Questions???

Why Wellness?Are You Feeling Lucky? Karen Hewitt, MBA May 6, 2011

4Blue Cross Blue Shield of Massachusetts

Cover Illustration, The Economist, Dec 13, 2002.Reference: Slide From Presentation entitled Antipsychotic Agents and Metabolic Syndrome by David C. Henderson, M.D MGH Harvard Medical School

The Evolution of UsThe Evolution of Us

5Blue Cross Blue Shield of Massachusetts

Major Cost Drivers in Healthcare

The CDC states that many chronic diseases can be eliminated or prevented by addressing these three risk factors

•Poor Diet•Smoking •Inactivity

Addressing these Factors would prevent•80 % of Heart disease cases•80% of type II diabetes cases•40% of cancer cases

Reference: Preventing Chronic diseases in the united states and abroad. Center for prevention and health services. Issue brief . December 2006Reference:http://www.cdc.gov/nccdphp/overview.htm#relatedReference: Massachusetts: Burden of Chronic Diseases. CDC 2008

6Blue Cross Blue Shield of Massachusetts

7Blue Cross Blue Shield of Massachusetts

8Blue Cross Blue Shield of Massachusetts

Major Cost Drivers in Healthcare

Lack of Regular Exercise, Poor Diet, Obesity and Smoking are the major levers to address a reduction of our medical spend on Chronic diseases.

Risk Factors for Chronic Diseases in MA • 59% of Adults and 15% of High School students in MA were overweight or Obese• 49% of Adults in MA were not engaged in enough physical activity• 73% of Adults in MA diets had less than 5 fruits and vegetables per day• 16% of Adults and 18% of High School students reported being smokers• 26% of Adults reported having High Blood pressure• 36% of those screened had high cholesterol • 7% reported having Diabetes (non-pregnancy related)

“If current trends continue, 1 in 3 Americans will develop diabetes sometime in their lifetime, and those with diabetes will lose, on average, 10–15 years of life.” http://www.cdc.gov/nccdphp/publications/aag/ddt.htm

9Blue Cross Blue Shield of Massachusetts

Our Solutions toImprove Health and Reduce Costs

Work with Employers to offer programs and interventions that address the lifestyles and behaviors that lead to chronic diseases.

As a health insurer we align our strategies to address the problem earlier in the continuum long before it shows up in our claims

When considering our members’ health; we take a proactive vs. reactive approach!

This strategy allows us reduce risks that lead to chronic disease and high costs.

“Although Chronic diseases are among the most common and costly health problems, they are also among the most preventable.”

Reference: http://www.cdc.gov/nccdphp/

10Blue Cross Blue Shield of Massachusetts

An Employer Experience

Gateway Health GroupPatrick W. MeagherAssistant Superintendent for Business & FinanceCarver Public Schools

11Blue Cross Blue Shield of Massachusetts

Gateway Health GroupWellness Incentive Program

Colonoscopy: $50 gift cardMammogram: $25 gift cardBiometric Screenings: $50 gift card raffle

—Cholesterol and Blood pressure

12Blue Cross Blue Shield of Massachusetts

13Blue Cross Blue Shield of Massachusetts

Results

78 employees participated in the program 67 had a mammogram 60 entered the screening drawing 29 had a colonoscopy