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Taking Health Care Consumer Engagement to the Next Level: The Employer’s Role

Taking Health Care Consumer Engagement to the Next Level: The Employer’s Role. Paul Landgraf Guardian Industries plandgraf@guardian.com. About Guardian Industries. Headquartered in Auburn Hills, Michigan Privately held companies with 19,000 employees

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Taking Health Care Consumer Engagement to the Next Level: The Employer’s Role

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  1. Taking Health Care Consumer Engagement to the Next Level: The Employer’s Role Paul LandgrafGuardian Industriesplandgraf@guardian.com

  2. 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

  3. 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”

  4. 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

  5. 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

  6. 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

  7. Guardian Health Risks N =1,581 AHA/ ACC Guideline CONFIDENTIAL- May not be copied, reprinted or redistributed without prior written approval.

  8. CareEngine: Identifying Gaps in Care AHA/ ACC Guideline 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.

  9. Who is Spending the Money? AHA/ ACC Guideline CONFIDENTIAL- May not be copied, reprinted or redistributed without prior written approval.

  10. 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

  11. 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

  12. 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?

  13. Clinical opportunity scenarios used to model savings

  14. A Final Thought – Health and Your Culture Questions?

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