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Wellness and Disease Management Program Sales Staff Presentations

Wellness and Disease Management Program Sales Staff Presentations. September 2014. May 23 , 2013. Agenda. Current State Wellness and Disease Management Definitions and CareFirst Policy Integrated Wellness and Disease Management Model Program Effective 1/1/15

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Wellness and Disease Management Program Sales Staff Presentations

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  1. Wellness and Disease Management Program Sales Staff Presentations September 2014 May 23 , 2013

  2. Agenda Current State Wellness and Disease Management Definitions and CareFirst Policy Integrated Wellness and Disease Management Model Program Effective 1/1/15 Enhanced Wellness Program Features Next Steps

  3. Current State Wellness and DM • Vendor Partners • HealthFitness delivers Wellness (Health Assessments, Lifestyle Coaching, Workplace Wellness Events) • Healthways delivers Disease Management (Chronic Condition Coaching) • CareFirst has offered multiple options of program packages for both Wellness and DM • 3 different Wellness packages • 3 different DM packages • Programs for Risk Accounts • Wellness is included • DM is NOT included • Programs for ASO Accounts – there is a mix as of Q1 2014 • 23 Wellness only • 61 DM only • 11 DM and Wellness • 83 Neither • Pricing for Risk Accounts • Wellness (Health Assessments, Lifestyle Coaching) is included as part of premium • Pricing for ASO Accounts • Wellness and DM pricing is broken out separate from the Admin

  4. Current State Wellness and DM Book of Business Program Offerings Wellness Package 3 includes Health Assessment, Telephonic Health Advising, Online and Telephonic Health Coaching Self Insured Purchase Options

  5. Definitions and CareFirst Policy Definitions Wellness – Assessments are important to identification of where members fall on the continuum of care and what targeted services they should receive. Lifestyle Coaching is targeted to those members with high risk for unhealthy behaviors and have not yet been diagnosed with a condition. Disease Management – Targeted chronic condition coaching (where we are identifying cases to outreach based on our predictive modeling) of members with full expression of a disease and who need outreach to be impactful. CareFirst Policy Healthways and HealthFitness will offer both Wellness and DM as opposed to having different vendors for one account. Healthways will manage all ASO and HealthFitness will manage all Risk.

  6. Integrated Wellness and DM Model Program Ideal State Effective January 2015 for Self Insured Business Only Vendor Partner: Healthways Assessment Process Well-Being Assessment Biometric Screening/Physician Form Incenting Member Participation Plan Design (HealthyBlue/Blue Rewards) Health Condition Tracks Early identification that a member may be headed towards developing a condition Coaching Interventions Lifestyle Management Coaching Disease Management Coaching (10 conditions) Workplace Wellness Services Supports a Culture of Wellness Available for an additional fee; may be deducted from wellness credits

  7. Effective 1/1/15 • Risk Accounts • No change for 2015 – looking to incorporate DM for 2016 • ASO Accounts • Price Wellness ($1) and DM ($3) into every opportunity upon medical renewal • The cost of these programs will be included and not broken out into the Admin fee • Messaging (depending on the mix outlined above) • Account members will receive targeted DM programs for 10 chronic conditions which includes: • Asthma • Diabetes • Coronary Artery Disease • Chronic Obstructive Pulmonary Disease • Congestive Heart Failure • Chronic Low Back Pain • Osteoarthritis • Atrial Fibrillation • Irritable Bowel Syndrome • Fibromyalgia • Wellness Assessments and Lifestyle Coaching which are critical to identification and management are now included as core so that we can appropriately risk stratify and support the Account’s population • This is part of our transition to a health care delivery manager so that we are meeting member where they are on the continuum of health

  8. Enhanced Wellness Program Features Shorter, more engaging Health Assessment Social experience throughout, including Groups, Challenges, Forums, etc. Personalized Messaging Wireless device integration (i.e., FitBit, Withing, etc.) Text messaging capabilities

  9. Next Steps • Account Transition • Effective 2015 for eligible accounts upon their medical renewal date • Including in all RFPs – pricing, written description and executive summaries • Currently identifying most appropriate accounts for 1/1 on a case-by-case basis • Collaboration between Sales, Wellness and Underwriting to determine best approach • Marketing Materials • New Print and PDF Brochure • Individual Sell Sheets and Program Descriptions • New Pricing Guide • Member facing materials (in development) • For all groups moving to this program, Sales to please complete new H+W Request form • Additional Questions: Please contact the Wellness Team for any questions • Scott Smith: 200+ Commercial, Health & Education Accounts • Jenna Schiffelbein: 200+ Municipal and Labor Accounts • Carla Savage: General Wellness

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