Health and Wellness Life Bridge Health September 19

Health and Wellness @ Life. Bridge Health September 19, 2014 If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health. --Hippocrates Cheryl Boyer, VP Human Resources Guy Van Tiggelen, Director Total Rewards

Who We Are • “As one of the largest, most comprehensive and most highly respected providers of health-related services to the people of the Northwest Baltimore region, Life. Bridge Health advocates preventive services, wellness and fitness services and programs to educate and support the communities it serves. ” • • Sinai Hospital of Baltimore Northwest Hospital Levindale Hebrew Geriatric Center and Hospital Subsidiaries • Life. Bridge Health & Fitness • Life. Bridge Medical Care Centers • Physician Offices

The LBH Triple Option Health Plan Cost Share • Level 1 – Narrow Network 0% after deductible • Level 2 – Care. First PPO 30% after deductible • Level 3 - Out of Network 40% after deductible

The LBH Triple Option Health Plan • 10, 085 Covered Lives • • Employees Dependents

Live. Well @ Life. Bridge - Journey Year 2003 2004 to 2008 2009 Program / Actions Wellness Committee established to promote simple wellness ideas at no cost to Life. Bridge Wellness Committee activities, as part of our Great Place to Work Strategy: Decision made to establish a formal wellness program

Live. Well @ Life. Bridge - Journey HRA +600 (full year) Points granted for exercise and screenings HRA & onsite biometrics $25 gift card. 2010 2011 HRA +400 pts. Surcharge introduced 2012/13 2014 me. Q stress assessment + 500 points plus mandatory physical with biometrics Onsite coaching

Participation 80% 69% 70% 69% 60% 55% 50% 40% Phase I – 2010 Phase II – 2011 Phase III – 2011 - 2012 Phase IV – 2012 -2013 Phase V – 2013 - 2014 30% 20% 14% 10% 0% Phase III Phase IV Phase V

Cost of the Program • • • Fees Administrative fees $285, 654 Metabolic Syndrome Coaching fee $46, 300 High Claims Coaching fee $186, 000 (charged to claims) Total = $517, 954 • Employee Surcharges $521, 437 • Cost = -$3, 483

Outcomes - Claims per Employee Per Year Plan Design Changes in 2014, included increases in cost share, deductibles, smoker and spousal surcharges $ 11, 000 $ 10, 000 $ 9, 657 Actual $ 9, 000 Trend (7%) $ 8, 193 $ 8, 000 $ 7, 825 $ 7, 830 2011 $ 7, 919 $ 7, 000 2012 2013 2014 Linear(Actual)

Employee Health Status Metabolic Syndrome Factor 1800 1627 1600 1400 1200 939 1000 800 2011 2012 844 762 2012 - 2013 617 600 400 2013 -2014 521 467 224 298 286 200 74 160 14 60 105 1 16 25 0 None One Two 2011 -2012 Three 2012 -2013 Four Five 2013 -2014 None 60% 38% 34% One 28% 29% 31% Two 8% 19% Three 3% 10% 11% Four 1% 4% 4%

Risk Stratification Advanced / Critical Illness 9. 0% 3. 2% 13. 1% 27. 1% Chronic Illnesses At Risk 1. 2% 3. 2% 6. 6% Stable 24. 1% 47. 6% Care. First Members Healthy Life. Bridge Wellness 64. 9%

Outcomes – Coaching

Outcomes – Culture of Awareness • "I chose [the Health Risk Counseling] Program with Support, because I need the accountability. I also would like to say that I thought this program so far has been very helpful. It is very well done and has given me a better understanding about what is going on in my body. It explained everything really well. " • " I didn't think I could do it. I thought that if I wasn't able to run or work out at the gym, that exercise wouldn't be worth it. I have learned that walking can be very empowering, not only physically, but for my mind and spirit. I was able to make very specific, realistic goals for myself and maintained my outdoor walking goal through the entire winter. I have lost 10 pounds and feel like I am finally moving in the right direction. " • "I was in a tough place when I started working with the clinician and Allegeant over a year ago, but I'm in a better place now. " • And finally, a common question asked: Will I get points for that?

Wellness Revisited 2015 and Beyond

Employee Health Plan Governance Employer Human Resources Insurer Managed Care Provider Plan Design Physician Network

Challenges/Actions – Data • Claims Reporting – Consolidated adjudication of claims – Enhanced data warehousing & analytics – Hired Insurance / Claims Manager • Absence Reporting – Scheduled/Unscheduled reporting

Challenges/Actions – Employee Perception • Streamline process – Reduce required wellness points – Consolidated deadlines – Improved participant communication & support • Recognition and Rewards – Fit. Linxx device – Fitness Challenges • Improved Computer Access – Expanded availability

Challenges/Actions – Care Gaps • Wellness Coach – To keep healthy employees healthy – High risk/chronic employees & dependents • Incentives for Providers – Provider compensation program to reward improved patient outcomes