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AGENDA. OVERVIEW WELLNESS SOLUTION CARE MANAGEMENT OCCUPATIONAL HEALTH SERVICES. Poor employee health can cost you 200 – 300 percent m ore than the cost of health benefits * due to:.
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AGENDA OVERVIEW WELLNESS SOLUTION CARE MANAGEMENT OCCUPATIONAL HEALTH SERVICES
Poor employee health can cost you 200–300 percent more than the cost of health benefits* due to: * “What should employers do about health care,” Harvard Business School Working Knowledge, Michael E. Porter, Elizabeth O. Teisberg, and Scott Wallace, 2008. Sick days, absenteeism, and reduced productivity. Unmanaged chronic conditions like diabetes. Poor medication adherence, health complications, and expensive hospitalizations.
Creating a culture of wellness. • Health assessment tools • Incentive and reward strategies • Worksite events • Special programs • Employee engagement plan • Wellness team(s) • Health Profile completion aggregate reporting • Reports on utilization of services • Evaluation and program adjustment based on your population’s data • Leadership support • Organizational goals • Budget • Employee interest survey • What’s currently driving costs • Access to technology • Industry-specific issues Using data unique to your population and organization, we can help you create a program that will change behaviors for improved health. It’s smart technology that gets more personalized the more it’s used.
Help your population meet their wellnessgoals with tools, resources, and trainedhealth care professionals. WELLNESS SOLUTION
Programs to reduce disease risks can improve your population’s health and morale.
GH members: Health Profile reveals risk of health issues. In-depth online health questionnaire Report with personalized health recommendations Promotes shared decision-making between doctors and patients Linked to medical record if member receives primary care at Group Health Medical Centers Collective results help us refine your wellness program
GH members: Lifestyle Coaching motivates behavior change to lower health risks. High-risk members identified through Health Profile “opt-in” for call outreach Coaches are specially trained registered nurses with 10–15 years experience Coaching is based on behavioral science theory and application Three targeted risk areas: physical activity, nutrition, and moderate depression Free to Group Health members 18 and older
GH members: Quit for Life® helps tobacco users become and remain tobacco free. • 5 phone calls with a Quit Coach® • Medications to support quitting • Individual counseling or group session • Online tools • Unlimited follow-up support 45 percent success rate, nine times more effective than attempting to quit without support* Helps members manage withdrawal symptoms Teaches how to identify triggers and develop new behaviors Re-enrollment allowed at any point
GH members: Fitness center discounts help make exercise part of their daily lives. Discounts at more than 10,000 fitness facilities nationwide Discounts on exercise videos and equipment for home workouts NutriSystem® weight loss program also available at a savings
GH members: Access to information helps with medical decisions. • Hip osteoarthritis • Knee osteoarthritis • Coronary artery disease • Enlarged prostate • Herniated disc • Spinal stenosis • Uterine fibroids • Abnormal uterine bleeding • Early stage breast cancer • Ductal carcinoma in situ • Breast reconstruction post-cancer • Benign prostatic hyperplasia • Chronic low back pain • Acute low back pain One-stop health resource at ghc.org with thousands of health-related articles reviewed by doctors Shared decision-making DVDs, online videos, and booklets help members explore treatment options with their doctors
GH members: Additional support through classes and community resources. Group Health offers classes and support programs in our clinics and online, including our popular six-week Living Well with Chronic Conditions workshops Phone-based Resource Line includes hundreds of classes, support groups, agencies, and other resources in its database—from alternative therapies and parenting tips to cancer support and sleep disorders
GH members: Discounts for alternative medicine and fitness providers. • Complementary ChoicesSM provider network • Over 900 providers statewide • When care doesn’t meet employees’ coverage or referral criteria, the network offers 20 percent discount to Group Health members • Unlimited number of discounted visits
Improve the health of your entire staff with our new product featuring RedBrick Health RedBrick’s digital platform uses innovative, interactive technology to create a healthier, more productive workforce. A leader in health engagement technology Action-oriented program of tools and services Combines smart incentives and powerful social elements
Entire population: New fee-based products drive higher level of engagement Data analysis delivers real-time, personalized recommendations Presented in an easy-to-understand friendly approach Format drives more immediate engagement
Entire population: Dynamic RedBrickHealth Assessment Lifestyle health questionnaire Reinforces Group Health’s clinical-based Health Profile Engaging visual format Provides instant feedback and rewards Focuses participants on behavior change programs that are personalized for each individual
Entire population: Activities motivate and boost participation Worksite health fairs including mini-screenings for biometrics Games and team challenges that promote healthy habits Real-time leaderboards with current employee standings Social elements to encourage fun, entertaining competition among staff
Entire population: RedBrick platform features device and smartphone integration • Programs, challenges, and more are easily accessed via smartphone • Integrates mobile apps like Runkeeper and device tracking like Fitbit to aid tracking of healthy behavior
Entire population: Unique approach to financial rewards Drives lasting positive behavior change Personal approach to rewards Designed with simplicity and emotional appeal
Add-on: Comprehensive biometric screening events at your worksite* * Fee-based. Helps with early detection of potentially serious health issues Nurses can check blood pressure, body mass index, cholesterol, and glucose Aggregate results provide valuable insights on your population’s health We provide resources—from planning to evaluation—to help make the event successful
Care management is an integral partof the coordinated care support provided toour plan members. CARE MANAGEMENT 23
Our Consulting Nurse Service is available 24 hours a day, 7 days a week. Phone-based triage for acute and chronic care needs Physician on-site for consultation and medication orders Advice on best next steps—self care, routine physician visit, urgent care, or ER Coordination with primary care team if care is received at Group Health Medical Centers
Care managers provide phone-based interventions to Group Health members with complex health needs. • Increase health-promoting behavior • Self-manage conditions • Set personal goals • Match personal goals and needs to available programs and services • Promote strong patient/personal physician relationship with shared decision-making • Optimize specialty care • Help prevent unnecessary and expensive hospital admissions and ER visits • Empower patients to manage and improve health and minimize complications
Transition management supports members as they move between care settings. 26
Disease management addresses specific conditions where interventions can improve health and lower costs. • Part of our innovative approach to primary care for all patients • Fully integrated with existing Group Health programs, such as case management, behavioral health, disability, and other lifestyle programs • Telephone-based coaching • Targets more than 40 conditions • Identifies members at high risk for elective surgeries, high risk for chronic conditions, high risk from lifestyle behaviors, and high financial risk • No additional fee for fully insured groups; fee-based service for self-funded groups
Utilization review ensures members are receiving appropriate care in the most appropriate setting. • Hospital/skilled nursing facility stays • Use of durable medical equipment • Specific high-dollar procedures • Use of certain medications • Mental health services Stringent monitoring process Program is staffed by physicians, nurses, psychiatrists, psychologists, and pharmacists Follows standards set by ERISA, NCQA, and applicable state and federal laws
Streamline workplace health, safety, andinjured worker care with an all-in-one source. OCCUPATIONAL HEALTH SERVICES
Expert occupational health care for your employees at Group Health Medical Centers. 12 clinics with occupational medicine physicians and specially trained clinicians Providers are in the Washington State Department of Labor and Industries’ Medical Provider Network Patient account reps trained in workers’ compensation paperwork Case managers to coordinate care and communication between employer, claims manager, employee, and physician Services available to all employees, not just Group Health members
Screenings and prevention services* to meet your organization’s needs. • Pulmonary function testing • Vision testing • Worksite exposure testing • Immunizations • Travel medicine * Fee-based. Drug testing Breath alcohol testing Medical Officer Review Random selection services Hearing testing
Industry-specific physicals and employment exams.* • Emergency medical response • Federal Aviation Administration(FAA) • Hazardous waste exposure • Asbestos exposure • Lead exposure • Other heavy metal screenings * Fee-based. Post-offer Return-to-work Commercial Driver’s License (CDL/DOT) Firefighter and law enforcement officer Respiratory clearance Vivarium environment 32
We’d like to help you improve the healthof your population and the health ofyour bottom line.Contact your account manager to learn moreabout Group Health Wellness Solution. NEXT STEPS 33