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David E. Edman LOOKING AHEAD: EMERGING TRENDS IN HEALTH BENEFITS Tuesday, May 20, 2008, 2:00 PM

David E. Edman LOOKING AHEAD: EMERGING TRENDS IN HEALTH BENEFITS Tuesday, May 20, 2008, 2:00 PM. 2008 Disease Management Colloquium. 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz. Manager of Health Benefits. RISK MANAGEMENT PARTNERS LLC

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David E. Edman LOOKING AHEAD: EMERGING TRENDS IN HEALTH BENEFITS Tuesday, May 20, 2008, 2:00 PM

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  1. David E. EdmanLOOKING AHEAD:EMERGING TRENDS IN HEALTH BENEFITSTuesday, May 20, 2008, 2:00 PM 2008 Disease Management Colloquium 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz

  2. Manager of Health Benefits RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz

  3. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work • WHY DOES HEALTHCARE COST SO MUCH? • Primarily because 25% to 30% of healthcare costs are wasted on: • Unnecessary Care • Inappropriate Care • Poor Quality Care 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  4. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work Annual Cost of Poor-Quality: $2500 Per Employee (est.) • MOST COSTLY QUALITY PROBLEMS • Drug misuse • Overuse of antibiotics • Overuse of inpatient care • Preventable hospital-acquired infections • Diabetes – direct and indirect costs • Depression – total economic burden • Inadequate care after heart attack • Underuse of influenza and pneumococcal vaccinations • Asthma – direct and indirect costs • Congestive heart failure – direct costs Source: Midwest Business Group on Health, in collaboration with Juran Institute, Inc. and The Severyn Group Inc., 2002. 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  5. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work “The Quality of Health Care Delivered to Adults in the United States” Source: RAND Corporation Study, published by New England Journal of Medicine, June 26, 2003 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  6. THE MYTH OF ‘BEST IN THE WORLD’BY SHARON BEGLEY, NEWSWEEK, March 22, 2008 RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work How does the US infant mortality rank among industrialized countries? 28th of 30 countries (7 deaths per 1000 live births) The five-year survival rate for cervical cancer? Worse than Italy, Ireland, Germany, and others. The survival rate for breast cancer? You would do better in Switzerland, Norway, Britain, and others. Asthma mortality? Twice the rate of Germany’s or Sweden’s. Source: Organization for Economic Cooperation and Development (OECD), 2007 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz

  7. THE SHAPE OF THINGS TO COME RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work From Dec 11th 2003, The Economist print edition. 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  8. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work Insurance (definition) Main Entry: 1in·sur·ancePronunciation: in-'shur-&n(t)s also 'in-"Function: noun1 a: the business of insuring persons or property b: coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril c: the sum for which something is insured2: a means of guaranteeing protection or safety <the contract is your insurance against price changes> 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  9. HSA Concept RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work 100% For In-Network Preventive Care To: From: Traditional Health Coverage Traditional Health Coverage Member Responsibility Health Savings Account (HSA)

  10. RISK MANAGEMENT PARTNERS LLC Healthcare Solutions That Work

  11. Healthy Acute Illness Chronic Illness Catastrophic Prevention: Health Coaching & Wellness Programs Prevention: Health Coaching & Wellness Programs On-line Portal: Patient Education, Information Gathering & Sharing On-line Portal: Patient Education, Information Gathering & Sharing 24 Hour Nurse: On-Line & Telephone Coaching 24 Hour Nurse: On-Line & Telephone Coaching Intermediate Care Programs Intermediate Care Programs Disease Management Programs Disease Management Programs Transition of Care Catastrophic Case Management Catastrophic Case Management RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work Population Management Segmented By Individual’s Level of Risk Source: 11

  12. HEALTH BENEFITSFROM PATERNALISM TO SHARED RESPONSIBILITY RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz

  13. BENEFITS OF SHARED RESPONSIBILITY RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work • Greater Efficiencies From Appropriate Application of Insurance Principles • Lower Costs and Great Value For Purchasers • Employee Incentives: Healthy Lifestyles and Appropriate Utilization • Greater Employer Control Over Future Healthcare Costs (Carrier Agnostic) 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz

  14. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work • CRITICAL ROLE • FOR PURCHASER DRIVEN ADVOCACY • Focus on Consumerism • Promote Enhanced Transparency • Centers of Excellence/Certificate of Need (CON) • Emphasize Primary Patient Care • Offer Association (Like) Health Plans 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  15. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work SPARK THE REVOLUTION: Health Reform is Gaining Traction in the Marketplace “HSAs put individuals in charge of their own ‘cost containment’, rather than the government or HMOs. The latest news is that they have been proving their attractiveness in the marketplace more rapidly than supporters expected.” --Wall Street Journal, December 27, 2005, A20 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ David@rmpllc.biz

  16. RISK MANAGEMENTPARTNERS LLC Healthcare Solutions That Work Will This Be déjà vu All Over Again? 175 Strafford Avenue ♦ Suite One ♦ Wayne, PA 19087 ♦ 610-975-4415 ♦ www.RMPLLC.biz

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