Wellness: It’s Not Just for
Health Claims Anymore
Conni Huber, City of Cedar
Rapids HR Director
Lisa Powell, Linn County HR
Director
City
Program Background
•
•
•
•
•
Began in 2007
Utilized 3 vendors
Current vendor in place for 5 years
Initial incentive = $50
Current incentive = premium reduction
of $40/month up to $78/month
• Participation rate – 70%
Program components
• Biometric screening
• Health questionnaire
• Monthly coaching for high and moderate
risk individuals
• Monthly wellness events planned by
employee group
Culture changing components
• Wellness activities, education and
celebrations
• Policies on healthy vending machines,
food at City functions, etc.
• Health Fair
• Newsletter articles including wellness
champion highlights
• Fitness centers for very low cost
Linn County Wellness
Annual Health Risk Assessment (HRA) and Biometric
Screening - $50 gift card incentive
Monthly on-site Health Coaching for eligible
employees (chronic condition or risk reduction)
Health Awareness Team – department wellness liaisons
Annual Health & Safety Fair – blood typing, skin
cancer screenings, massages, etc.
Challenge Activities – Lose It Linn County!; Walking
Moai; Summer Fun Fitness Competition
Healthy Lifestyle Education Seminars – exercise,
nutrition, stress management
Financial Education and Retirement Planning
Linn County Wellness
Healthy Steps Newsletter – highlight wellness
champions,
Preventative Exams – 100% paid
Smoking Cessation – 100% paid
Blue Zones Certifications
Employee Well-Being and Healthy Vending
Policies
On-site Fitness Centers
Fitness Reimbursement Program
Targeted disease management for top diagnoses
Linn County Wellness
Annual screening is voluntary, currently at 50%
participation.
Compare results between participants and nonparticipants.
Each employee’s point where they decide to
change an unhealthy behavior is different and
what causes them to change is different.
A comprehensive program designed to engage
ALL employees increases ROI potential.
Linn County Wellness
Is it working?
Engaged wellness vendor in 2005
Had resistance from AFSCME union/ULP
Rebounded from that in 2007
Participation now up to 50% of ee population
Low single digits increases in claims (3% last 6
years) even with blips in 2008 and 2013
Employee testimonials as to how participation
in the wellness program has made them
healthier, changed their lives, etc.
Linn County Wellness
Health Solutions Data show the following:
Average health claims for participants are lower
Average workers’ compensation claims for
participants are lower
City of Cedar Rapids Results
Comparison Trend 2013 & 2014
Same 789 Participants
2013 High Risk
2013 Moderate Risk
108 participants
305 participants
2014
2014
30%
39%
Remain High
Risk
Improved to
Moderate Risk
31%
5%
51%
44%
Improved to
Low Risk
376 participants
2014
77%
20%
Increased to
High Risk
Increased to
Moderate Risk
Maintained
Low Risk
12
Maintained
Moderate Risk
Improved to
Low Risk
In Summary…
2013 Low Risk
3%
Increased to
High Risk
1. 61% of High Risk participants improved
risk status
2. 95% of Moderate Risk participants
maintained or improved risk status
3. 77% of Low Risk participants remained
low risk status
Medical and Rx Claims
Analysis
13
Total Paid Medical and Rx Claims* Per Year
(Claims Date: 1/1/2010 - 12/31/2013)
$19,173,557
$20,000,000
$18,000,000
$16,000,000
$15,919,419
$16,278,645
$15,206,862
$14,000,000
$12,000,000
$10,000,000
2010 Claims
(1/10-12/10)
2011 Claims
(1/11-12/11)
*Total Employee, Spouse and Dependent Claims
14
2012 Claims
(1/12-12/12)
2013 Claims
(1/13-12/13)
Average Paid Medical and Rx Claims* Per Covered Member
(Claims Date: 1/1/2012 - 12/31/2013)
$12,000
$10,000
$10,398
$8,222
$8,000
$6,000
2012 Claims (1/12-12/12)
2013 Claims (1/13-12/13)
Number of Covered Members **
2012
2013
1408
1392
*Total Employee and Spouse Claims
**Includes Assessors, all Active City Employees, Linn County SLWST, Cobra and Retirees
15
Average paid Medical and Rx Claims Comparing
Members and Spouses
(Claims Date: 1/1/2012 - 12/31/2013)
$7,875
$6,803
$5,731
$8,000
$6,000
$4,000
$4,828
$4,073
$3,318
$6,952
$6,089
$6,521
$4,508 $4,414 $4,461
$2,000
$0
Employee
Participants
Employee
Non-Participants
2012 (1/12-12/12)
Spouse Participants
2013 (1/13-12/13)
Spouse
Non-Participants
Total Average
Member** Participants
Member**
Non-Participants
Spouse Participants
Spouse
Non-Participants
2013
852
556
28
893
2014
906
486
10
896
*Total Employee and Spouse Claims
**Includes Assessors, all Active City Employees, Linn County SLWST, Cobra and Retirees
16
Average Medical and Rx Claims Per Participant
by Health Solutions Risk Category
(Claims Date: 1/1/2013 - 12/31/2013)
$7,731
$8,000
$5,100
$6,000
$4,249
$4,000
$2,000
$High Risk
Moderate Risk
Low Risk
2013 (1/13 - 12/13)
2014
17
Total Participants
High Risk
Moderate Risk
Low Risk
916
79
295
542
Workers Compensation
Results
$19,663
$15,000
Does Not Include
Fire & PD
$8,929
$10,000
Does Not Include
Fire & PD
$10,997
$9,270
$7,134
Does Not Include
Fire & PD
$5,727
$4,011
$5,000
$2,305
$2010
2011
Participants
2012
Non-Participants
2013
Linn County Worker’s Compensation
Aggregate Trend
$1,147,297
$1,000,000
$917,488
$867,843
$800,000
$411,385
$600,000
$400,000
$200,000
$0
2010
2011
2012
2013
Total Spend Per Year
2010
2011
2012
2013
19
Total Participants
Participants
Non Participants
54
69
62
56
11
22
11
19
43
47
51
37
Worker’s Compensation
Participants versus Non Participants Total Spend per Year
378%
Net Difference
$945,929
$1,000,000
$800,000
$2,765,785
$804,273
$676,580
$578,432
$600,000
$400,000
$339,003
$201,368
$191,262
$113,420
$200,000
$72,382
$0
2010
2011
Participants
2010
2011
2012
2013
20
2012
2013
Total Spend
Non Participants
Total Participants
Participants
Non Participants
54
69
62
56
11
22
11
19
43
47
51
37
Worker’s Compensation
Participants versus Non Participants Average Spend per Year
$25,000
$20,126
$17,388 $15,734
$20,000
$11,754
$15,000
$10,000
$5,000
$15,770
$9,153
$10,311
$9,162
$5,844
$759
$3,810
$1,891
$0
2008
2009
2010
Participants
2008
2009
2010
2011
2012
2013
21
2011
2012
2013
Non Participants
Total Participants
Participants
Non Participants
NA
NA
54
69
62
56
NA
NA
11
22
11
19
NA
NA
43
47
51
37
Total Paid Medical and Rx Claims* Per Year
(Claims Date: 7/1/2006-6/30/2013)
$7,405,585
Program Overview
$7,500,000
•
$50.00 gift card for
participating in
annual HRA and
health screening
•
45% of eligible
employees
participated in the
annual HRA and
health screening
•
Follow up coaching is
offered to high and
moderate risk
participants on a
voluntary basis
•
8% of the total
population
participate in follow
up coaching
$7,000,000
$6,673,085
$6,500,000
$6,257,791
$5,987,353
$6,000,000
$5,689,113
$5,638,962
$5,500,000
$5,270,120
$5,000,000
2006
2007
2008
*Total employee and spouse claims
22
2009
2010
2011
2012
Average Paid Medical and Rx Claims* Per Covered Employee
Program Overview
(Claims Date: 7/1/2006-6/30/2013)
$9,410
•
$50.00 gift card for
participating in
annual HRA and
health screening
•
45% of eligible
employees
participated in the
annual HRA and
health screening
•
Follow up coaching is
offered to high and
moderate risk
participants on a
voluntary basis
•
8% of the total
population
participate in follow
up coaching
$9,000
$8,500
$8,079
$8,000
$7,745
$7,500
$7,257
$6,998
$7,005
$7,000
$6,579
$6,500
$6,000
2006
2007
Number of Covered Employees
2008
2010
2011
2012
2006
2007
2008
2009
2010
2011
2012
805
801
808
813
825
826
787
*Total employee and spouse claims
23
2009
Average paid Medical and Rx Claims Comparing Employees and Spouses
(Claims Date: 7/1/2009-6/30/2013)
Average 68% Net Difference
(Participants to Non Participants)
$8,000
$6,245
$7,056
$6,028
$5,461
Average 33% Net Difference
(Participants to Spouses)
$5,988
$5,686
$5,407
$6,000
$4,000
$3,012
$2,682 $2,283
$4,074
$3,556
Program Overview
$4,724
$4,397
•
$50.00 gift card for
participating in
annual HRA and
health screening
•
45% of eligible
employees
participated in the
annual HRA and
health screening
•
Follow up coaching
is offered to high and
moderate risk
participants on a
voluntary basis
•
8% of the total
population
participate in follow
up coaching
$4,720
$2,000
$0
Employee Participants
Employee
Non-Participants
2009 (7/1/2009 - 6/30/2010)
2010 (7/1/2010 - 6/30/2011)
2012 (7/1/2012 - 6/30/2013)
Average Spend
24
Spouses
2011 (7/1/2011 - 6/30/2012)
Employee Participants
Employee Non-Participants
Spouses
2009
313
500
528
2010
329
496
522
2011
401
425
522
2012
387
452
492
Linn County Return On Investment
Based on Medical Claims Analysis
2007 and 2008
• 247 Participants
• Savings $1,574 per participant = $388,778 total
savings
• Total 2007 and 2008 Spend: $55,060
• ROI 6:1
2009
•
•
•
•
2010
•
•
•
•
25
313 Participants; 500 Non Participants
Savings $2,725 per participant = $852,925 total
savings
Total 2009 Spend: $70,785
ROI 11:1
329 Participants; 496 Non Participants
Savings $3,745 per participant = $1,232,105 total
savings
Total 2010 Spend: $86,128
ROI 13:1
2011
•
•
•
•
401 Participants; 425 Non Participants
Savings $4044 per participant = $1,621,644 total savings
Total 2011 Spend: $72,465
ROI 21:1
2012
•
•
•
•
387 Participants; 452 Non Participants
Loss $784 per participant = $303,408 net loss
Total 2012 Spend: $74,741
ROI 1:3
Wellness Research
A Harvard University report, published in the journal Health
Affairs, found that the average medical cost savings per dollar
invested in wellness programs was $3.27.
Typically takes 3 years to see a 3:1 ROI; this means investing
about $250 per employee annually on health and well-being.
Lowering risk factors to their theoretical minimums (if possible)
would reduce average annual costs per working-age adult by
18.4%. (January 2013, Journal of Occupational & Environmental
Medicine)
Align investments with goals
Example: If health plan costs are increasing 7% annually per employee and the goal is
2%, an employer would have to reduce its trend by over $500 per employee plus the
additional cost of the wellness program.
Wellness Research
“The imperfect evidence that wellness programs reduce medical costs is
better than the data corporate executives have for most key decision.”
(David Anderson, Chief Health Officer for StayWell Health Management)
2012 employer study by StayWell Health Management and Towers
Watson showed that:
If you reduce health risks, lower costs accrue quickly, so
immediate savings from risk reduction makes the financial case
for prevention stronger.
Financial implications for prevention may be greater than for risk
reduction. For every health risk added, costs increased by 45%
above the cost savings resulting from eliminating a risk. In other
words, preventing employees from adding new health risk over
time produces greater cost savings than focusing on eliminating a
health risk after it emerges.
A long-term solution is better than a quick fix – greater savings
realized from reducing health risks for people with chronic
conditions; cost savings were 4 times greater for those with CC
who reduced their health risks compared to those without CC!
Wellness Research
Other studies indicate that wellness programs
can produce immediate savings in
productivity-related costs, including reduced
absenteeism, disability and workers’
compensation costs, as well as enhanced
work performance. The combination of
direct health care savings and indirect
productivity savings support the business
case for investing in a prevention-focused,
population-based health management
strategy.
Wellness Research
Bottom line for employees is that if you start to
change employee behaviors, you will start seeing
health care cost savings quickly.
An employer can save an average of $100 in health
care costs per employee per health risk eliminated in
the year of change, and $105 per risk reduced in the
year following the reduction.
But if healthy people don’t stay healthy and start
accumulating new health risks, not only are savings
negated but health care costs increase by $145 per
employee per health risk added in just one year.