1. County wellness program update

• Diabetic prescriptions at a reduced co-pay • Tobacco cessation medications at no cost Two important components of this list are the lifted restrictions on age and followup screenings. For example, if an employee has a family history and should have a screening earlier than the recommended age, they won’t be blocked from having it. Also, if follow up screenings or blood work are needed, employees and their families will be covered. This ensures that employees can better manage their risk factors or conditions and prevent those risks or conditions— and their future care costs—from escalating. What the State of Nebraska has found is that, for people who have these risk factors or family histories, these services can be even more of an incentive than the premium discount. The State of Nebraska wellnessoptions program has helped change our lives! Getting and staying healthy takes hard work and commitment. The wellness program provides a variety of tools to help employees reach and/or maintain good health. Success breeds success! -Bobbi and Steve Olson, Nebraska Department of Roads W E L C O A C A S E S T U D Y 7 Section II: Delivering The Program Qualifying For The Wellness Plan State of Nebraska employees who take the time to invest in their personal health by qualifying for the Wellness Plan are rewarded with lower premium costs and comprehensive preventive coverage. Any enrolled employee and enrolled spouse can choose to qualify for the Wellness Plan by completing 3 STEPS on an annual basis. STEP 1: participants choose and enroll in their choice of a wellness program* STEP 2: participants complete a biometric screening option STEP 3: participants complete an online health assessment (*Employees who do not choose the Wellness Plan can still participate in any of the wellness programs.) Year-Round Wellness Program Offerings Each year, the State evaluates its wellness programs to ensure the offerings are aligned with the population’s needs and interests. In addition, the State firmly believes that healthy lifestyles are a life-long commitment. As a result, all of the wellness programs are offered year-round instead instead of as short-lived, 12-week programs. The wellness programs available to enrolled State of Nebraska employees and their spouses include: • Walk This Way® -Participants boost their activity levels by wearing a free pedometer and tracking their steps online. With over 8,000 employees and spouses participating the past three years, this program is now being offered each year due to popularity. • EMPOWERED Coaching™: Lifestyle and Condition Management -Participants work with their own personal health coach to support and guide lifestyle changes related to physical activity, healthy eating, smoking cessation and stress management. In addition to lifestyle management, individuals with chronic conditions can also work with a coach to help them manage their health. Over 7,700 participants have participated in this telephonic-based coaching program during the past three years. • NutriSum -As a result of employees expressing interest in additional weight management programs, this online weight management challenge helps participants learn strategies for weight loss and maintenance of a healthy weight. • Cardio Log -Based on feedback, wellness participants expressed interest in logging a variety of workouts. With Cardio Log, wellness participants can now track a variety of sports, fitness classes, cardiovascular, strength training and flexibility workouts. • Biometric Screening -Onsite screenings are offered at approximately 30 State of Nebraska locations each year. In addition, home kits can be requested to obtain a finger-stick blood draw kit mailed to participant homes. PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org 8 w w w . w e l c o a . o r g ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a W E L C O A C A S E S T U D Y Wellness Champions: A Resource To The Employee Wellness Program Wellness Champions serve as a resource to the wellness program by communicating wellnessoptions programs to fellow co-workers, while providing constructive feedback to the wellness team. Currently, there are approximately 40 Wellness Champions at locations all across the state and among the different agencies. The feedback from the Wellness Champions is imperative to the program. For instance, it was the Wellness Champions who first voiced the need for more preventive coverage in the health plan. Because aligning health plan coverage in this manner falls right in line with the goals and objectives of the wellness program’s focus on prevention and early detection, the State changed the Wellness Plan design to include specific follow-up preventive screenings. Senior Leadership Support With previous involvement in the military, Governor Dave Heineman’s physically active lifestyle and personal interest in fitness and wellness is the cornerstone for for the wellness program. The Governor makes time to promote the wellness program. In fact, at the launch of the wellness program, the Governor recorded a video to support and promote the benefits of the wellness program. The video was made available for all employees to view. A terrific example of senior leadership support is the Governor’s own idea of recognizing walking program participants with a group photo session at the State Capitol. Those who achieve 1 million steps, all the way up to the individual with the highest amount of steps (10 million!) are recognized in a photo with the Governor. It is also not uncommon to hear the Governor actively promoting and challenging others to beat his own daily step count in the State Capitol hallways. Governor Heineman leads by example and makes an effort to visibly promote his active participation. The Governor wants to be a part of employee success stories. As a result, individual testimonial stories are displayed on a quarterly basis in the State Office Building’s “Wellness Wall of Fame” and on the wellness website. Wellness Wall of Fame participants get an individual picture taken with the Governor and receive a letter and certificate to honor their achievements. WELCOA’s Well Workplace Model Offers Results www.welcoa.org/wellworkplace Nebraska can be proud to be recognized as having one of the only wellnessfocused health care programs for state government in the country. -Governor Dave Heineman PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a w w w . w e l c o a . o r g 9 W E L C O A C A S E S T U D Y Final Walk This Way Step Achievement (number of participants) Date Enrollment Wellness Criteria Achievers 1 Million+ 2 Million+ 3 Million+ 4 Million+ 5 Million+ 6 Million+ Total Steps Logged 2010 3,670 1,684 521 171 42 4 1 1 2,120,050,343 (803,049 miles) 2011 5,222 2,662 891 360 163 61 15 10 4,722,554,785 (1,788,847 miles) 2012 5,931 4,912 1,783 723 320 119 44 16 6,013,053,701 (2,77,672 miles) Governor’s Wellness Awards Luncheon At one point, the wellness program staff was getting so many participants with amazing lifestyle changes and lifesaving stories that the Governor suggested holding a banquet at his residence to further recognize these achievements. This resulted in what is now the annual ‘Governor’s Wellness Awards Luncheon’ at the Governor’s residence. Wellness Champions, Agency leaders and a keynote speaker attend this awards luncheon, at which the Governor presents two awards. The first award goes to the Wellness Champion who demonstrates going “above and beyond” to promote wellness at their location. The second award goes to the Agency with the greatest wellness program participation and health improvements. Results from the Governor’s Wellness Award luncheon have created some powerful traction for the wellness program throughout the State of Nebraska. For example, after one such luncheon, the Department of Corrections Agency Director requested to have Wellness Champion representation at every Corrections location throughout the State. Lastly, when the State of Nebraska won WELCOA’s Gold Well Workplace Award in 2011, the Governor announced this prestigious accomplishment in a media news call and press release. The Governor ultimately strives to maximize opportunities that help build wellness into the culture of the State government. Section III: Health Improvements And Early Detection Efforts Pay Off Improved Lifestyles, Reduced Risk Factors And Increased Preventive Care Early accomplishments are being reported after only three years of the State of Nebraska providing its wellnessoptions program. Results are showing improved lifestyles, reduced risk factors and increased adherence to early detection and preventive screenings. Last year, over 5,800 employees and 2,500 spouses enrolled in a wellness program, which is approximately 42% of the employee population. Comparing 2010 to 2011, participation in the wellness programs has increased 10% and biometric screening attendance has increased 16%. Walk This Way! Participants enrolled in the State of Nebraska’s Walk This Way program literally take millions of steps during this year-round walking initiative. This year, more than 1,700 participants have logged over 1 million steps and several have logged over 6 million steps. And recently, the program celebrated its first participant to log over 10 million steps! PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org 10 w w w . w e l c o a . o r g ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a W E L C O A C A S E S T U D Y Based on comparative analysis among those who completed a health assessment in 2010 and 2011, the State saw statistically significant improvements in the following high risk areas: physical activity, consumption of vegetables and fruits, tobacco, stress and depression. • 11.3% who were previously high risk for low levels of physical activity are now exercising more than two days per week. • 7.7% who were previously high risk for low fruit/vegetable consumption are now eating more than three fruits/vegetables per day. • Participants reporting they use tobacco decreased from 9.3% to 7.8%. • Those at high risk for depression decreased from 11.6 % to 9.6%. The overall average number of individual risks significantly declined from 2010 (1.72 risks) to 2011 (1.55 risks). The percentage of employees at low-risk status (0-2 risks) increased from 73.8% in 2010 to 76.9% in 2011. Consequently, the percentage of employees at moderate-risk (3-4 risks) decreased from 21.9% to 19.8% and those at high-risk (5+ risks) decreased from 4.2% to 3.3%. -Governor Dave Heineman Our [employees’] success in leading healthy lifestyles is a great example of what is possible when you make a commitment to invest in your personal health. 22.5% 27.6% 23.7% 14.6% 7.3% 2.7% 1.1% 0.5% 26.4% 29.5% 21.0% 13.7% 6.1% 2.4% 0.6% 0.3% 0% 5% 10% 15% 20% 25% 30% 35% 0 Risks 1 Risk 2 Risks 3 Risks 4 Risks 5 Risks 6 Risks 7+ Risks Plan Year 2 Plan Year 3 2010/2011 Change In Risk Factors (78199 :ar;ci<ants) # of Risks Plan Year 2 % Plan Year 3 % 0-‐2 Risks (Low Risk) 73.8% 76.9% 3-‐4 Risks (Moderate Risk) 21.9% 19.8% 5+ Risks (High Risk) 4.2% 3.3% Average Number of Risks Per Participant 2010........1.72 2011........1.55 * *Statistically significant change PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a w w w . w e l c o a . o r g 11 W E L C O A C A S E S T U D Y Just as leading national research illustrates, reducing individual health risk factors has also shown to result in a reduction of health care costs at the State of Nebraska. Based on State of Nebraska medical claims analysis among wellness program participants, the findings show a positive relationship between the number of individual risk factors and medical costs. In addition, the analysis shows cost savings as the population shifts from the high and moderate risk categories to a lower risk category. Onsite screening satisfaction survey results show that 99.2% of participants were satisfied with their experience. Post-survey results indicate that 90.6% of participants were satisfied with the EMPOWERED CoachingTM program. A recent interest survey among wellness program participants found: • 67% are somewhat or very enthusiastic about the wellness program • 83.5% indicated the wellnessoptions program has somewhat or considerably affected health and well-being positively • 83.8% like the premium savings with with the Wellness PPO. Aggregate results among wellness program participants have shown a reduction in the average number of individual risk factors. Associated health improvement results include increased levels of physical activity and consumption of fruits and vegetables, along with decreased prevalence of stress and tobacco use. In fact, 130 participants have now quit smoking as a result of the EMPOWERED CoachingTM program combined with smoking cessation medications available at no cost within the Wellness Plan. Other conditions newly diagnosed from onsite biometric screenings include over 1,100 new high cholesterol cases and 1,300 new high blood pressure cases— which means these risks were successfully caught and now the program can provide employees with resources and support to better manage these conditions. Results from the State of Nebraska’s interest survey indicated 85% of wellness program participants attest that the wellnessoptions program has positively affected their health. Good Catch! Some Some have argued that the State’s targeted home mailings are not cost effective due to postage costs. But the reality is this: if a low cost home mailing catches ONE case of early-stage cancer, diabetes, heart disease, high blood pressure or other condition— just ONE—then this communication strategy has more than paid for itself. Not to mention, early detection can have a game-changing quality of life benefit. Why? The cost to treat some conditions in the late stage can range in the tens of thousands to hundreds of thousands of dollars per year. If diagnosed early, the benefits in treatment savings are enormous to both the individual and the State. And if caught early, the odds of the person’s health status improving with time are much greater. With its targeted messaging strategy, the State of Nebraska has helped to catch 514 new cases of early stage cancer before it was too late! 0 1000 2000 3000 4000 5000 6000 7000 8000 Walk This Way Coaching Biometric Screenings Health Risk Assessment !"#$%&'()$*+," -.//*.,,"#%01%$2"#$%&'()$&0*"3%04+5" 2010 2011 2012 PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org 12 w w w . w e l c o a . o r g ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a W E L C O A C A S E S T U D Y Personalized Messaging Like No Other The State of Nebraska personalized messaging strategy started with one concept and grew like a Nebraska thunderstorm. Based on claims, the State found the preventive and chronic care screening adherence rate was extremely low among all those with health coverage. The volume of medical claims and life changing events told a clear story that contributed to a poor quality of life and health costs that were out of control. The focus of the State’s personalized messaging is on increasing preventive screenings such as mammograms, colonoscopies, cholesterol checks, etc., as well as chronic condition screenings like hemoglobin A1C and liver enzyme checks, among others. Based on U.S. Preventive Screening Task Force guidelines, the State uses its most recent claims data (health assessment, biometric screening, medical and pharmacy claims) and self-reported data to target messaging to those participants who are not current with their preventive or chronic care screening. The diverse and disperse population at the State of Nebraska posed many communication challenges, so the State turned to a two-prong communication strategy called Personalized Messaging. This messaging system provides datadriven outreach to employees to generate meaningful actions and outcomes. Targeted Home Mailings: • Inform of screening type that is due or overdue (i.e. mammogram or A1C) • Provide participant’s health plan coverage info for the specific screening • List doctor’s office near to participant’s home if no primary doctor is on file Consumer Health Advocacy Campaigns: • Target those who are high users of emergency rooms • Target those taking brand name medications that have a generic equivalent • Provide immediate cost savings both the participant and the State Other Personalized Messages: • Customized: precisely targeted to specific employee populations • Timely and data-driven: based on claims or self-reported data • For example: seasonal musculoskeletal issues have patterned to peak in January and July, so messages with safe back care education are sent prior to those highest incident times. In addition, the location of the closest urgent care clinic is sent to those who have had a previous diagnosis of back pain and are on the list of frequent ER users. While personalized messaging and mailings have proven effective for communicating to the State’s diverse workforce, the scope of communication has also expanded to drive enrollment messages to those currently not participating in the wellness program. Reminders are also sent to those who were short of qualifying for the Wellness Plan. As you would expect, recommendations for State wellness programs are specific to the participant’s risks factors and/or chronic conditions. It’s easy to set up. People are you. Please call your physician to schedule appointment. For help finding an physician, contact (800) 642-3022 bcbsne.com It’s overdue. You should get an HbA1C four times a year if your current levels more, according to national guidelines. It’s covered. Your portion will be Network after deductible if you have a medical This April, Sharon * Any medical condition diagnosed during a routine exam may be billed as an illness. This letter coverage. For coverage/payment information refer to http://www.das.state.ne.us/personnel/benefi ts responsibility may vary based on the manner in which the provider submits your claims. Your information stays confidential as required by privacy regulations such as HIPAA. All personal database and is not shared with the State of Nebraska. This message is based on national guidelines only. It is not meant to replace the advice of a healthcare professional. To unsubscribe, please visit information on the State of Nebraska wellnessoptions program, please visit www.wellnessoptions.NOTE: Participation is to be done on personal time, and is in no way to be considered part of workers’ compensation or for any other purpose. Approved activities during work hours are allowed Health Assessment and on-site Biometric Screening. $ $ Sharon Sample 501 N Racine Waverly, NE 68462 March 23, 2012 getting her Hemoglobin A1C Set up your appointment now! Last year alone, 1363 people took advantage of their coverage and got it done. It’s easy to set up. People are ready to help you. Please call your physician to schedule an appointment for a colon cancer screening. For help finding an In-Network physician, contact (800) 642-3022 or visit www.bcbsne.com It’s overdue. You should get a colonoscopy at least once every ten years (and more often if you’re high risk), according to trusted national guidelines. It’s free. Your portion will be $0 In-Network (covered 100%) Covered at 100% per Patient Protection and Affordable Care Act (PPACA) guidelines. If services are outside the National Health Care Reform guidelines, they are not covered. * This March, Robert is * Any medical condition diagnosed during a routine exam may be billed as an illness. This letter should not be considered a guarantee of coverage. For coverage/payment information refer to http://www.das.das.state.ne.us/personnel/benefits or call (877) 721-2228. Your financial responsibility may vary based on the manner in which the provider submits your claims. Your information stays confidential as required by privacy regulations such as HIPAA. All personal health information is held in a secure database and is not shared with the State of Nebraska. This message is based on national guidelines and is meant for information purposes only. It is not meant to replace the advice of a healthcare professional. To unsubscribe, please visit www.myhealthreminders.com. For more information on the State of Nebraska wellnessoptions program, please visit www.wellnessoption s.nebraska.gov. © 2012 Evive Health, LLC. NOTE: Participation is to be done on personal time, and is in no way to be considered part of or arising out of employment for the purposes workers’ compensation or for any other purpose. Approved activities during work hours are allowed only for completing Open Enrollment, the Health Assessment and on-site Biometric Screening. $ $ Robert Sample 441 W Larson Lincoln, NE 68521-5317 February 28, 2012 getting his colonoscopy. Set up your appointment now! Last year alone, 1327 people took advantage of their coverage and got it done. Edward Hines 1234 Prarie St. Lincoln, NE 60050 STEP 1. You’ve already completed your choice of at least one wellness program (Walk This Way, EMPOWERED Health Coaching, Feel Like a Million, and Condition Management Coaching). Congratulations! STEP 2. Complete your 2011 biometric screening using one of three convenient screening options. To learn more (including on-site screening dates), log on to www.wellnessoptions.nebraska.gov and click on ‘Biometric Screenings’ on the left sidebar. STEP 3. Complete your 2011 online INSIGHT Health Assessment. Just log on to www.wellnessoptions.nebraska.gov and click on ‘Health Assessment’ on the left sidebar. Your individual Health Risk Assessment results are kept confidential from the State of Nebraska. Your information stays confidential as required by by privacy regulations such as HIPAA. All personal health information is held in a secure database and is not shared with the State of Nebraska. This message is based on national guidelines and is meant for information purposes only. It is not meant to replace the advice of a healthcare professional. To unsubscribe, please visit www.myhealthreminders.com. For more information on the State of Nebraska wellnessoptions program, please visit www.wellnessoptions.nebraska.gov. © 2011 Evive Health, LLC. NOTE: Participation is to be done on personal time, and is in no way to be considered part of or arising out of employment for the purposes of workers’ compensation or for any other purpose. Approved activities during work hours are allowed only for completing Open Enrollment, the Health Assessment and on-site Biometric Screening. Edward’s April TO-DO LIST: This To-Do List is worth least $1,936.32 you in savings.* And already gotten started! * Amount reflects annual premium savings for a family + spouse + chidlren) chidlren) enrolled in the 2010-2011 Wellness BlueChoice. Complete the three annual steps below to qualify for the 2011-12 Wellness PPO Plan. And remember: BOTH the enrolled employee AND covered spouse must complete all Steps on an annual basis in order to qualify for the Wellness PPO. ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a w w w . w e l c o a . o r g 13 W E L C O A C A S E S T U D Y Life-Saving, Cost-Saving ‘Catches’ Before the launch of the State’s wellnessoptions initiative, only 33% of employees were current with their recommended preventive screenings (compared to national guidelines). And now, three years later, 70% are current with their recommended screenings! As a result of this increase in preventive screenings, the State has also seen a spike in the amount of conditions detected in an early stage. Along with more favorable health outcomes, significant cost savings are also associated with identifying conditions in an early stage. The good news is that over the past two years, 514 new early-stage cases of cancer were detected (mostly colon and breast), which allowed for early treatment. Unfortunately, 26 new cases of late stage cancer were diagnosed, and in many of these cases, the individuals were getting screened for the first time. Personalized Messaging Outcomes The impacts of the State’s personalized messaging engagement strategy are measured in data-driven outcomes reported from claims data and wellness program participation. • Total employee preventive screening adherence rate has increased 37% • 10% increase in wellness program participation the past year • 10% increase in Wellness Plan enrollment the past year • 5% increase in use of generic prescriptions the past year WELCOA Members Get Free Incentive Campaigns www.welcoa.org/freeresources Wellness helps us reach new levels of quality in fulfilling our mission. In a prison environment, we are much more confident in our personal safety when we know our co-workers are physically fit and mentally alert. -Bob Houston, Director, Nebraska Department of Correctional Services PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org 14 w w w . w e l c o a . o r g ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a W E L C O A C A S E S T U D Y Bucking The Health Care Cost Trend The State of Nebraska continues to attack modifiable health care costs from many different avenues. Prior to the wellness program, the State experienced double digit health care cost increases each year. Last year, the State experienced an overall cost trend of less than a 1% increase among all State of Nebraska health plans. Major Contributors To Cost-Savings: • Reduced prescription utilization— in fact, the total number of prescription scripts filled within the Wellness Plan reduced 3% last plan year as a result of improved lifestyles • Reduced ER visits • Reduced hospital admissions • Reduced hospital stays Just as national research illustrates, reducing individual health risk factors has also shown to result in a reduction of health care costs at the State of Nebraska. Specifically, the analysis of medical and pharmacy costs has demonstrated $4.2 million in reduced medical and pharmacy claims spending during the first two years when comparing wellness program participant’s health cost experience to nonwellness participants. The resulting return on investment is above industry average at 2.70:1 for a program that is just three years young. This means that for every $1.00 spent on the wellness program, $2.70 is returned in health care savings based on an independent review of claims data. “I am very pleased with the success of our wellness program and I am even more pleased that state employees are embracing this program,” Govenor Heineman said in reflecting on the early progress of the wellness program. To read more about the State of Nebraska’s wellness efforts, visit www.wellnessoptions.nebraska.gov. WELCOA Offers Premier Webinars www.welcoa.org/consulttrain/about.php Wellness is beginning to have a positive impact on employees’ lives, both at home and at the office. -Carlos Castillo, Director Administrative Services PASS IT ON! Know someone who would enjoy this? Click here to send them a copy. www.welcoa.org ©2 0 1 2 W e l l n e s s C o u n c i l o f A m e r i c a w w w w . w e l c o a . o r g 15 W E L C O A C A S E S T U D Y Wellness Council of America [WELCOA] 17002 Marcy Street, Suite 140 Omaha, NE 68118 Phone: 402.827.3590 | Fax: 402.827.3594 www.welcoa.org