KING COUNTY EMPLOYEE HEALTH AND WELL BEING PROGRAM

2012 State of Reform Health Policy ConferenceJanuary 4, 2012

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AGENDA

Overview of King County Employee Health and Well-Being Program

Results/Program Effects Lessons Learned Next Steps

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STRATEGYSupply Side: •Work with Puget Sound Health Alliance (PSHA) to improve quality of care, pay for value

Demand Side: •Improve employee health•Increase employee health consumer skills

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Employers, physicians, hospitals, patients,health plans working together to measure and report

Best Care + Least Waste

SUPPLY SIDE

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DEMAND SIDE--Healthy IncentivesSM Improve employee health

Healthy Incentives program—annual wellness assessment and individual action plan

Worksite health promotion—Eat Smart, Move More, Stress Less

Increase employee health consumer skills Own Your Health Campaign Community Checkup Report on provider

quality

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Comparison of original Gold, Silver and Bronze Member Out-of-Pocket Expenses

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Item KingCareSM Gold 2006-2009

KingCareSM Gold 2010-2012

Group Health Gold2010-2012

(No Change from 2009)

Deductible (medical) $100 per individual$300 per family

$300 per individual$900 per family None

Coinsurance (medical) 90% In network 70% Out-of-network

85% In network 65% Out-of-network $20 copay for office visits

Annual out-of-pocket maximum for member coinsurance (medical)

In network services$800 per individual$1,600 per familyOut-of-network services$1,600 per individual$3,200 per family

No change from 2009In network services$800 per individual$1,600 per familyOut-of-network services$1,600 per individual$3,200 per family

$1,000/ individual$2,000/family

Prescription drug copays (at pharmacy)

$10 generic drugs$15 preferred brand $25 non-preferred brand

$7 generic drugs$30 preferred brand $60 non-preferred brand

$10 generic drugs$15 preferred brand $25 non-preferred brand

New Out-of-Pocket Expense Levels in 2010

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WORKSITE WELLNESS Health Matters website Health Matters Newsletter Health Promotion Leadership Team

Leadership Forums Annual surveys/focus groups

Employees and s/partners

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WORKSITE WELLNESS Gym discount program Live Well Challenge Weight Watchers at Work Farmer’s market Farm to Work fresh produce delivery Employee Demonstration/Giving Garden Healthy vending Choose well consumer education/Own Your Health

campaign Flu shots Health Heroes Lunch and Learn sessions on timely topics

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Employees Improved 12 out of 14 health risk factors.

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0.0%2.0%4.0%6.0%8.0%

10.0%12.0%

11.0%

6.2%

Average Annual Growth Rate of Medical and Prescription Expenditures per Member, 2001-

2005 & 2006-2010

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2007 2008 2009 2010 2011 2012$0

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000

$300,000,000

Actual Total Exp.Actuary's 2011 3-Yr Financial PlanActuary's 2012 3-Yr Financial Plan

Based on results in medical and prescription drug claims in 2010 and early 2011, King County was able to reduce the overall Employee Benefits Budget projections for 2011 by $23 and 2012 by $38M.

King County Benefits Cost Actual vs. Budget Projections 2010-2012

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2007 2008 2009 2010 2011 2012$0

$200$400$600$800

$1,000$1,200$1,400$1,600$1,800

King County Benefits Cost 2010-2012Actual vs. Budget Projections Per Employee

Per Month

Actual PEPMActuary's 2011 PEPMActuary's 2012 PEPM

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Out-of-Pocket Employer Total$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$1,309

$11,819$13,128

$517

$7,504 $8,021

King Care Group Health

Group Health HMO Costs 37% Less Than KingCare SM PPO per Employee

per Year

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No significant difference in the age, gender, education level, smoking, body mass, ethnicity, salary or general health status between members in Group Health and KingCareSM

Group Health provides the most fully integrated staff model health care in the Seattle metropolitan area

Analysis shows less use of brand name drugs, surgery,

diagnostic radiation and other preference sensitive treatments in Group Health compared to providers in the KingCare SM plan

More Information on Group Health Compared to KingCareSM for the King

County Employee Population

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Healthy IncentivesSM Participants Lost More

Weight Than a Comparison Group

2006 2007 2008 2009 2010 201127.227.327.427.527.627.727.827.928.028.128.2

Healthy IncentivesSM 5-year CohortHealthy IncentivesSM 5-year Cohort

Body

Mas

s In

dex

(BM

I)

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Weight Loss by Obese Members

≥ 5% Weight Loss ≥ 10% Weight Loss0%

5%

10%

15%

20%

25%

30%

35%

40%

MEPS 1-yr KC 1st-yr KC 5-yr

% o

f Obe

se C

ohor

t

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Women Benefit More Than Men 20-Somethings Don’t Benefit At All African-Americans Benefit the Most College Graduates Benefit Less

Healthy IncentivesSM successfully managed weight for King County employees, spouses and partners

This is the first study to find significant benefits for a large percentage of employees over a multi-year period

Impact On Obesity

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LESSONS LEARNED Partnership with Labor is essential Engaged Leadership is critical Most effective strategy for moderating

costs requires 3-part focus Supply—Improve quality, reduce waste Demand—better health, smarter

consumers Plan design that rewards both providers

and patients to “do the right thing.”

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NEXT STEPS New benefit plan RFP for new wellness vendor Work with the Puget Sound Health Alliance,

Washington State and other partners to improve quality/reduce waste in healthcare “Whether it’s the employee or the employer,

it doesn’t matter who gets stuck with the bill if the bill itself is growing exponentially.”

King County Executive, Dow Constantine

Continue to engage Leadership Study causes for reduced PEPM costs 2005-2012

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FOR MORE INFORMATION Programs: http://

kingcounty.gov/employees/HealthMatters.aspx Toolkit: http://

kingcounty.gov/employees/HealthMatters/Visitors/HRIToolkit.aspx

Contacts: Karleen Sakumoto, Manager, Employee Health and Well-

Being, Human Resources Division, Department of Executive Services, karleen.sakumoto@kingcounty.gov

John Scoggins, Health Care Economist, Office of Performance, Strategy and Budget, john.scoggins@kingcounty.gov