A Consumer Centered Health Plan

Our Vision Mercy Health Plans is an innovative health management company. We facilitate the effective delivery of healthcare and provide services that empower members to make healthy choices. We are driven by the need to increase access to quality care, provide excellent service and demonstrate significant value to those we serve.

30%60 million20 years obese 30% of US adults --or 60 million people-- 20 years of age and older are obese. cost of heart disease $403 billion in The cost of heart disease and stroke in the US is projected to be $403 billion in smoking 1 in every 5 deaths each year. Cigarette smoking is the leading preventable cause of death in the US, accounting for approximately 1 in every 5 deaths each year. The cost of unhealthy behaviors *according to the Centers for Disease Control

average medical plan A 2005 Kaiser Family Foundation survey of 2,995 employers showed that the average medical plan premium for family coverage is $10,800 a year… exceeds the annual …This costs now exceeds the annual pay for a minimum wage employee. Health costs: CEOs number one expense challenge

premium increasesHuge premium increases year after year. insurer to insurerJumping from insurer to insurer. Constant adjustmentsConstant adjustments of benefit options to help control healthcare costs. increased absenteeism.Unhealthy employees and increased absenteeism. Does this sound familiar?

Consumer directed healthcare… Is it the answer? Is it the answer? Key Components: Reduced benefits Increased copayments Cost-shifting to the consumer The Outcome: Consumers forgo needed medical care Harms patients with chronic conditions Cost of bad behavior is shared by all

The Right Solution Instead of shifting costs or blame, we need to shift our thinking… Employees need to view health insurance as contract with mutual responsibilities, NOT just an employer-sponsored benefit.

MyChoice is the Solution engage employees personal responsibility accountability It’s designed to engage employees, and emphasize their need to take personal responsibility and accountability for their health and lifestyle choices. influence better health, high-quality smarter health coverage. It’s a way for employers to influence better health, while protecting their ability to offer high-quality, smarter health coverage.

Why is MyChoice the solution? improve the overall health It will improve the overall health of an entire member population; - including those consumers who are not currently at serious risk and are not major drivers of healthcare costs. reduce the costelement Over time, you would be able to systematically reduce the cost element of the healthcare system. Lower costslower premiumsmore affordable coverage Lower costs, in turn, translate to lower premiums and more affordable coverage for employers.

Why it’s a smart choice for employers Higher productivity and job performance Lower absenteeism and presenteeism Improved morale Lower health care costs Higher employer job satisfaction and retention

How does MyChoice work? Participating employees and covered spouses must: Be willing to take responsibility for their health Use a secure web-based Personal Health Record to monitor their progress towards achieving health goals.

3 Steps of Participation Personal Health Record Step One: MyChoice Eligibility Questionnaire Step Two: My Plan for Health Step Three: Health Risk Assessment

Eligibility Questionnaire The employee and spouse must take and pass the eligibility questionnaire by agreeing to follow certain lifestyle behaviors. The questionnaire is taken yearly during the MyChoice open enrollment period. Question topics include: Question topics include: Seat Belt Usage Tobacco Usage Obesity Blood Pressure Cholesterol Diabetes Preventive Screenings

My Plan for Health A personal plan for health will be generated from your answers to the eligibility questionnaire. -Examples of health activities include cholesterol test, colon cancer screening, tobacco cessation program, and mammography. Throughout the year, the employee and spouse will login to a secure website and enter the date that the health activity was completed. Participating employees and spouses will be required to complete these health activities in order to be eligible for the MyChoice benefit plan the following year.

Health Risk Assessment (HRA) The HRA is a health and lifestyle questionnaire. The answers to these questions form a personalized Health Analysis Report, which includes a good habit score. Recommendations from the Health Analysis can be used to develop health and wellness goals for the upcoming year.

Healthwise Knowledgebase Highlights Access to thousands of topics including: - Health conditions; - Medical tests and procedures; - Medications; and - Everyday health and wellness issues.

What’s in it for the employees? Healthier, more productive lives A sense of mutual responsibility in their healthcare Increased benefits Decreased premiums and copayments

MyChoice Benefit Options Option A: Selection based on benefit levels Option B: Selection based on contribution levels Option C: Selection based on both benefit and contribution levels

The correlation between incentives and adoption The optimal reward amount should be just enough to tip the balance. Employees must perceive the difference in either benefit or contribution levels to be significant.

Results: what is the outcome of using MyChoice? given the opportunity they embrace it.When members are given the opportunity – with incentives – and the appropriate tools to take responsibility for improving their personal health, they embrace it. focuses on wellness and rewardsThis enables employers to foster a culture that focuses on wellness and rewards employees who get and stay healthy. healthier employeesspend less Ultimately, healthier employees spend less on healthcare services.

MyChoice Results

Keys to your Success Employer support and accountability Employee education and responsibility Incentives in the form of richer benefits and reduced copays

Why you can’t afford not to use MyChoice Shifting costscan hurt Shifting costs to employees can hurt employee morale and commitment and will not solve the cost problem. Poor lifestylesill health Poor lifestyles lead to ill health. Indirect costs of poor health can be more costly Indirect costs of poor health – incidental absence, disability, and presenteeism – can be more costly than medical and drug costs. Healthy employees cost the least Healthy employees (and dependents) consume fewer services and cost the least.

The Bottom Line Healthy employees mean more productive employees, a result every employer wants.

A Final Thought Employers invest large amounts of money in training, computers, and pay-for-performance to maximize employee output… Shouldn’t employers also invest in the health of their employees to improve both the quality and value of the goods and services they produce?