Population Health Management

NEW RESULTS WHAT WE DO NEXT GEN BENEFITS OUTCOME BASED

Population Health Management Retirement Health to Wealth

Replace Open Enrollment Paper Docs with our CD Rom!

EMPLOYERSTRATEGIES

BROKERSERVICES

VENDORS& TPAs

CONSULTINGSERVICES

Lifestyle Risk Calculator

This presentation contains proprietary information. It is intend for use only by our contracted brokers and employer groups. Any redistribution or other use is strictly forbidden. The benefit descriptions are intended to be a brief overview of some benefits available. For Agent/Broker use only. Not for distribution to the general public, nor for solicitation purposes.

https://advancedbenefitdesigninstitute.com/index.php/component/content/article/41-uncategorised/104-4th-gen-benefits

Scott Hettesheimer Suite 1002 513-661-7581 [email protected]

Population Health ManagementCopernican Evolution in HealthCare

ManagementBenefits delivery platform, population health management, outcomes based

wellness initiatives, disease treatment compliance and much more. Delivered from 1 Website. A vendor agnostic platform.

AFFORDABILITY!

Overview

Affordability and competitive benefits that retain and attract talent, can only be accomplished with better healthcare management and

simplifying your benefits delivery.The Population Health Management system will create a healthier

world with its one-of-a-kind behavior motivation process driven with Modifiable Risk Factor reporting.

Unlike any other solution on the market, the Lifestyle Risk Calculator correlates behavior costs to retirement health to wealth.

Outcomes based financial & clinical incentives drive engagement, creating significant outcome based measurable results.


Problems

How do we deliver all of our benefits from one website?

How do we engage all of our employees and dependents?

How do we simplify our benefits delivery?How do we improve benefits satisfaction?How can we manage all healthcare benefits by way of supply chain management processes?

Limited Ability to Deliver

The Strategy Cornerstone


Benefits Delivery Increasing Engagement

Single Source Website, Login & Password Simple to Use & Familiar User Interface Managing All Health & Employer Communications Presenting All Benefits From One Website

Healthcare Qualified Retirement Dental, Vision & Ancillary/Voluntary

Connecting All HealthCare Data Claims Pharmacy Biometrics Manual Input Available for Wellness & Members


Benefits Delivery - User InterfaceSingle Source Website, Login & Password

Ex. A family health manager will be able to view all family activities and alerts through the News Feed

As an authorized caregiver, user receives a notification that a family member has completed a physical activity challenge

The News Feed is constantly updated

"To-Do" lists identify tasks that are not complete .Users can add their own "To-Do" items for themselves and/or their family members

Receive reminders of an upcoming doctor’s appointment

Benefits Delivery -User Interface Managing All Health & Employer Communications

Benefits Delivery -User InterfacePeer Support Reinforces Engagement & Positive Change

Drill into specific health topics: medications, allergies, immunizations, visits, procedures, etc.

Notifications: Based on a user’s preferences, the system will send out a variety of notifications, ranging from upcoming calendar appointments to a notification that new data has entered the user’s record

Alerts: The system will notify a user if the system has identified a problem in the user’s record

Benefits Delivery -User Interface Familiar & Simple

On-the-go employees present biggest costs and biggest savings opportunities

Dossia system leverages aggregated data to engage employees with personalized text-based programs to promote health behavior change

Benefits Delivery – CommunicationsEngaging Hard but Critical-to-Reach Employees

No computer. No internet. No Problem.

Your employees don’t have to be web native to benefit

Text-based engagement programs may include:

Mobile Engagement Solution

Health awareness / communications Patient decision support Health care consumer support Health rewards & incentives Medication adherence Preventive care reminders Nutrition and activity promotion Diabetes management

Choose apps that are meaningful to you

Apps integrate with PHR

Many apps are free

Dossia vets all apps for quality, value and reliability

Benefits Delivery - ServicesHealth Marketplace… Because Your Health is Yours!

All apps are segmented into 5 categories for easy search

Population Health ManagementDisparate Health Data; All Shareholders Now Connected

HealthCare Cost Equation

Pre-Diagnosis:Reverse disease trendingSlow disease progression Better disease managementAvoid healthcare need

After-Diagnosis:Negotiate deeper discountsDiscover cheaper pricesShift more cost to memberUnknown effects of ObamaCare

In order to accurately manage risk, 100% of the risk must be identified. Historical claims data only identifies current healthcare spending or current diagnoses, a backward look of less than 20% of your members.According to CDC’s analysis:Forty-five percent of adults had at least one of three diagnosed or undiagnosed chronic conditions—hypertension, hypercholesterolemia, or diabetes; one in eight adults (13%) had two of these conditions; and 3% of adults had all three chronic conditions.

Do You Know Who These People Are?This presentation contains proprietary information. It is intend for use only by our contracted brokers and employer groups. Any redistribution or other use is strictly forbidden. The benefit descriptions are intended to

be a brief overview of some benefits available. For Agent/Broker use only. Not for distribution to the general public, nor for solicitation purposes.

Population Health Management

Founded by a group of CEOs from some of the largest employers in the US, a platform was created that functions as the heart of your corporate benefits initiatives.

Population Health ManagementPromotion of Health

American Journal of Health Promotion, 1989 “Health promotion is the art and the science of helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior, and create environments that support good health practices.”

Current Health Care Model Focuses On: – Disease Status rather than health

status – Mortality rather than Morbidity. Traditional physical health risk factor(s) with less emphasis on behavior change and quality of financial and clinical state of health.

Serious need to Change Your Benefits Delivery Platform. This presentation contains proprietary information. It is intend for use only by our contracted brokers and employer groups. Any redistribution or other use is strictly forbidden. The benefit descriptions are intended to

be a brief overview of some benefits available. For Agent/Broker use only. Not for distribution to the general public, nor for solicitation purposes.

Population Health ManagementReal Health Data … Real Health Decisions … in Real Time!

PRESENTING…..

Hospitals

Population Health Management&

Dashboard™

Doctor’s Offices

Health Plans

LabsPharmacies

Population Health Management…Total Personal Health Management System

Unique Attributes:

Seamless integration

Consumer Friendly

Comprehensive clinical and non-clinical data: 360o view

Secure, Private

Automated, Pre-Populated Data

Single Sign-On

Sharing Capabilities

Personal, Patient-Controlled, Private, Comprehensive, Lifelong Electronic Health Record Plus a Set of Personal Health Applications

Modifiable Risk FactorsPower Your HRA with Personal Health Information

Modifiable Risk FactorsKnow Your Number Reporting

Modifiable Risk FactorsRisk Factors Impact on Claims


Modifiable Risk FactorsHealth Issues Related to Obesity

Sleep Apnea Diabetes Type II Hypertension Cholesterol Triglycerides Cardiovascular Disease Erectile Dysfunction Degenerative Joint Disease Gout Gerd Depression Metabolic Syndrome Venous Stasis Asthma

Achieving a healthy BMI – 24.9 or under improves “Quality of Life” in 95% of individuals and Mortality improves in 89% of individuals

Heart disease and stroke

Type 2 diabetes and cancer

Colon cancer

Gall stones

Osteoarthritis in hip and knee

joints

Respiratory problems


Modifiable Risk FactorsStatistics

Diabetes: 2008 Statistics:

24 million diabetics, 57 million pre-diabetes 2011 Statistics:

26 million diabetics, 79 million pre-diabetes • Heart Disease

$448.5 billion in 2008. 16 billion more than in 2007 • Depression

Medical cost is $44 billion annually (Mental Health America) • Obesity cost $147 billion annually (CDC 2006)


Modifiable Risk FactorsStatistics (Continued)

– 65% to 85% of heart disease– 66% of cancers– 91% of diabetes

– are caused by modifiable personal health behaviors – If adapted – 50% reduction in all cause mortality

(Knoops et al., Rimm and Stampfer, 2004)


Modifiable Risk FactorsLeading Cause of Morbidity and Mortality

Tobacco Use Unhealthy Diet Physical Inactivity Overweight and Obesity Increasing in prevalence. Only 10% of the population does not have any of 4 risk factors. (American Cancer Society)


Lifestyle Risk CalculatorCorrelating Behavior Cost to Lost Retirement Income


Personal Health RecordLife Long; Electronic; Portable.

Users may choose to share their record with wellness coaches and disease managers

Health managers can monitor profile updates and progress through Dossia’s activity feed or the Dossia Dashboard

Care coordinators are able to securely communicate through Dossia’s messaging system

The Health Management System enables wellness and disease managers to contact members via the medium of their choice: Dossia messages, text and email

Outcomes-Based Wellness & Incentives

Chronic diseases related to lifestyle account for 75% of national medical costs. Eleven separate studies by the Centers for Disease Control suggest that worksite wellness programs can produce significant improvements in employee health.

- Centers for Disease Control, 2006

53% of U.S. adults think its fair to ask those with unhealthy lifestyles to pay more for their health insurance. (Up from 37% only three years ago.)

- Wall Street Journal/Harris Interactive Poll

56% of employers plan to hold employees more responsible for the cost of health benefits.

- Washington Post, March 12, 2010


Outcome Based WellnessHealthy Lifestyles Should Pay Less

Outcomes-based wellness is like other insurance discounts for state of health. Drivers with fewer tickets and accidents pay less Non-smokers pay less for life insurance Homeowners with security alarms pay less

It is fair for employees who live healthy lifestyles to pay a lower contribution for their insurance.

Non-smokers should pay less than smokers.


Outcome Based Wellness Average, Measured, employer results;

After several years of a participation-based program, little lifestyle changes are seen and typically cannot be measured.

The Outcome Based Wellness driven with financial incentives produce different, measured results.

• Participation/Engagement (96+%)

• Measured improvement first year:• 16+% more members passed blood pressure goal.• 10+% went from obese (30+ BMI) to non-obese.• 11+% lowered their cholesterol levels.• 2+% quit smoking .• Cost-shift in year one ROI was $3+ saved to $1 spent. • Total Return on Investment for the first two years of the program,

including risk reduction, was $6+ saved to $1 spent.• Non-incentives measures do not improve. Everything tied to money did.


Outcome Based Wellness Average, Measured, employer results;

An Analysis of the Cost Effectiveness

•26% change in sick leave •27% change in health claims •40% change in workers’ comp •24% change in disability management

Benefits for Employees include improvements in state of health, moral, quality of retirement –

Health to Wealth.

Reduce the overall cost of premium by integrating calculator into their activities of daily living. Provides employees the tools to help them live a healthy lifestyle and improve the quality of their life.


Evidence Based Reporting Evidence Based Analysis; On-Demand Real, Measurable ROI

Measure Interventions & Quantify Value

• Who did what?

• What were the outcomes?

• What were annual health trends?

• What were year-to-year results?

• What did you spend?

• What did you save?

• What is ROI


Evidence Based Reporting Health Transformation Starts Once You Know The Problems

Advance a Culture of Health with: 3-year historic health assessment

Identification of key health cost trends

Identification of key intervention strategies

Evidence Based Reporting …And Their Related Cost

Stratify Modifiable Risk:

By condition

By Rx use

By clinical data

By biometric data

By claims data

By individual or multiple factors


Evidence Based Reporting See When & How your Population Engages

Track Key Indicators of Health Engagement

Unique logins

Time on platform

Apps installed

Time on programs

Challenges initiated

HRA starts

HRA completions

Six Sources of Payer ROI

The aggregation point for varied health initiatives Single sign-on enables secure integration of all health apps within a unified

framework No need to navigate to multiple web sites No need to memorize multiple passwords

Enables your health initiatives to integrate with PHI Integrates health apps with an individual’s PHI to create a holistic, personalized

experience Applications are intuitive (i.e., Recipe Planner shows sodium-free recipes if PHI shows

hypertension) Programs are interactive (i.e., Walking Program app displays progress on

Measurements app)Integrated data design improves care coordination

Sharing capabilities, notifications & core apps enable physicians and pharmacies to be alerted to adverse drug interactions

Integration with with clinical technologies (e.g., EHR) enables physicians to see a patient’s complete health history

Six Sources of Payer ROI

Enables portability of self-reported and professionally-sourced data Mitigates the incidence of duplicative, expensive diagnostic tests

Reduce risk of misdiagnosis, medical errors in emergent situations

Health Manager uses unadjudicated claim feeds Health Language™ program translates medical jargon into “plain-spoken

words”

Easy-to-read data enables laypeople to understand and, when appropriate, challenge inaccurate billing

Dashboard analyzes clinical, claim and Rx data in near real-time Health Triggers & Health Rules enable automation of interventions to address

modifiable risk

Drives personalized “just-in-time” interventions

Real-time data improves response time to emerging population health issues

Best Practices

Evaluate your current culture. Does it support better behavior

Form a team to develop your program.Implement effective communication programs. Manager education/Employee

participation in program implementation. Communicate confidentiality. Design program to change behavior. Provide tools needed and incentive

programs to motivate employees to change. Data management. Report Participation. Collect and store health behaviors

and personal risk factors. Validate effectiveness and success. Meet HIPAA requirements.

Evaluation is shared with organization and used for learning and improvement.Creation of a supportive social environment for individual to achieve their

health goals.


Create a Phased Strategy

Begin by identifying good health standards, illustrating how each member’s biometric measurements compare. Our “Know Your Number” reporting identifies risk of chronic disease and illustrates peer comparisons. Incent for disease treatment compliance, BMI reductions and the creation of an exercise program – counting steps and walking. Employer impact – Break Even.

Year 2. Establish formulas to earn a 20% contribution to medical premium. Biometric measurements confirm accomplishments. Employer Impact: up to 8% net savings.

Year 3. Be aggressive and implement formulas that represent behavior change that achieves clinical outcomes that represent significant improvements in Biometric measurements. Employee Impact is up to 30% of premium contribution and possible loss of benefit incentives if not compliant with disease treatment. Employer financial impact up to 15% net savings.


Benefits Satisfaction

We simplify the delivery of needed healthcare for all members We help solve the Healthcare Need Crisis We help solve the Retirement Crisis We improve people’s lives – Health to Wealth

HealthCare is Complicated


Security

The most important thing is the privacy and security of patient data. When the platform was built, it was done with complete HIPAA compliance. But beyond that, compliance with the privacy laws of all 50 states relative to adolescents and sexually transmitted disease. SOC3 security, which is the same standard that is used in the banking industry. In addition, security is tested annually by outside audit by companies like Intel, AT&T, and Walmart. Security certification is done every year from SysTrust, which is the gold standard in technology security.Security and privacy is without a doubt the most-important component of what we do… simply because of the nature and product provided. So, in addition: Fully compliant with HIPAA Privacy and Security regulations; the organization works with SysTrust auditors who do multiple SysTrust audits annually and certify HIPAA compliance. The staff is required to undergo yearly HIPPA training courses to make sure everyone is up to date on all HIPAA provisions. Extensive experience in integrating CCR, CCD, CDA, LOINC, ELINCS, HL7, HIE, CVX, EDI X12, ICD, CPT, HCPCS and other healthcare data standards.


The Strategy Cornerstone

Conclusions

The Population Health Management System makes individuals’ aggregated health data actionable, all applications brought together on a simple user platform delivering personalized, data-driven strategies that enable users to get more value from healthcare spending, better manage chronic conditions and pursue a healthier lifestyle. Automated and targeted messaging fosters lasting engagement and behavior change, yielding long-term value to employers, employees and families. Employers overspend on health benefits for which they realize little value. The Population Health Management System is the solution for forward thinking employers that aim to rationalize their health benefits spending while engaging their employees as true partners in achieving high value healthcare, better satisfying their health needs.


Services

Open Enrollment Custom CD Rom Creation DOL Audit Compliance Manual Benefits Business Plan Creation ERISA Academy Re-Invent Yourself Business Plan Full Benefits Audit New Small Group Self-Insured Solutions Benefits Delivery Platform Population Health Management Lifestyle Risk Calculator

Other Services:www.AdvancedBenefitDesignInstitue.com


http://www.advancedbenefitdesigninstitute.com/index.php/services

NEW RESULTS WHAT WE DO NEXT GEN BENEFITS OUTCOME BASED

Population Health Management Retirement Health to Wealth

Replace Open Enrollment Paper Docs with our CD Rom!

EMPLOYERSTRATEGIES

BROKERSERVICES

VENDORS& TPAs

CONSULTINGSERVICES

Lifestyle Risk Calculator


https://advancedbenefitdesigninstitute.com/index.php/component/content/article/41-uncategorised/104-4th-gen-benefits

Contact:

Advanced Benefit Design Institute, LLC

3254 Montana Ave., Suite 1003

Cincinnati, Ohio 45211

513-661-7581 [email protected]

http://www.AdvancedBenefitDesignInstitute.com


mailto:[email protected]

http://www.advancedbenefitdesigninstitute.com/

https://advancedbenefitdesigninstitute.com/

https://www.facebook.com/pages/Advanced-Benefit-Design-Institute/132030578220

http://www.linkedin.com/profile/view?id=44788410&trk=nav_responsive_tab_profile

http://www.bbb.org/

Health & Medicine

Population Health Management