1. The Trust and MiPCT Partnerships in Health Care Innovation
Devorah E. Rich, PhD
Senior Program Director
UAW Retiree Medical Benefits Trust

2. The mission of the Trust is to serve as a source for retiree health care coverage for its members:
Creating a new model of health care for retirees
Partnering with members, health plans, and providers to improve the health and quality of life for retirees
Prudent purchaser of health benefits focused on providing the best value for its members
Responsible steward of the fund’s assets

3. The Trust … Manages health care benefits for 820,000 members
Uses data to identify opportunities
Actively engages in partnerships that test and spreads innovations in health care delivery
Must live within its means, now and in the future
Trust has created a data warehouse
We have continuous data on our retirees over their lives to support research and measure impact of interventions

4. Who We Serve

5. Membership Demographics Trust Population by State
WI 2.6%
MI 40.4%
NY 4.5%
IL 2.3%
OH 11.8%
CA 1.3%
IN 8.7%
NJ 1.3%
MO 4.0%
KY 1.9%
TN 2.3%
There are UAW VEBA members in every state.
The picture below shows the states with significant numbers of our members.
AL 1.5%
GA 2.5%
TX 1.6%
Top 10 states (yellow + gold) – 83% of population
Top 15 states (yellow + blue) – 90% of population
FL 3.7%
1% is approximately 8,300 covered lives

6. Multi-Generational Trust Also called Traditional or Veterans
Membership
Also called Traditional or Veterans
Baby Boomers
Born X Y Z
Silent Generation
Born
Children of the Great Depression
G.I Generation
Born
WWII Veterans
Pre-65
Post-65
Current Dependents
Future Retirees
104,000
145,000
149,000
Membership facts:
Trust members make up more than 521,000 households
- Single people represent 48% of all households, there are 40,700 dependent children
Age of the population ranges from zero to 112
- 58% of all members are 65 or older
- 25% are 75 or older
- Approximately 20,000 members (2.4%) are 90 or older (71% women)
Approximately 2,000 members die each month
64% of members are covered by Medicare and 36% are pre-Medicare
Members covered by Medicare will steadily increase with the aging of the population (approximately 34,500 will turn 65 in 2012, 30,000 in 2013)
117,000
101,000
87,000
55,000
64,000
48,000
58,000
Figures rounded to nearest thousand
as of December 2011
Member Age Buckets

7. Trust Demographics Over 521,000 households Age ranges from zero to 112
Single people represent 48% of all households
40,700 dependent children
Age ranges from zero to 112
58% of members are 65 or older
25% are 75 or older
Approximately 20,000 members (2.4%) are 90 or older (71% women)
- 46,304 of the 519,537 Medicare members are under 65 (8.9%)
- These 46,304 represent 5.6% of the total Trust population.

8. Future Demographics Approximately 2,000 members die each month
64% of members covered by Medicare
Future retirees: Potentially 104,000
Medicare Members will increase with aging of population
34,500 turn 65 in 2012
30,000 turn 65 in in 2013

9. Trust Membership in Major Michigan Metropolitan Service Areas
Total Membership Count by MSA Groupings
MSA Groupings
Total Member Count
Michigan - Detroit MSA
86,111
Michigan - Northern Oakland MSA
82,908
Michigan - Flint MSA
72,306
Michigan - Lansing MSA
27,987
Michigan - Grand Rapids MSA
12,445
Total MSA Group Count in Michigan
281,757
Trust Population in MiPCT practices
15,296
Population is concentrated in a small set of metropolitan areas

10. Estimated Yearly Health Care Spend
______________
$4.4 Billion
Medical
Pharmacy
Health care spend was $4.6 billion in 2010.
This was all we knew about the population at the time of the Trust initiation – no claims data 10

11. Annual Medical Spend
Medical spend: 68% of Trust’s total health care spend
Approximately 168,000 admissions
Over 262,000 emergency room visits
Variation in care and quality evident across markets and care providers

12. Trust Annual Pharmacy Spend
Pharmacy spend: 32% of Trust’s total health care spend
14 million prescriptions filled in 2011
Increased generic utilization rate from 68% to 80%
47% of Trust Medicare members take 10 or more prescriptions
Confirmed that 12% are not receiving prescriptions through the Trust pharmacy benefit, probably driven by the younger portions of the population served by the Trust
Source: Medco 2011

13. Patient Stratification Utilizing Pharmacy Data
Patient Care Needs
Constipation/ Hemorrhoids, Contraception/ Hormone Therapy, Skin Conditions
Well
Provides specialized patient-centric care for members with chronic or complex conditions.
76.2% of the population are Chronic or Complex patients
Chronic and Complex represent 99.5% of Plan Cost
Colds & Flu, Strep Throat, Ear Infection, Headache, Sprains
Acute
Heart Disease, Diabetes, Arthritis, High Blood Pressure, High Cholesterol, Dementia, Back Pain
Chronic
Multiple Chronic Conditions such as Heart Failure & Diabetes, Cancer, AIDS, Multiple Sclerosis, Metabolic Syndrome
Complex
Source: Medco Q 13

14. MiPCT Matters to the Trust
75% of members have chronic disease
Trust provides member coverage over their lifetime
Trust manages its resources to provide coverage for many years into the future
Need innovative models that engage patients in managing chronic disease
As members age into Medicare, Medicare picks up a portion of the cost but the Trust is responsible for pharmaceutical costs.
Source: Medco 2011

15. Trust Active MiPCT Supporter
Steering Committee
Data and Evaluation Committee
Incentive Working Group
Patient Advisory Council—Co-Chair
Confirmed that 12% are not receiving prescriptions through the Trust pharmacy benefit, probably driven by the younger portions of the population served by the Trust
Source: Medco 2011

16. Measurable Results Paramount
Trust has a wealth of data
Trust uses data to show variation and opportunities
Key improvement areas:
Radiology
Avoidable Admissions
ER Utilization
Cancer
Diabetes
Advance Illness management
Confirmed that 12% are not receiving prescriptions through the Trust pharmacy benefit, probably driven by the younger portions of the population served by the Trust
Source: Medco 2011

17. Road to Best Value for Members
A new model of health care
Driving innovations in care
Providing measurable value based upon the Triple Aim:
Superior Quality
Superior Customer Experience
Affordable Care
MiPCT affords opportunity to manage patients with chronic disease
A new model requires engaging patients and families to help them maintain health, and address health issues that are specific to this population
MiPCT affords opportunity to manage patients with chronic disease
Manage complex chronic members
Keep moderate chronically ill members from deteriorating

18. Impact of Chronic Disease Management
Reduced Emergency Room visits
Reduced avoidable hospitalizations
Reduced readmissions
Healthier retirement
Sustainability of Trust funding over time

20. The Golden Years
Source: Medco 2011