Population Health: Employers and Beyond

OSHE Fall MeetingOctober, 2015

Karen Volmar, JD MPHOregon State University

• History of employer involvement in population health

• Current employer based population health management strategies

• Moving forward– examples of partnerships and programs from the field

Employers – the first population health managers

Health Insurance Coverage

Management Features & Plan Design

Employee Wellness Programs

Partnerships for

Population Managemen

t

2015

2014

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

$4,955

$4,823

$4,565

$4,316

$4,129

$3,997

$3,515

$3,354

$3,281

$2,973

$2,713

$2,661

$2,412

$2,137

$1,787

$1,619

$1,543

$12,591

$12,011

$11,786

$11,429

$10,944

$9,773

$9,860

$9,325

$8,824

$8,508

$8,167

$7,289

$6,657

$5,866

$5,274

$4,819

$4,247Worker Contribution

Employer Contribution

Average Annual Worker and Employer Contributions to Premiums and Total Premiums for Family Coverage, 1999-2015

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

SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2015.

$5,791

$6,438*

$7,061*

$8,003*

$9,068*

$9,950*

$10,880*

$11,480*

$12,106*

$12,680*

$13,375*

$13,770*

$15,073*

$15,745*

$16,351*

$16,834*

$17,545*

Among Large Firms (200 or More Workers) Offering Health Benefits, Percentage of Firms Offering Incentives for Various Wellness and Health Promotion Activities, 2015

Offers or Re-quires Health Risk Assess-

ment

Also has an In-centive to Complete

Health Risk Assessment

Offers or Asks Employees to

Complete Biometeric Screening

Also has an Incentive To

Complete Biometric Screening

Offers Specific Wellness Programǂ

Also has an In-centive or

Penalty to Par-ticipate in

Wellness Pro-grams

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

50%

31%

50%

28%

81%

31%

• ǂ Firms which offer either “Programs to Help Employees Stop Smoking”, “Programs to Help Employees Lose Weight”, or “Other Lifestyle or Behavioral Coaching“.

• SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2015.

Health Risk Assessments

Biometric Screening Wellness Programs

Among Firms Offering Health Benefits, Percentage of Firms Offering Specific Wellness Program to Their Employees, by Firm Size, 2015

Programs to Help Em-ployees Stop Smoking

Programs to Help Em-ployees Lose Weight

Other Lifestyle or Behav-ioral Coaching

At Least One of These Programs

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

41%* 39%* 39%*

49%*

71%*

61%*

68%*

81%*

All Small Firms (3-199 Workers)All Large Firms (200 or More Workers)

• * Estimate is statistically different between All Small Firms and All Large Firms (p<.05).

• NOTE: “Other Lifestyle or Behavioral Coaching” can include health education classes, stress management, or substance abuse counseling.

• 2% of health benefit dollars spend on wellness

• 20% of companies spend more than $400 per employee per year on incentives

• 1in 4 companies do not measure outcomes of wellness activities

2010 SHRM Survey (Fidelity and NBGH)

Additional Challenges

• Employee Privacy concerns

• Financial Incentives

• Discrimination concerns

Catastrophic Health

Coverage

Health Maintenance Organization

s

Employee Wellness Programs

Partnerships for

Population Managemen

t

Partnering with Providers and Payers• Program

design

• Developing the evidence base

• Program execution

• Managing privacy

Thank you