PeopleCARE Wellness: Data-Driven Solutions for a Healthy Workforce

2. What’s Unique About the Workplace? • Captive audience • Consistent environment • Social support • Employer-sponsored • Interested in ROI, recruitment, retention, productivity

3. 3 Generations of Workers • Different needs, expectations, methods of communicating and ways of determining value • For different populations benefits design must provide: • appropriate mix of services • the tools to engage • flexibility to offer value

4. Today’s Workforce U.S. Workforce by Age Category 2008 48+ Baby Boomers 16% 25-48 Gen X 69% 16-24 Gen Y 15% Source: U.S. Dept of Labor & Statistics Source: Tahmincioglu, E. “Boomers will spend golden years at work”,MSNBC, 2007

5. Today’s Workforce U.S. Workforce by Age Category 2014 55+ Baby Boomers 21% 35-54 Gen X 65% 16-34 Gen Y 14% Source: U.S. Dept of Labor & Statistics Source: Tahmincioglu, E. “Boomers will spend golden years at work”, MSNBC, 2007

6. Baby Boomers • Highly prized as reliable, skilled • Goal oriented, high achievers • Working longer due to: • Financial concerns • Desire to stay active, productive • Seeking quality of life as they age

7. Generation X • Motivated by personal satisfaction • Strong work ethic • Expect to be heard; need to understand the big picture • Loyalty to team, not institution • Often intolerant of Gen Y’ers • New “Sandwich Generation” caring for elderly relatives and children

8. Generation Y • Gen X on steroids • Extreme technophiles; web 2.0 • Multi-taskers • High performance/high maintenance • Change jobs frequently • Casual; used to pampering • Financially savvy; interested in benefits • Living at home to save money

9. Issues for All Workers • Limited time to take care of themselves • Work stress • Workplace safety • Healthcare options controlled by company health plan or by personal income

10. U.S. Employer’s Challenge The most expensive healthcare in the world • $2.4 trillion annually or $7,868 per capita1 • 75% increase over the past 8 years, outstripping inflation and per capita income increases by several multiples2,3 • Will reach 20% of GDP by 20164 1,2 Wilson, K, Healthcare Costs 101, 2008 Edition, California Healthcare Foundation 3 U.S. Department of Commerce, U.S. Bureau of Economic Analysis 4 “Facts on the cost of health insurance and healthcare”, 2008, National Coalition on Healthcare Costs

11. U.S. Employer’s Challenge Need to balance healthcare costs with need to be competitive Premiums have doubled in 9 years Source: Kaiser Foundation 2008 Annual Health Benefits Survey

12. U.S. Employer’s Challenge Aging employees; more chronic diseases • Unhealthy employees – 5X more likely to miss work than healthy employees • Moderately unhealthy employees – 2X as likely to miss work as healthy employees • Obese workers vs. non-obese employees1 • 2X as many wc claims • 13X more lost work days • Medical claims 6.8X more expensive • Indemnity claims 11X more expensive 1 Ostbye, T. at al, “Obesity and Workers’ Compensation”, Journal of the American Medical Association, April, 2007.

13. Employer’s Goals • Provide healthcare benefits in a way that is affordable yet sufficient to attract and retain employees • Ensure that medical benefit programs not only treat illness but also support a healthier workforce. • Capture data for informed decision-making

14. PeopleCARE’s Unique Perspective • Targeted wellness and disease management programs • Focus on medical costs that affect productivity • Financially incentivize good healthcare choices • Bring medical care to workplace • Expedited prescription dispensing • Fully exploit technology • Appeal to multi-generational workforce • Data-driven, data-driven, data-driven! • Partnership

15. PeopleCARE Wellness Approach Step I - On-line health risk assessment Technological/Convenient Step 2 - Intervention plan is developed Individualized Step 3 - User receives on-line, targeted health education materials Focused high risk areas “readiness to change”

16. PeopleCARE Wellness Approach Step 4 - Points for each article read, each review test about the article taken, each journal entry result in lower health plan deductible Incentives Step 5 - Collect clinical data on-site and on-line – Data driven Results • Higher utilization • Stronger compliance • Better clinical outcomes

17. Medical Cost Drivers Focus on Medical Cost Drivers that Affect Productivity Medical-Only Costs Medical+Productivity Costs • Cancer • Back/neck pain • Coronary Artery Disease • Chronic Pain • High Cholesterol • GERD • Diabetes • Sleeping Problems • Hypertension • Arthritis • Musculoskeletal • Depression • Fatigue • Chronic Pain • Sleeping Problems • High Cholesterol • Arthritis • Hypertension • Obesity • Anxiety “Poor employee health costlier than employers think”, Journal of Occupational and Environmental Medicine, July 2007

18. Incent Healthcare Choices Financially Incentivize Good Healthcare Choices • Implement High Deductible Health Plan • Fund deductible through HRA for participation in wellness programs Results • Lowers premiums immediately for both employer and employee • Incentivizes workers to make healthcare choices that lower short term and long term medical costs

19. Workplace Medical Care Bring Medical Care to WorkplaceOn-site Medical Visits Episodic care, routine wellness care and chronic disease management available at the workplace through occupational health and primary care providers on-site Results • Supports proactive medical care • Supplements disease management • Reduces time away from work

20. Workplace Medical Care Bring Medical Care to WorkplaceMedical E-Visits • On-line physician consultation; real time videoconferencing • Diagnostic peripherals such as the ability to measure temperature, pulse, respirations, blood pressure heart rhythm, and oxygen saturation Results • Less costly • Reduces needless waiting and time away from work

21. Workplace Medical Care Expedited Rx Dispensing Improves Compliance • 20% of new prescriptions go unfilled, up to 85% of prescriptions never get refilled1 • Bring dispensing on-site with automated system to dispense most common Rxs Results • Less expensive • More convenient • Better compliance = improved health 1"Pharmaceutical Patient Compliance and Disease Management" Cutting Edge Information, 2006

22. Fully Exploit Technology • On-line medical visits • Electronic medical record • On-line wellness programs • On-line support groups

23. Multi-Generational Appeal • Baby Boomers • Improves health; lengthens life • Saves money • Generation X • Recognizes/supports busy life • Invites participation, personal goals • Generation Y • Technology-driven • Saves money

24. Data Driven • Traditional insurers • data based solely on utilization and diagnostic or procedure codes • PeopleCARE • collects and analyzes pre-claim clinical data to anticipate future medical needs • Supplements insurer data • Deeper understanding of healthcare needs and plan future benefit programs

25. Employer – Medical Partnership • Reduces medical liability, complexity and uncertainty • Active participant in benefits discussions • Presence onsite in the workplace • Hands-on care and medical management • Healthcare costs better controlled • Employees report higher satisfaction with benefit plans

26. PeopleCARE Best-in-Class Approach • Makes on-site medical care affordable • Extends MD visits electronically including the ability to collect and send clinical data electronically • Correctly incentivizes employees to choose healthy behaviors and make smart healthcare decisions

27. PeopleCARE Best-in-Class Approach • Captures never-before-available pre-claim data that makes program planning more targeted and more effective • Tames drug costs through smarter benefit policies • Places a healthcare expert on company’s team

28. Contact Steven A. Gest, MD 1900 Powell Street, Suite 910 Emeryville, CA 94608 (510) 653 5200 X 105 dr@emeryvilleoccmed.com