OEBB Well-being Program - Oregon Documents/OEBB...Medical carrier -agnostic well -being platform for...

OEBB Well-being ProgramStrategy and Vendor Review

October 2, 2018

SEOW Attachment 2

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This document was prepared for OEBB’s purposes only and should not be considered a substitute for specific professional advice. In particular, its contents are not intended by Willis Towers Watson to be construed as the provision of investment, legal, accounting, tax or other professional advice or recommendations of any kind, or to form the basis of any decision to do or to refrain from doing anything. As such, this document should not be relied upon for investment or other financial decisions and no such decisions should be taken on the basis of its contents without seeking specific advice.This document is based on information available to Willis Towers Watson at the date of issue, and takes no account of subsequent developments. In addition, past performance is not indicative of future results. In producing this document Willis Towers Watson has relied upon the accuracy and completeness of certain data and information obtained from third parties. This document may not be reproduced or distributed to any other party, whether in whole or in part, without Willis Towers Watson’s prior written permission, except as may be required by law.

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Agenda

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Wellness program subgroup work Summary of key findings, opportunities, challenges Detailed findings



Executive Summary

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OEBB Wellness Program Subgroup Work

Background:In 2017, OEBB established a subgroup to formally review its current health risk-based well-being offerings to determine overall strategy, baseline metrics, communication opportunities, vendor / market review, member awareness and interests and identify gaps or duplicative offerings.

Milestones of the review: Creation of well-being program Mission statement, goals and strategies Identification of stakeholders Establishment of collaborative workgroups including representatives from OEBB, OEBB staff, OEA

Choice Trust, Kaiser, and Moda and Willis Towers Watson consultants Comprehensive review of all vendors, program offerings, communications, participation and

outcomes Review of incentive program options Vendor communications audit Focus groups with members at the statewide annual Oregon School Employee Wellness Conference

as well as fielded an employee interest survey



Executive Summary

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Key Findings

Participation and engagement Overall participation is low Completion/engagement rates for programs is low Lack of uniformity among vendors in definitions of participation, engagement, eligibility and outcomes OEBB members primarily use Kaiser and Moda wellness offerings for chronic condition education

and management Highest interest / awareness among members is with Weight Watchers and Healthy Futures

Vendors and programs OEBB’s current wellness vendor partners have top tier resources, tools and tracking mechanisms Healthy Team Healthy U (HTHU) / Provata was acquired by StayWell, Q4 2017. Opportunity exists

for an evaluation of new offerings and pricing structure. Weight Watchers has received the CDC designation of a Diabetes Prevention Program, DPP There are duplicative efforts from vendors to address various health risks:

Diabetes prevention — Weight Watchers and Virtual Lifestyle Management (VLM), VLM (StayWell has a buy-up option)

Weight management — Kaiser, Moda, Weight Watchers, HTHU (StayWell), VLM Blood pressure — Kaiser, Moda, StayWell, VLM Chronic conditions — Kaiser, Moda, Canary Health’s Better Choices Better Health (BCBH)



Executive Summary

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Key Findings

Value to OEBB members OEBB Members want wellness information and resources from OEBB Addressing stress and resiliency is a key theme — and an area of opportunity for additional focus Highest member awareness of Weight Watchers and Healthy Futures Need for additional communication/outreach efforts Need for established analytics and metrics related to outcomes

Support of entity workplace wellness efforts Lack of coordination or communication with entities Program management responsibilities are, most often, at the entity level with few dedicated

coordinators Cohesive communication of programs is a key need for both the entities and members Entities have a responsibility to create an environment where policy and practice support well-being.

A successful worksite wellness program has a culture that integrates wellness as a core value embraced by leadership, supervisors and co-workers.



Executive Summary — Recommendations

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Stay the Course …

Keep the following vendors in place based on offerings and engagement: Kaiser and Moda’s chronic condition management programs Weight Watchers StayWell (HTHU)

Work with each vendor to: Define engagement, outcomes, etc. Increase completion/engagement rates Enhance reporting to demonstrate program effectiveness Work collaboratively with OEBB’s vendor / partner ecosystem Establish metrics for measurement — value of investment (VOI) and return on investment (ROI)

Monitor Canary Health’s BCBH and VLM programs for cost/benefit analysis

Implement grants funded by Kaiser Innovation Fund: Stress and resiliency app for all members Onsite flu shot clinics Entity well-being rooms (select locations)



Executive Summary — Recommendations

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Key Opportunities

Increase the frequency and coordination of communications to OEBB members: Quarterly wellness newsletters with topical themes that coordinate with carriers efforts Digital tools such as a mobile app or targeted e-mails Well-being program tool-kits for members to help to educate and direct members to resources Well-being program tool-kits for entities to help develop new or enhance existing programs

Review expanded capabilities with worksite wellness vendor: Ability to target and segment populations Medical carrier-agnostic well-being platform for programs as well as educational resource for

additional benefits (i.e., triage members to carrier program, if appropriate) Available to all OEBB members or as a value add for entities with formal workplace wellness

programs?

Explore options for supporting Entity workplace wellness efforts Dedicated OEBB resource/employee to coordinate OEBB wellness programs and provide entities

with advice, support and resources to complement entity-specific efforts



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Condition Specific Vendors and Recommendations

Detailed Findings

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Chronic Condition Management

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OEBB’s Top Chronic Conditions:Cancer: 9% Moda; 5% KaiserArthritis: 18% BSSEDepression: 12% BSSEDiabetes: 6% BSSE

Both Moda and Kaiser have condition management programs in place to address these issues, as well as Canary Health’s ‘Better Choices Better Health’ (BCBH) and Virtual Lifestyle Management (VLM) Programs designed to address chronic and lifestyle related conditions

OEBB member participation in Moda/Kaiser chronic condition programs was higher than member participation in carrier traditional wellness programs

Market review — condition specific vendors are increasing in the market with per participant pricing and performance guarantees. OEBB members have access to BCBH and VLM — both of which are top-tier vendors.

Strategies/Recommendations: Enhance communication strategies, modalities and targeted outreach Leverage the data of the current 500 BCBH members and 800 VLM members as baseline measurements and

measure participation, risk reduction and potential claims analytics from carrier partners Goals — work with Moda, Kaiser and Canary Health to establish cohesive reporting / metrics around eligible, targeted

outreach, enrollment, participation and outcomes. Goal of 100% outreach to eligible members and increase in year-over-year participation.

Potential ROI analysis with this population via claims and verified risk reduction Review data warehouse opportunities for medical and Rx analysis

Engagement in Moda’s diabetes care management program was 18% of identified population

(5% greater than benchmark)



Lifestyle Conditions

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OEBB’s Top Lifestyle Conditions:Overweight / Obese: +31% BSSE and KaiserHigh Cholesterol: ~20% BSSEHigh Blood Pressure: ~24% BSSEPrediabetes: 37% Kaiser

OEBB offers a range of well-being programs to address a variety of lifestyle-related risks: both Kaiser and Moda have comprehensive programs and education (Online/digital and coaching), StayWell has individual and team based programs (Online or app), Weight Watchers offers onsite, online and community based programs, as well as VLM’s programs

Overall awareness of OEBB’s well-being program (specifically Healthy Futures) was reported as high, when surveyed, but participation in the individual programs remains low

Market review — new entrants into the well-being space occur daily. OEBB’s current vendors are top tier and evidence-based.

Strategies/Recommendations: Enhance member and entities communications strategy, targeted outreach and implement recommended

communication strategies. Establish member and entity tool-kits to help with the administration of programs. Work with all vendors to establish cohesive reporting definitions and metrics. Insist on enhanced outcomes reporting

from Weight Watchers and VLM. Work with HTHU to remove self-reported data, where possible. Goals — key goals should focus around participation and engagement from both members and entities Potential VOI analysis with this population and potential ROI analysis with Weight Watchers and VLM Review data warehouse opportunities for medical and Rx analysis

Overall engagement / participation in OEBB lifestyle offerings (Carrier, Healthy Team Healthy U, Weight

Watchers, and BCBH) was less than 1% of total population



Weight Management

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Weight management is the top lifestyle related risk factor for OEBB. Some conditions related to obesity include: Diabetes High blood pressure High cholesterol Musculoskeletal issues Higher than average pharmacy spend

OEBB offers a range of weight management programs: Carrier, HTHU, Weight Watchers and VLM Increase in participation and opportunities for outcomes reporting are higher with OEBB’s vendors as opposed to

Kaiser and Moda Communication for both entities and members is key for participation in programs Market review — OEBB’s current vendors are top tier and evidence-based; however, many new entrants have

performance guarantees regarding outcomes / verified weight loss


communication strategies. Establish member and entity tool-kits to help with the administration of programs. Work with all vendors to establish cohesive reporting definitions and metrics. Insist on enhanced outcomes reporting

from Weight Watchers and VLM. Work with HTHU to remove self-reported data, where possible. Goals — key goals should focus around participation and engagement from both members and entities Potential ROI analysis with Weight Watchers and VLM Review data warehouse opportunities for medical and Rx analysis

27% of BSSE respondents indicated they met physical activity guidelines (40% Kaiser)

33% of BSSE respondents indicated they met nutritional guidelines



Blood Pressure and Cholesterol

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High blood pressure and high cholesterol are top lifestyle risks for OEBB. Along with heredity, weight, physical activity and nutrition play a big role in addressing these risks OEBB offers a range of blood pressure and cholesterol management education and programs: Carrier, HTHU,

Weight Watchers, BCBH and VLM Both high blood pressure and high cholesterol are asymptomatic, meaning the conditions do not present symptoms

and are not discovered without a medical evaluation or an emergent episode Monitoring participation in programs, as well as metrics around preventive exams and Rx utilization (statins and

antihypertensives, for example), will be useful in analysis and measurement Market review — OEBB’s current vendors are top tier and evidence-based; however, new entrants in the blood

pressure space provide wireless blood pressure readings and provide guarantees around outcomes and impact


communication strategies. Establish member and entity tool-kits to help with the administration of programs. Explore potential for onsite biometrics at entities and/or promotion of annual physicals to identify risks Work with all vendors to establish cohesive reporting definitions and metrics. Insist on enhanced outcomes reporting

from Weight Watchers, BCBH and VLM. Work with HTHU to remove self-reported data, where possible. Carrier reporting should be around outreach and engagement of targeted populations, medication adherence and others.

Goals — key goals should focus around participation and engagement from both members and entities Potential ROI analysis with Weight Watchers, BCBH and VLM Review data warehouse opportunities for medical and Rx analysis

High Cholesterol: ~20% BSSE (~33% benchmark —CDC)

High Blood Pressure: ~24% BSSE (~30% benchmark —American Heart Association)



Prediabetes

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Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enoughyet to be diagnosed as type 2 diabetes. Approximately 84 million American adults — more than 1 out of 3 —have prediabetes. Of those with prediabetes, 90% don’t know they have it.

OEBB offers VLM to address prediabetes; however, Weight Watchers and StayWell (HTHU) offer similar programs Most diabetes prevention programs, DPPs, are focused around nutrition, physical activity and weight loss Encouraging members to ‘know their numbers’ will aid in the awareness of potential risks and promotion of the

offerings (annual physicals, onsite biometric screenings, etc.) Communication for both entities and members is key for participation in programs

Strategies/Recommendations: Enhance member and entities communications strategy, targeted outreach, and implement recommended

communication strategies. Establish member and entity tool-kits to help with promotion of programs as well as the importance of annual physicals and health status awareness.

Explore potential for onsite biometrics at entities and/or promotion of annual physicals to identify risks Work with all vendors to establish cohesive reporting definitions and metrics. Insist on enhanced outcomes reporting

from VLM including performance guarantees around success metrics. Goals — key goals should focus around participation and engagement from both members and entities Potential ROI analysis with VLM exists Review data warehouse opportunities for medical and Rx analysis

Prediabetes: 37% Kaiser (34% Benchmark — National Institute of Diabetes and Digestive and Kidney Diseases)

Only 11.6% of individuals living with prediabetes know they have the condition — (Centers for Disease Control and Prevention)



Depression, Stress and Resiliency

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Depression impacts millions of adults and has a far-reaching impact on medical, Rx spend, work performance, relationships and beyond

Stress and resiliency was the key topic at the statewide annual Oregon School Employee Wellness Conference EAP programs can assist in directing members to resources and clinicians; however, most systems are complicated

to navigate and provide delayed care The majority, but not all OEBB members have access to EAP services Reducing mental health stigmas and awareness of resources is a key communications goal Market review — OEBB’s has limited offerings in addressing depression and stress and resiliency. The vendor

market has become robust with offerings that range from mindfulness apps; Headspace, Whil, Ginger.IO, Vida health, etc., to concierge EAP-type services who expedite access to clinicians for video or phone therapies

Many telemedicine vendors have branched out to tele-behavioral health offerings Consider Financial Wellness campaigns to help alleviate stress around finances

Strategies/Recommendations: Leverage Kaiser’s grant offering of providing all OEBB members with an app-based stress and resiliency program

(Kaiser is currently reviewing the market to make recommendation). Leverage Kaiser’s offering of creating entity specific wellness rooms for members.

Promote EAP services offered to members, launch campaigns to destigmatize mental health and annual physical where members can access additional care via their primary care physicians

Goals — establish baseline metrics and focus primarily on engagement and awareness

Antidepressant medication was the number 1 Rx class by script count for non-specialty Rx for OEBB Moda members — (Moda data; October 1, 2015 – September 30,

2016)



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Vendor Review and Recommendations

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Current Vendor Review and Recommendations

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OEBB’s current vendors are top tier in the population health marketplace. The array of vendors address the majority of conditions and interests for members across the health spectrum (low risk → case management).Recommendations:Keep Kaiser — leverage Kaiser’s fund to provide stress and resiliency app-base vendor for all OEBB members, onsite flu

shots and onsite wellness spaces at a limited number of entities Kaiser and Moda — work with carriers to enhance reporting, establish definitions around engagement / outcomes,

etc.; target “at-risk” populations based on medical / Rx data [as well as care avoidance (i.e., absences of claims)] to educate programs, coaching and appropriate use of benefits

Kaiser and Moda — leverage carrier wellness consultants and coordinators for entity outreach and promotion of programs

Weight Watchers — Weight Watchers has committed to enhancing their own communications and marketing. Monitor participation and engagement in the three modalities of offerings to determine interest and outcomes. Establish definitions around participation / engagement, etc. and request continued claims analytics (i.e., analysis conducted with Kaiser to support ROI claims)

Weight Watchers — Review Weight Watchers DPP program and compare to current offering Monitor Canary Health — BCBH and VLM — Promote participation and engagement in the program offerings, as well as

establish definitions around both metrics and outcomes metrics. Work with carriers or potential data warehouse to provide claims analysis to support ROI claims. Monitor program engagement and impact for cost/benefit analysis.



Current Vendor Review and Recommendations (Continued)

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Healthy Team Healthy U HTHU’s company, Provata Health, was acquired by StayWell (parent company Merck Rx.) in November 2017. StayWell’s health education materials are found in most U.S. hospitals and health care centers. The combination of the two companies provides new options for OEBB to explore

Recommendations: Review pricing options. Explore potential to offer the program on an entity specific basis as support

for entity worksite wellness program Remove as much self-reported data as possible. This will aid in the credibility of outcomes reporting,

and any medical Rx claims analysis. Consider enhanced capabilities from Staywell (HTHU) or other vendors available in the market to

provide: Enhanced member platform and app to create entity specific content, carrier specific messaging

and targeting of services, for example; a member who has data indicating high blood pressure will be automatically provided addition information around their medical carrier’s hypertension programs as well as any additional programs (i.e., BCBH)



Strategic Roadmap

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OEBB’s wellness subgroups identifies the following key strategic initiatives: Select and offer wellness benefits and programs that target OEBB's risk factors Develop and monitor wellness programs/benefits participation, engagement and outcome goals

annually Develop a resource center/toolkit for entities to be used in collaboration with an entity or school

District’s own workplace wellness efforts Create a resource center/toolkit for members to help them find the right wellness program resources Create and implement an outreach plan to increase awareness and promote engagement of OEBB’s

wellness resources, programs and benefits Collaborate with stakeholders in the design, promotion and engagement of OEBB members in OEBB

wellness programs/benefits Facilitate a meeting of OEBB’s wellness vendor and carrier partners (vendor summit) to ensure all of

OEBB’s carrier partners understand OEBB’s wellness program goals and foster collaboration Implement and monitor strategies ongoing



OEBB Worksite Flu Shot Clinics2018-19

Glenn BalyProgram/Policy Liaison

SEOW Attachment 3October 2, 2018

Agenda

• Background on OEBB Flu Shot Options• OEBB Worksite Flu Shot Clinics – Process &

Participation• Next Steps

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OEBB Flu Shot OptionsBackground

• Flu vaccination is low among OEBB members and Oregonians– 45% of Oregonians received flu vaccinations in 2016-17.– 1/3 of Kaiser OEBB members received vaccinations– 59% of Moda members (commercial) received vaccinations

• Flu Shot Options prior to 2018-19– Kaiser – Vaccinations available at Kaiser facilities. Worksite flu shot

clinics were available upon request at an additional cost– Moda – Vaccinations available at no cost through contracted

providers, pharmacies and onsite flu shot clinics • In 2018, Kaiser proposed no cost worksite flu shot clinics for Kaiser

members as part of the Kaiser Innovation Fund.

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OEBB Flu Shot ClinicsProcess & Eligibility

• GetAFluShot.com will administer no-cost flu shot clinics at OEBB worksites with 10 or more expected participants.

• Clinics will be conducted between September and December• Entities can schedule clinics through GetAFluShot.com website or

phone.• Clinics are open to subscribers and dependents 18 years old or

older who are enrolled in an OEBB medical plan or one of the nine health plans subcontracted with GetAFluShot.com. Members may also pay directly at the clinic.

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OEBB Flu Shot ClinicsCommunications & Participation

• OEBB flu shot webpage with clinic and vaccination options information.

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OEBB Flu Shot ClinicsCommunications & Participation (contin.)

• Entity representatives e-mailed about availability and process for scheduling worksite flu shot clinics.

• Worksites have already started scheduling onsite flu shot clinics.

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OEBB Worksite Flu Shot ClinicsNext Steps• Frequent communications. OEBB to regularly e-mail

entities about the availability and process for scheduling worksite flu shot clinics.

• Monitor administration and address any issues.• Evaluate participation in the worksite flu shot clinics and

make recommendations on future utilization

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OEBB Well-being Program - Oregon Documents/OEBB...Medical carrier -agnostic well -being platform for...

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