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HRA Management Report 2005

This report provides an overview of the HRA program's context and background, major findings, interpretation of results, update on coaching activity, and the challenge ahead. It also discusses the need for lifestyle change to prevent health cost increases and presents the impact of single and multiple health risks on absenteeism, workers' compensation costs, and group-level health care expenditures. The report outlines the strategic approach to health management, ROI goals, and the THAW Program implemented at the University of Alaska. It highlights the participation rate, risk status, wellness score, and interventions targeting cardiovascular disease, inactivity, and stress management. The report concludes with information on the stages of behavior change and the effectiveness of personal health coaching.

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HRA Management Report 2005

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  1. HRA Management Report 2005

  2. Agenda • Context for the program • Background on the HRA report • Major findings • Interpretation of results • Update on coaching activity • The challenge ahead • What’s needed next?

  3. Health Cost Increases: The “Problem” Another year of double-digit health cost increases

  4. Health risks push costs up!Yet preventable through lifestyle change Average annual per capita excesshealthcosts when risk is present. Goetzel, R et al.  The Relationship Between Modifiable Health Risks and Health Care Expenditures,  Journal of Occupational and Environmental Medicine.  1998;10:843-854

  5. Effect of single risk factors Percent higher sick leave absenteeism N = 35,451 Source: Serxner, S., et al., (2001). The impact of behavioral health risks on worker absenteeism. JOEM, 43(4), 347-354

  6. Effect of single risk factors Percent higher Workers’ Comp cost N = 3,388 X 4 years Source: Musich, S., et. al., (2001, June). The Association of Health Risks with Workers’ Compensation Costs, JOEM,, p. 534-541.

  7. Effect of multiple risk factors Multiples of Annual Health Plan Cost Multiples Number of Health Risks N = 1,838 Source: Yen, Louis, et al., (1991, Sept/Oct). Associations between health risk appraisal scores and employee medical claims costs in a manufacturing co., AJHP, 6(1), p. 46-54.

  8. Preventable claims costGroup Level health care expenditures Depression Stress Blood Sugar Smoking Obesity Blood Pressure Sedentary Life N = 46,026 X 6 years Source: Anderson, et. al., (2000, Sept/Oct). The Relationship Between Modifiable Health Risks and Group-Level Health Care Expenditures, AJHP, 15(1), p. 45-52.

  9. Wellness has evolvedROI goals determine model

  10. Summex Health ManagementStrategic approach • Control costs by reducing risks • Maximize HRA participation • Identify health risk cost drivers • Reduce risks through coaching for behavior change • Incent people for wellness • Keep low risk low • Measure outcomes • Determine ROI

  11. University of Alaska The THAW Program 1. Tri-Fold brochure sent to participants homes 2. Mayo Clinic Self-Care Guide sent to participant homes 3. Deploy Online HRA 4. Paper HRAs sent to all non-participants 5. Incent HRA ($100 Benefit Credit) 6. HTML EMAIL Weekly Campaign 7. Enroll into IMPACT™ and IMPACT™ MR

  12. University Of Alaska HEALTH MONITOR™ HRA • Participation • 2,927 HRA Participants = 45.7% Participation Rate • 58.4% of Participants were Female • 41.6% of Participants were Male • 26.3% of Participants were spouses • 73.7% of Participants were employees • 28% were paper • 72% were online

  13. Risk Status of HRA Completers N = 6,399 N = 2,927

  14. Risk status of HRA completers N = 2,927 <76.3 76.4 to 80.4 >80.5 (1,449) (764) (714) Total Eligible = 6,399

  15. Are HRA participants healthier? Per Member Per Month (PMPM) * = 7/1/2004 to 6/30/2005 Source: Premera, Knowledge Services

  16. Campus HRA Participation SW UAA UAF UAS

  17. University of Alaska Multiple Risk Factor Prevalence

  18. Cost of Multiple Risk Factors Multiple risks multiply costs Multiples Number of Risks Source: Yen, Louis, et al., (1991, Sept/Oct). Associations between health risk appraisal scores and employee medical claims costs in a manufacturing co., AJHP, 6(1), p. 46-54.

  19. Overall Wellness Score (OWS) Risk Factors Used in OWS • Aerobic • BP • Weight • Stress • Fat • Cholesterol • Alcohol • Lift • DUI • Seatbelt • Speed • Screen • Self Care • Depression • Pre-Diabetes • Tobacco • Multi-CVD • Multi-Stroke • Multi-Psych

  20. Overall Wellness Score

  21. Overall Wellness ScoreComparison of U o A with Summex database

  22. Identifying your “low hanging fruit” • Intervention Opportunity Index (IOI) • Located on page 27 & 28 of the management report • “Low hanging fruit” • The IOI ranks your organization’s top risk factors based on: • Your risk prevalence • Your excess costs • Your readiness to change • Your top “3” IOIs • CVD prevention • Physical inactivity • Stress

  23. #1 IOI Target:Cardiovascular Disease Prevention

  24. Cardiovascular Disease RisksParticipants with multiple risks

  25. #2 IOI Target:Inactivity

  26. University of Alaska Weight management

  27. #3 IOI Target:Stress management

  28. University of Alaska Readiness to change profile

  29. IMPACTTMStages of Change Permanent behavior change • Pre-contemplation • Contemplation • Preparation • Action • Maintenance • Termination termination maintenance action preparation High-risk individuals will change health behaviors given the right coaching at the right time. contemplation pre-contemplation Risky behavior

  30. IMPACTTMPersonal health coaching • Engaging • Lifestyle-focused • Goal-oriented • Personal • Confidential • Supportive “About 40% of high risk move out of high risk the first year of coaching.”

  31. IMPACTTM and IMPACTTM MRPersonal health coaching • Welcome Kit or Physician Letter • Telephone & mail-based counseling • Impact: Up to 12 counseling sessions per year • Impact MR: Up to 6 counseling sessions per year • Stage-of-change protocol • Personal health journal • Integration of health resources: EAP, DM, worksite activities • HEALTHSTAGESTM change guides • Quarterly management reports

  32. Current IMPACTTM Program Personal health coaching IMPACT™ • 1,189 enrolled (82.0%) IMPACT™ MR • 440 enrolled (57.6%) As of February 1, 2006

  33. What needs to happen now • Statewide is not driving the site-based wellness activity, so… • Each campus needs to organize for wellness and… • Then focus on the IOIs • CVD prevention • Inactivity • Stress

  34. Virtual and site-based wellness: Options for University of Alaska Virtual   + + + + + + Site-based

  35. What can be done? • CVD prevention? • Cholesterol? • Blood pressure? • Weight management? • Tobacco use? • Nutrition? • Inactivity? • Stress?

  36. Summary of Key Points • Health risks drive a large proportion of your health costs. • You have made an excellent start! (45.7%) • The infrastructure for measurement and intervention with individuals is in place. • Awareness and coaching are usually required for behavior change. • There is much that can be done at each location. • Each location must organize and conduct programming and help create healthy cultures. • Volunteers are available. • Site leadership is needed. • Wellness produces benefits and value for everyone.

  37. Questions

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