1. Manatee County Utilities Department Manatee County Administrator’s Office Manatee County Government Kim Stroud, Benefit Manager Manatee County Government Bradenton, Florida

2. Manatee County Utilities Department Manatee County Administrator’s Office YourChoice Plan Overview 4 Plan Options-All Plans have the same premium and same coverage. Member out of pocket is different. –Ultimate/Best/Better/Basic Member selects plan based upon completion of preventative care: –Full Lab Draw-Diabetes/Tobacco –Health Risk Assessment –Wellness Physical –Age-Based Screening (Colonoscopy, Mammogram, etc) –Diabetes and Tobacco Requirements 97% complete Lab, HRA and Wellness Exam 85% are enrolled in the Ultimate

3. Manatee County Utilities Department Manatee County Administrator’s Office Incentives: Health Bucks Rewards Participation Outcome Examples: –YWeight: $400 1 st Year. Up to $4,600 over 7 years –Cardiac Program: $144 –Blood Pressure Consultation: $75 –Exercise Management: $144 –Mission Control-Diabetes: up to $300 Used for: –Reducing Premiums –Health Care Spending Account (FSA) 3

4. Manatee County Utilities Department Manatee County Administrator’s Office Integrated On-site Programs Member and Plan Design Mental Health Therapists and Case Managers Registered Nurses Nutritionist Diabetic Educator Fitness Specialists Personal Trainers Communication Specialists Clinical Pharmacist 4

5. Manatee County Utilities Department Manatee County Administrator’s Office Clinical Outcomes Behavioral Health –32% overall decrease depression claims-Year 1 and remaining stable –Only 11% are Tobacco Users (FL. Average is 17%) Diabetes –Reduced Diabetes Hospitalization: $500K to $70K and stable Pharmacy Advocate –Patient Savings: $102,113 (annualized) –Plan Savings: $304,738 (annualized) 5

6. Manatee County Utilities Department Manatee County Administrator’s Office Financial Outcome 1.2%-Average trend: over the last four years (2008-6/2012) still well below national annual average of 9%-10%. ( No Network changes and no cost shifting ) 4% Negative Trend : Medical and Rx FY10 vs. FY11 – 9.5% Reduction in chronic care spend – 22% Reduction-Inpatient Hospitalization – 11% Reduction –Emergency Room Plan Paid 6

7. Manatee County Utilities Department Manatee County Administrator’s Office Wellness Campaigns 2011: Know Your Numbers: – Over 2000 enrolled 2012: Change Your Numbers: – Over 1500 enrolled 2011/2012: Yweight: – 2790 enrolled: – Over 1900 completed program – 71% earned a reward between $285-$400 7

8. Manatee County Utilities Department Manatee County Administrator’s Office Progressive Incentive Campaign Goal: Ongoing campaign to incentivize members to engage in long term healthy behaviors that reduce risk factors related to excess weight. CDC Reports: “People who lose weight gradually and steadily are more successful at keeping weight off”.

9. Manatee County Utilities Department Manatee County Administrator’s Office Program Outline Gold Reward: $400-$800 –Maintain a Healthy BMI –Lose 5% w/in the year Silver Reward: $285 –Lose between 2-4.9% Bronze Reward: $200 –Maintain, once a 10% weight loss is achieved Maintenance Reward: $100 –Begins July 2013: Just don’t get worse!

10. Manatee County Utilities Department Manatee County Administrator’s Office Process October 2011-Intial weigh in: –Establishes baseline weight to determine goal for July. July 2012=Weigh Out: –Establishes new weight –Determines goal earned –Sets goal for July 2013 July 2013=Weigh Out Repeats annually

11. Manatee County Utilities Department Manatee County Administrator’s Office

12. Manatee County Utilities Department Manatee County Administrator’s Office 12

13. Manatee County Utilities Department Manatee County Administrator’s Office RESULTS 10,875 lbs. Or 5.4 TONS! 13

14. Manatee County Utilities Department Manatee County Administrator’s Office BMI Change 14

15. Manatee County Utilities Department Manatee County Administrator’s Office Health Benefits of 5-10% Loss Regulated Blood Sugar-prevent Type II Diabetes Improvement in Cholesterol Blood Pressure improves Reduces chances of developing certain cancers Sleep Apnea effects improve 15

16. Manatee County Utilities Department Manatee County Administrator’s Office Participant Feedback “Exercise classes were helpful” “Goals motivate me” “Motivation and Accountability” “ I had a date and a goal to look forward to” “Seeing my coworkers participate helped me stay on track” “Money is a great incentive to get started” “This is a great program, thank you for offering it”. 16

17. Manatee County Utilities Department Manatee County Administrator’s Office What’s Next? Continued progressive weight loss: It’s a Journey! Maintenance First FIT-NUTS-Programming Vendor for engagement 17

18. Manatee County Utilities Department Manatee County Administrator’s Office Questions and Contacts Kim Stroud Employee Health Benefits- Division Manager 941-748-4501 x6432 Kim.Stroud@mymanatee.org www.ManateeYourChoice.com 18