics

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Colon cancer

Second leading cause of U.S. cancer deaths70-80 percent preventable/curableMajority diagnosed today are not curableChemotherapy/biologicals, radiation and surgery will prolong life at great expense139,000 new cases diagnosed annually in the U.S.

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SupportiveSymptomaticLate cancer

PreclinicalBenign early cancer

PreventionPromotionMaintenance

TerminalDiseaseHealth

Identify, prioritize and implement opportunities along a continuum for colon cancer and measure results

Risk Assessment

Behavioral change Quality Metrics

Primary Secondary

-aspirin-screening

Fecal Occult Blood Test*Colonoscopy

*Living WillsPower of AttorneyHospice

*Initial Quality 6 Sigma Projects

An Integrated Care Delivery Model: Colon Cancer

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Continuum of CareColorectal Cancer (CRC)

MaintenanceMaintenance PromotionPromotion PreventionPrevention PreclinicalPreclinical SymptomaticSymptomatic SupportiveSupportive

AllPrimordial

Total fat intakeSaturated fatPhysical activityFiber, fruits, veggiesWeight control

High RiskPrimary

ASA / NSAIDsCalcium supplements

Health Disease

SecondaryAvg risk (50-54)

FOBT annualNegativePositive (Rx screening)

Avg risk (55-64)

Screening >65 (Medicare)

High risk (screening @ <55)

Preventive Strategies

Risk StratificationPolyps

HyperplasticAdenomaDysplastic

CRC

Acute CareCancer stagingAdjuvant RxChemo, Biologies, RadiationQuality

Surgical PathologyHospitalOncology

Surveillance

Chronic Care

StratificationStratification

Low riskAverage riskAbove averageHigh risk

Community HealthCommunity HealthEnd of Life

CareEnd of Life

CareHealth Risk Appraisal

Health Risk Appraisal

30%

QualityQuest

Project 1: Data

Analysis for Baseline and

Risk Stratification

Project 1: Data


Risk Stratification

Project 2: Patient

and Physician Education

Project 2: Patient


Project 3: Procedure

quality


quality

Goal: Reduce incidence of

Colorectal cancer

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Atherosclerosis

Leading cause of morbidity and mortalityHigh costPotential to reduce risk factorsMost patients with CV risk factors are not at treatment goals

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MaintenanceMaintenance PromotionPromotion PreventionPrevention PreclinicalPreclinical SymptomaticSymptomatic SupportiveSupportive

PrimordialTotal fat intakeSaturated fatPhysical activityFiber, fruits, veggiesAspirinAvoid tobaccoLimit calories

Health Disease

Continuum of CareAtherosclerosis

SecondaryLipid screeningBP screeningDiabetes screeningTobacco use ID

HyperlipidemiaDietActivityDrug RxLDL controlBP controlTobacco cessation

Acute CareER chest painACSAcute MIRehabStenting

Renal PVDCarotid

CVAOP imaging

ESTDopplerAngiography

Chronic CareCHFFollow-up care

StratificationStratification

Community HealthCommunity Health

Metrics

Quality of Care

Metrics

Quality of CareEnd of Life

CareEnd of Life

CareHealth Risk Appraisal

Health Risk Appraisal

QualityQuest

Goal: Reduce cardiovascular

events

Project 3: Patient


Project 3: Patient



quality


quality

Project 2: Lipid

management

Project 2: Lipid

management

Project 1: Data


Risk Stratification

Project 1: Data


Risk Stratification

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Lipid Class Review

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Aspirin Project

Health Promotion Newsletter addressed aspirin chemopreventionHRA identified those at risk of MITailored feedback based on primary or secondary prevention, contraindications and readiness to change1714 non-users with no contraindications600 (35%) reported starting daily aspirin

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Health ScorecardCorporation Facility

Self-Reported Data forHealth Promotion Eligible Employees

Male 30,463 259Female 8,663 517Average Age 42 45Participation Rate 81% 90%

Self-Reported Blood PressureHigh 6% 5%BP Unknown 23% 17%

Body Mass IndexNormal 28% 39%Overweight 42% 34%Obese 30% 26%

Smoking Rate 16% 8%Physically Inactive (Leisure Time) 35% 36%High Fat Diet 28% 16%

Disease Specific Data (2005)Average Employee CostDiabetes Prevalence 5.74% 3.36%

Medical Cost Coronary Artery Disease Prevalence 5.45% 3.74%

Medical Cost

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Health and Productivity Management

Integrate all elements– Healthcare, Plan design, Health promotion, Occupational

health, Disability managementMetrics and goalsCultural changeInvolve the leadership

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We have a great opportunity to deliver quality improvements and enterprise value.

Thank You

Documents

Caterpillar Presentation - ACOEM · 2019. 2. 7. · CATERPILLAR CONFIDENTIAL: Green Caterpillar Inc. Global Enterprise – Nearly 95,000 employees – Nearly 300 operations in 40