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THE COST DRIVERS

THE COST DRIVERS. BRUTAL FACT – ’04 Shock Claims. CVD Relationship. R. x. CVD COSTS. #1 LIPITOR #2 ZOCOR #3 PLAVIX. 417 CVD prescriptions at $ 47,250.00. AVERAGED. PER MONTH. THE TI STRATEGY. ESSENTIAL ELEMENTS. Focuses on Cardiovascular Disease.

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THE COST DRIVERS

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  1. THE COST DRIVERS

  2. BRUTAL FACT – ’04 Shock Claims CVD Relationship

  3. R x CVDCOSTS #1 LIPITOR #2 ZOCOR #3 PLAVIX 417 CVD prescriptions at $ 47,250.00 AVERAGED PER MONTH

  4. THE TI STRATEGY

  5. ESSENTIAL ELEMENTS Focuses on Cardiovascular Disease Includes health screening in benefits design Follows evidence based medical standards Stratifies risk based upon clinical findings Directs “high-risk” to interventions that lower risk & normalize lab values Distributes non-compliant/un-successful into appropriate management

  6. LEVEL 5 LEADERSHIP If you can’t measure it… You can’t manage it!

  7. CREATIVE PLAN DESIGN 80/20 Base Plan 80/20 Participation In Screening & Interventions $1000 Deductible Premium Plan $250 Deductible

  8. Highest Risk Risk Reduction ELEVATED CHOLESTEROL Abnormal Glucose High Blood Pressure Overweight Indicator Intervention Identify Risks Root Cause POOR DIETARY HABITS Physical Inactivity Tobacco Use RISK REDUCTION STRATEGY FOCUS ON CHOLESTEROL Reduce the population ‘At Risk’ Virtually No Risk CVD Risk Factors are shared by Diabetes, Digestive Diseases, Certain Cancers , Stroke and many other chronic and acute conditions

  9. WE IDENTIFIED High Risk/High Cost…

  10. HEALTH SCREEN Identify Associates at High Risk HRA - BMI - Blood Pressure - Glucose - Lipid Profile

  11. CHOLESTEROL Identified Root Causes >240 12% <150 12% 200-239 31% 150-198 31% 32 – Identified @ Significant Risk

  12. WE ATTACKED High Risk/High Cost…

  13. ELIMINATE ROOT CAUSES Risk Reduction “Tell me and I forget, Teach me and I remember, Involve me and I learn.” - Benjamin Franklin Risk Reduction Dietitian Non-Compromising “Can Do” Philosophy

  14. IMPROVINGOur Environment • Vending Labeling • Meetings • Cafeteria Walk the Talk

  15. IMPLEMENTED Physical Activity 10,000 Steps

  16. ESTABLISHED Tobacco Use Policy

  17. DEMANDED Consistency of Message

  18. CARTERSVILLE, GA OUR OUTCOMES Measurement of Success…

  19. AFTER CLINICAL IMPROVEMENT Before and After Risk Reduction Program BEFORE

  20. 2005 TI Automotive Project Outcomes -17% -18.4% Total Cholesterol Cholesterol -73% 258 CHD Mortality 202 -44% All Cause Cancer “At Risk” Group Avg Post Risk Reduction TI Automotive - Risk Reduction Group lowered Total Cholesterol by an average of 56 points. 1992 NORTH KARELIA 20 Year Project Outcomes

  21. WEIGHT Before and after program BLOOD PRESSURE High readings - before and after program “Not” a weight-loss program 203 7 190 2 Start Start Finish Finish Average Weight Loss = 13 lbs

  22. CHOLESTEROL CHANGE Cartersville, GA 18.4% Average Decrease Baseline

  23. LIPID RISK PROFILE CHANGE Cartersville, GA 35 Initial Program Participants 4 Remaining High Risk Participants 13 To Ideal Risk <200

  24. 2005-2006 U.S. Initiative Cardiovascular Risk Reduction

  25. 96% Participation 3600 Participants Screened Individuals Identified at “High Risk” 330 with Cholesterol levels of 240 or higher 41 Newly Diagnosed Diabetics 2005 Screenings

  26. U. S. LOCATIONS Pre-Program and Post Program Pre-test - Number of Participants with Total Cholesterol >240 Post Program-test - Number of Participants with Total Cholesterol >240

  27. CHOLESTEROL Identified & Addressed Root Cause – Cholesterol  240 Program Start Program Finish • 240 16% <150 08% 330 Completed RR Program 52 Participants “at risk” 200-239 50% 150-199 28%

  28. BLOOD PRESSURE RISK Number of Individuals “high risk” – Pre and Post Program 55 “at risk” 30 “at risk” 45% Start Finish This was “not” a Blood Pressure Control Program * Blood Pressures are highly variable from day to day – Diastolic Blood Pressure only

  29. WEIGHT CHANGE Average Weight – Pre and Post Programs 198.3 Average 193.5 Average 4.8lbs Start Finish This was “not” a Weight Loss Program 64% of participants lost weight

  30. ADDITIONAL FINDINGS Respondents indicating the following areas have been positively affected from participating in the Risk Reduction Program. 62% 48% Productivity More Positive Attitude

  31. “However beautiful the strategy, you should occasionally look at the results” -Winston Churchill

  32. 2007 - 34% decrease A CHANGE IN DIRECTION Cartersville, Georgia $25,140 Per Employee Per Year At 12.0% increase per year CVHI 2004 2006 2008 2010 2012 2014 2016

  33. R x #1 Lipitor #2 Zocor #3 Plavix COST AVOIDANCE 330 “high risk” at $125/mo. $ 41,250 - per month - for life ASSUMING: “all” at high risk would have been treated with pharmaceuticals..

  34. COST AVOIDANCE (1) By-Pass Surgery = $ 60,000+ (1) Angioplasty = $ 50,000+ (1) Stroke = $100,000+

  35. COST IMPACT TI Automotive, Cartersville, GA

  36. COST IMPACT TI Automotive, Corporate

  37. COST IMPACT TI Automotive, Corporate, 2004 - 2007 TI Automotive Average Annual PEPM Increase: 3.1% Consumer Price Index Average Annual Increase: 3.2% Kaiser Foundation Average Trend Increase: 7.9% * TI Automotive data does “not” include annual plan changes made by employers to control costs ** Kaiser data includes annual plan changes made by employers to control costs

  38. THE FACES OF TI AUTOMOTIVE

  39. My family & friends can’t believe that my company is doing this for us! -Joan

  40. It’s the best thing the company ever did for me! - Darcy

  41. Thank God for TI. I could never have done it with out the class! -Beverly

  42. City of Dalton, GA 319 Participants – 98% Administration – Fire – Police – Public Works – Landfill – Trade Center – Parks & Recreation – Solid Waste

  43. “Whether you think you can or think you can’t. You’re Right” -Henry Ford

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