DaVita’s Village Vitality - DFWBGH · DaVita’s Village Vitality Measuring Wellness Program...

DaVita’s Village Vitality Measuring Wellness Program Performance

DFWBGH Wellness Forum / November 29, 2012

Agenda

What are most employers measuring?What are most employers measuring?

About DaVita

Wellness at DaVita

Question: What does our CEO want to see?

Measuring Wellness & Using the Data

©2010 DaVita Inc. All rights reserved. Proprietary and confidential. For internal use only. 2

What are most employers measuring?g

Question…Are you asked by your senior leadership to provide measurable results in your wellness programs?

Question…

y p g

For Example...o a p e- Participation

- Satisfaction

- Improvement in biometric data

- Reduced utilization in certain areas

©2010 DaVita Inc. All rights reserved. Proprietary and confidential. For internal use only.

- Reduced medical claims trend

3

Typical types of measurement

ROI Did benefits or savings outweigh the investment?

Long-Term(18 to 60 months)

Medical costsH lth t d

Outcome Did we alter health or business outcomes? Intermediate

Health care trendOrganizational culture

ROI

Impact Did we change levels of risk or behaviors?

(12 to 24 months)Risk, Risk MigrationAbsence, Disability

Workers’ CompTurnover

Sh t TAttitude

p

Did we change attitudes, readiness or opinions?

g TurnoverPerformance, Productivity

Preliminary ROI

Short-Term

(0 to 12 months)AwarenessUtilization

SatisfactionProcess Did we get high levels of participation?

Did we change attitudes, readiness or opinions?


SatisfactionKnowledge, Readiness,

AttitudesBaseline analysis

Process g g p pAre vendors performing?

4

New thinking around measurement

Old Thinking: measuring in silos and how many different tools can be introducedtools can be introduced

New Thinking: understanding health care that emphasizes wholes rather than parts and stresses the role ofwholes rather than parts, and stresses the role of interconnections; using a designated process and approach to create the optimal health measurement plan and metrics

Does it really matter where savings and health y gimprovement comes from; as long as health

improves and savings occur?!


p g

5

About DaVita

DaVita Inc., a Fortune 500® company,DaVita Inc., a Fortune 500® company,Leading provider of kidney care; delivering dialysis services to patients

with chronic kidney failure and end stage renal disease.

44,000 Teammates

2,000 outpatient dialysis centers and145,000 patients in U.S.

15 outpatient dialysis centers and 400 patients in 3 countries


At DaVita we call it “Village Vitality”


Village Vitality tools and resources

National Online Campaigns – focus is on physical activity, nutrition and other modifiable behaviors

Vitality Points – earn points and lower health insurance premiums –includes biometric screenings, HRA completion and taking action.includes biometric screenings, HRA completion and taking action.

Cigna Wellness Team – Dedicated Wellness Team, Lifestyle Management Programs Health Assessment etcManagement Programs, Health Assessment, etc.

We Are Well Award – Awards one year FREE health insurance i t t t f b i l d lpremiums to teammates for being role models.

Wellness Champions – local advocates for Village Vitality.


Wellness Champions local advocates for Village Vitality.

8

Village Vitality is part of our culture


The Question

Question:What does our CEO Want to See…?Question:

Answer:It just depends, so be prepared for anything!

Being prepared means “Knowing DaVita’s Numbers”


Be Prepared

Steps to “Knowing DaVita’s Numbers”Steps to Knowing DaVita s Numbers

Step 1: Step 2: Step 3:

Identify data sources & key analytic drill-

Identify and populate key

Document methodologyanalytic drill

downsmetrics

methodology


Step 1: Identify Data Sources

Data sources used collectively and independently

1. Biometric screening results

2. Cigna Health AssessmentMedical & Rx Claims

3. Data Warehouse/Claims

4. Wellness Program participationHealth

Demographic&

Engagementparticipation

5. Cigna Health Team Reports

6. TM feedback

Health Intelligence on Demand

Health Status and Risks 6. TM feedback

7. Disability claims

8. Performance scoresSTD/ LTD / LOA & PDR

D t


9. Absenteeism ratesData

12

Step 1: Identify Key Analytics

More Aggressive and Action-able Measurement & Monitoring

Health Intelligence

Health Risk Living Well

Segmentation Carrier / Plan bi ti

Continuously Enrolled

gon Demand

StatusSegmentation

Profiles combinations

Pre-High Cost Cl i t & Hi h

Enrolled Indicator

Absence Annual Performance

Health ImprovementClaimant & High

Cost indicatorsCategories

Site-specific Di i i ll Top Location

Performance Review Rating

Improvement Program

R i l ll


wellness participation

Division roll-ups Top Location roll-ups

Regional roll-ups

13

Step 2: Identify & Populate Key Metrics

Key Metrics Key Metrics

1. Clinical

2. Financial

3. Health Engagement

4. Lifestyle Behaviors

5. Wellness Culture

Key Metrics are supported by Key Indicators


Clinical Key Indicators

Clinical Key IndicatorsClinical Key IndicatorsM i l i h l h f h l h h k ib i diM i l i h l h f h l h h k ib i di

Metric 2010-DVA Baseline 2011 Result ~TM Movement

Moving people into healthy ranges for health measurements that are key contributors to more serious disease states. Moving people into healthy ranges for health measurements that are key contributors to more serious disease states.

TMs with Bp of <= 120/80 33% ~172

TMs with Bp of <= 140/90 76% ~523

36%

80%p /

TMs w/ elevated TC/HDL RatioF <4.4 / M <5.0

M: 35% ~70

F 20% 6417%

31%

F: 20% ~64

TMs w/BMI >=30 or waist F <=35” / M <=40” 38.6% ~13

17%

38.8%


TMs w/BMI <=25 29% 029%15

Step 3: Document Methodology

Clinical Indicators: MethodologyClinical Indicators: MethodologyClinical Indicators: MethodologyClinical Indicators: Methodology

Metric Data Sources Measurement Methods Frequency Data 2010 Data 2011The proportion of teammates who have a blood pressure of ≤140/90

OHD Biometric Screening Data or Annual Report

Data from DaVita biometric screening report will identify percentage of participants with normal blood pressure defined as systolic pressure <140mmHg and diastolic pressure

Annual 14,30618,728

76 4%

11,87314,868

79 9%<90mmHg.

The numerator is the number of participants with normal blood pressure and the denominator is the total benefit participants participating in the biometric screenings.

76.4% 79.9%

Example©2010 DaVita Inc. All rights reserved. Proprietary and confidential. For internal use only. 16

Example

Using the Data

• Incentive development• Incentive development• Plan design; renewal• Budget• Vendor evaluation

P liInternally

• Policy• Business integration and partnerships internally• Communication; targeted and impact to cost

y

• Recognition/awardsE t ll • Recognition/awards• Community involvementExternally


More DaVita Examples

Health Risks - Snapshot

Represents 22,000+ TMsTotal TM Population Snapshot

Self Reported Risks(Cigna HRA)

Grade 2010 vs.

2011 movement

2010 2011

Weight 48% 48%

Total TM Population Snapshot

e g t 48% 48%

Blood Pressure 25% 26%

Stress 16% 16%

Positive Movement Having positive impact on annual trend!

Physical Activity 13% 11%

Biometrics Risks – Out of Range

(Vitality Screenings)

W i ht 71% 71%

2010-2011 Screening results shows improvement in two key risk categories:

Weight 71% 71%

Blood Pressure 67% 64%

Blood Sugar 13% 19%

• Blood Pressure – 2,600 TMs• Cholesterol – 2,700 TMs

More in-depth analysis, including metrics, fin n i l imp t nd p e h oni g o p


Cholesterol/HDL Ratio 17% 14%financial impact and pre-chronic groups

during renewal mtg.

18

Where Did Our Risk Migrate?

Positive Risk Migration 6.9%Negative Risk Migration 8.3%

74.5% 75.0%

60%

80% *excludes new enrollees/claimants (may not total100%)

Period 1 (‘10) Period 2 (‘11) % change

11.8% 10.0%1.0%

10.8% 10.3%1.1%

0%

20%

40%

Period 1 ( 10) Period 2 ( 11) % changeLow Risk Moderate Risk High Risk Extreme High Risk

Prior Year Current Year

$372 PEPYAvg Age 35.8

$2,455 PEPYAvg Age 44.1



• While 82.1% of teammates’ risk level remained status quo• 6.9% saw a positive risk migration


6.9% saw a positive risk migration • 8.3% saw a negative risk migration

Able to show a positive change

Risk for High and Moderate Groups are moving in the right direction

$3,739 PEPY

$4,018 PEPY

$3,761 PEPY

$2,439 PEPY

$6,244 PEPY

$4,766 PEPY

$4,047 PEPY

$3,809 PEPY

$3,325 PEPY

81% 74%67% 65%

50%36%

80% 73% 66% 60%48%

35%40%

60%

80%

100%1.3% ↓ 1.1% ↓ 1.5% ↓ 0.1% ↑8.4% ↓0.8% ↓0.6% ↓ 4.4% ↓ 1.4% ↓

20%8%

1%11% 7% 1%

0%

20%

40%

Nutrition Weight Physical Activity

Blood Pressure

Cholesterol Stress Blood Sugar Tobacco Usage

Alcoholy g

Prior Year Current Year

2010 - 2011


2010 2011

20

Individual Health & Absenteeism

Correlation between absenteeism and risk factors

Meets (54%)

Above (43%)• 96% HRQ Participation • 51% at High Risk• 38% Obese

B l (3%)

• 95% HRQ Participation • 53% at High Risk• 43% Obese• 25% pre-diabetics

8% Hi h b

%• 23% pre-diabetics• 6% High absence• $2892 Med Paid/TM

Below (3%)• 91% HRQ Participation • 57% at High Risk• 47% Obese• 28% pre-diabetics

• 8% High absence• $3081 Med Paid/TM


• 28% pre diabetics• 11% High absence• $4182 Med Paid/TM

21

Putting It All Together

1. Be proactive in your data analysisSenior Leadership may ask for anything anytime!- Senior Leadership may ask for anything, anytime!

2. Adopt evidence-based decision making- Value-Based Plan Design: additional coverage for certainValue Based Plan Design: additional coverage for certain

preventive medicines- Design of wellness program incentives based on biggest

challengeschallenges- Addition of some pilot programs based on identification of pre-

chronics, chronics, and those with metabolic syndrome

3 R b t fi d d t3. Remember to refine and update

4. Avoid the silos – look for data correlations and ask “why”If data is available include it in our overall measurement


- If data is available, include it in our overall measurement

22

Questions ?Questions ?


DaVita’s Village Vitality - DFWBGH · DaVita’s Village Vitality Measuring Wellness Program...

Documents

Transcript of DaVita’s Village Vitality - DFWBGH · DaVita’s Village Vitality Measuring Wellness Program...