Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Taking Health Care Consumer Engagement to the Next Level: The Employer’s Role Paul Landgraf Guardian Industries [email protected] About Guardian Industries Headquartered in Auburn Hills, Michigan Privately held companies with 19,000 employees 60 work locations in 21 countries, on five continents Large manufacturer – – – – World’s largest mirror manufacturer World’s 2nd largest manufacturer of flat glass Tier 1 supplier of auto glass and body trim One of the largest manufacturers and distributors of fiberglass and building materials Unique culture – Accountability extends to personal health – Significant leadership support The Challenge: Guardian’s Largest Expenses Raw Materials Labor, Administration, Payroll Taxes Freight Depreciation Maintenance and Repair Furnace Energy Electricity/Utilities Health Care Packaging Guardian Management point of view: “Employee health and productivity are business issues” The Ongoing Problem 1 plant, 374 employees, average age = 40 – – – – – – – – 87% participated in screenings and HRA 42% classified as obese (BMI over 30) 30% had blood pressure over 140/90 32% have never had complete physical 26% reported tobacco use 63% seldom or never exercise 59% had 5 or more health risks 68% reported their own health as either good or excellent Reinventing HealthGuard Started in 1984 -- “Seven Steps For Better Living” – – – – – – – 1. Exercise 2. Diet 3. Limiting alcohol use 4. Avoidance of smoking and illegal drugs 5. Blood pressure awareness and control 6. Use of seat belts 7. Developing positive attitudes. It may sound dated today, but the expectations were clear Today our focus has changed – It is not about turning joggers into marathoners; the problem is getting members off the couch – Not a traditional “wellness” perspective; now much more clinical, outcomes driven, we talk about health What Do We Want Folks to DO? Health screenings and physicals Health risk assessments Exercise, “Winner’s Circle” participation HealthGuard activities and education Preventive care No tobacco on U.S. property Respond to Care Considerations and participate in Disease Management if contacted Guardian Health Risks Blood Pressure Body Mass Index 2006 Smoking 2007 Cholesterol N =1,581 Glucose 0% AHA/ ACC Guideline 10% 20% CONFIDENTIAL- May not be copied, reprinted or redistributed without prior written approval. 30% 40% 50% CareEngine: Identifying Gaps in Care SOLVD study: ACEI reduces CHF mortality by 11.3% and hospitalization by 18% CONFIDENTIAL- May not be copied, reprinted or redistributed without prior written approval. AHA/ ACC Guideline Who is Spending the Money? 100% 90% 94% 39.1% 80% 70% 60% 19.2% 50% 40% 4% 30% 41.7% 20% 2% AHA/ ACC Guideline 10% 0% % of Population CONFIDENTIAL- May not be copied, reprinted or redistributed without prior written approval. % of Health Care Costs Condition Management – Where’s the Savings? Fendrick and Chernow will be releasing a review of the current literature, critical of most study protocols Need to “separate the dolphins from the tuna” Target well – ROI is greatest when you – – – – Identify the highest risk patients Availability of effective services, real clinical value Services have low current use Price responsive so people will readily comply ROI is lost when lower risks are swept in, patient would have done intervention anyway, or will not do the intervention; look at copays, reach rates, opt-ins We focus on the chronically and acutely ill The Problem Wanted to improve engagement in Condition Management, especially in higher risk groups Strategy – the carrot or the stick? We wanted to address two issues How to increase engagement in Condition Management, and How to improve drug therapy adherence Willing to consider Value Based Insurance Design approach, but dolphins v. tuna problem Use Condition Management and VBID, by using CM engagement to trigger drug cost incentive Finding a Solution - CM Simulation What drug classes should be subject to incentives? How much benefit incentive did we need to provide? What would the savings be from improved drug adherence? Did we expect overall savings from adherence, minus the cost of the incentives? How does the PBM provide the incentive? How will this be communicated? Clinical opportunity scenarios used to model savings CLINICAL RISK SCENARIOS MEDICATIONS APPLICABLE Related care considerations CAD or Cerebrovascular disease or Peripheral arterial disease or Diabetes Lipid-lowering agents (e.g., statins) On RX but not in a specific clinical scenario Related care considerations Respiratory (Asthma, COPD) Inhaled corticosteroids Related care considerations CAD or Cerebrovascular disease or peripheral arterial disease or Diabetes CHF ACE inhibitors or ARBs Chronic kidney disease plus Hypertension Refractory hypertension* On RX but not in a specific clinical scenario Related care considerations CAD CHF Chronic kidney disease plus Hypertension Beta-blockers Refractory hypertension* On RX but not in a specific clinical scenario Related care considerations Diabetes Injectable, inhaled, and oral meds for diabetes A Final Thought – Health and Your Culture Questions?