Year End Review New Year Preview

Year End Review New Year Preview
January 21, 2015

Welcome!

Leadership in Action Why? The Action Group is the only Minnesota organization whose sole purpose is to align and represent the collective voice of those who pay the bill for health care – employers, public purchasers and individuals. We drive innovation, collaboration and engagement among these groups in ways that improve health and ensure the economic vitality of all Minnesota communities. The Action Group has a history of innovation as one of the most progressive organizations, and was the first employer-owned health plan that highlighted and offered incentives to providers based on cost and quality differences. There are a number of ways you can get involved at a level that fits your interests, experience and availability. We categorize our work into the areas of Innovation, Collaboration and Engagement, which I will go through next. If you tend to be a joiner, we can find a role for you in one or more of these areas, or you can simply focus on attending events that correlate to your interests.

Congratulations New Board Members!
Ken Horstman Director, Benefits and Compensation Human Resources University of Minnesota Nathan Moracco Assistant Commissioner Human Services Human Services Department State of Minnesota Deidre Serum Director of Employee Benefits Rewards Team / HR / Best Buy Jeremy Zajicek Human Resources Manager Benefits and Staffing Divisions Hennepin County

The Year in Review 2014 Highlights

Our Members We’re excited to celebrate our newest members:
Blue Earth County City of Apple Valley City of Mankato Fairview Health Services Independent School District 196 League of Minnesota Cities Minnesota Inter-County Association Minnesota School Boards Association St. Louis County Wright County The Action Group understands your concerns about health care cost, quality and satisfaction. This is why all of these companies have joined us – to use their collective voice to drive essential marketplace change. Join us in improving health care to benefit your employees…and all Minnesotans.

INNOVATION Care System, Health Plan, Hospital Focused
Bridges to Excellence Care Delivery Learning Network Innovation is related to issues involving care systems, health plans and hospitals. There is always a lot happening in the area of Innovation at the Action Group. One example is the national Choosing Wisely initiative. The Action Group and the Institute for Clinical Systems Improvement have been chosen as the regional Choosing Wisely collaborative to advance campaigns encouraging physician and patient conversations about overuse in health care. We recently launched a co-branded website with ConsumerReports®Health that I can to you if you would like to learn more. Innovation is also where you can get involved with MN Bridges to Excellence. This purchaser-led pay-for-performance program advances both care delivery and outcomes by rewarding clinics for meeting or exceeding a strict set of care standards for patients with diabetes, depression and vascular disease. These are just two examples of many.

Minnesota Bridges to Excellence
MNBTE

Innovating in Minnesota through Collaboration
Champions of Change Best Buy Carlson Companies State of Minnesota Department of Human Services State of Minnesota Employer Group SW/WC Service Cooperative University of Minnesota U.S. Bank Wells Fargo

Leveraging Community Partnerships and Best Practices
Institute for Clinical System Improvement (ICSI) Develops guidelines and drives physician consensus The Action Group understands your concerns about health care cost, quality and satisfaction. This is why all of these companies have joined us – to use their collective voice to drive essential marketplace change. Join us in improving health care to benefit your employees…and all Minnesotans.

Institute for Clinical System Improvement (SCSI) Develops guidelines and drives physician consensus Minnesota Community Measurement (MCMN) Measures development, data aggregation, quality review, performance rates, public reporting for increased transparency The Action Group understands your concerns about health care cost, quality and satisfaction. This is why all of these companies have joined us – to use their collective voice to drive essential marketplace change. Join us in improving health care to benefit your employees…and all Minnesotans.

Institute for Clinical System Improvement (SCSI) Develops guidelines and drives physician consensus Minnesota Community Measurement (MCMN) Measures development, data aggregation, quality review, performance rates, public reporting for increased transparency The Action Group understands your concerns about health care cost, quality and satisfaction. This is why all of these companies have joined us – to use their collective voice to drive essential marketplace change. Join us in improving health care to benefit your employees…and all Minnesotans. Aligned measure specifications used by all payers for rewards Health Plans

Institute for Clinical System Improvement (SCSI) Develops guidelines and drives physician consensus Minnesota Community Measurement (MCMN) Measures development, data aggregation, quality review, performance rates, public reporting for increased transparency The Action Group understands your concerns about health care cost, quality and satisfaction. This is why all of these companies have joined us – to use their collective voice to drive essential marketplace change. Join us in improving health care to benefit your employees…and all Minnesotans. Aligned measure specifications used by all payers for rewards Health Plans Formed guiding coalition of employers, providers, health plans, MMA, ICSI, MNCM, Stratis Health; ensure collaboration, consensus and success of program Guiding Coalition

Minnesota Bridges to Excellence (MNBTE): 2014 Highlights – How it Works
Champions of Change (the purchasers), reward clinics for the delivery of optimal care in diabetes, vascular disease and depression, three conditions that are known to be primary drivers of health care costs. They provide health care coverage to over 900,000 covered lives. Uses Minnesota Community Measurement’s performance rates for three measures that reflect “best care” for these chronic conditions to determine clinic eligibility for rewards. Clinics are eligible for two different types of rewards: Achievement – Clinic meets or exceeds a MNBTE-specific performance target, rewarding the “best of the best”. In 2014 these targets were: 51% for diabetes (state-wide average clinic performance was 39%) 63% for vascular care (state-wide average 50%) 14% for depression remission at six months (state-wide average 8%) Improvement – Clinic improves last year’s performance rate by at least 10 percentage points, motivating lower performing clinics to improve their performance

Minnesota Bridges to Excellence (MNBTE): 2014 Highlights - RESULTS
Record number of clinics rewarded; Champions funded more than $700,000 in reward payments Optimal Diabetes Care: 62 clinics for achievement (highest performance rate – 76.0%); 64 clinics for improvement Optimal Vascular Care: 69 clinics for achievement (highest performance rate – 76.9%); 132 clinics for improvement Depression Six Months: 75 for achievement (highest performance rate – 44.0%); 49 for improvement Of special note, the 12 clinics that met the achievement goals in all three disease states, compared to only 3 in 2013 Allina Health clinics (Centennial Lakes, Richfield, Shoreview, Uptown) Entira Family clinics (Maplewood/Battle Creek, Shoreview, Vadnais Heights, White Bear-Bellaire Avenue) Park Nicollet clinics (Eagan, Maple Grove, Plymouth, Prairie Center) Increase in rewarded clinics directly translates to more Champions’ members receiving “best care:” 5,600 more patients with diabetes 2,700 more patients with vascular disease 850 more patients with moderate-severe depression, as determined by a PHQ-9 score of greater than 9

Care Delivery Learning Network

Learning Network Background
Deep dive into overuse, high cost, and variability Back pain/surgery (Early 2012-June 2013) Maternity/Infertility (July - December 2013) Hip and Knee Replacements (January - July 2014) Specialty Pharmacy Phase 1 (October 2014 – April 2015) Specialty Pharmacy Phase 2 (May - December 2015) Typical Deliverables Community Dialogue Kick-off High level analysis to identify key problems, priorities, and areas of focus Review of existing related health plan programs Develop employer “Value Statement” reflecting goals, values, and desired outcomes Disseminate Value Statement to health plans and providers Face to face meetings between purchasers and key providers Communicate value statement Learn about related practices and initiatives Gather information on employers’ best practices to increase value Produce and deliver Purchasers Guide including: What’s right and wrong with care today Questions to ask providers, health plans and vendors A description of benefit plan best practices Member meeting to share key findings

Typical Learning Network
Market Assessment What’s wrong What’s right Who’s doing what Identify key providers Community Dialogue Key note expert Respondents Health Plan Purchaser Providers Facilitated discussion Value Statement Evidence based Consumer Engagement Transparency Aligned incentives Purchaser’s Guide Current State Questions for providers Questions for vendors Health Plan Conversations Value Statement feedback Current approach to increasing value Future plans Provider Conversations Leading providers Value statement feedback Comparison to Value 2012 – 2013 Back Pain and Surgery 7/2013 – 12/2013 Maternity and Infertility 1/2014 – 8/2014 Knee and Hip Replacements 9/2014 – 4/2015 Specialty Pharmacy TBD

2014 - Maternity & Total Joint Replacements
Wrapped up Maternity/Infertility Learning Network February 4, 2014 Member Meeting Purchaser Guides produced and distributed Total Joint Replacements (TJRs) Learning Network Community Dialogue March 28 The Alliance, Madison WI Twin Cities Orthopedics – Provider HealthPartners - Health Plan Hennepin County - Employer Expanded number of participants (11 purchasers) Purchaser - Provider face to face meetings (5) Twin Cities Orthopedics Tria – HealthPartners – Park Nicollet Summit Orthopedics – HealthEast Allina Fairview Meetings with health plans and their client employers Produced Purchaser Guide July 16, 2014 Member Meeting HealthPartners – Regions – Park Nicollet – Tria testimonial Two employers’ perspectives

Specialty Pharmacy Learning Network
Expanded to seventeen purchasers MN Medicaid (DHS) participates as both a purchaser and a plan – offers unique insights Project Manager – Linda Davis Project Advisor - Steve Schondelmeyer Ph.D., Professor of Pharmaceutical Economics, University of Minnesota What can individual purchasers do? What can we do as a collective purchasing voice? How might we influence public policy? 2014 Key Informant Meetings Understanding the marketplace, challenges and opportunities Ethical considerations from two ethicists. Medical & Pharmacy Data Analytics Four different models for Specialty Pharmacies Insights from Pharmacy Consultants Health Plan interventions and tactics Wrap up and next steps Decision to extend into Phase 2 - “mobilization phase”

COLLABORATION Peer-to-Peer and Community Initiatives and Meetings
Annual Health Care Benefits Survey Action Group Meetings Toolkits and Purchaser Guides Through our Collaboration activities, we open diverse, unique ways to collaborate with people from Minnesota employers large and small, and from influential organizations like ICSI and MN Community Measurement, among others. In addition to contributing to your personal growth, you will be part of discussions about what is going on in the marketplace and how you and [PROSPECT ORGANIZATION NAME] can contribute to making positive change happen. Here are some highlights of how you can benefit from our collaboration with members and community groups: Exclusive Annual MN employer benchmarking survey that encourages peer- to-peer information sharing and best practices. Annual Leadership Summit, attracting local and national experts in a variety of existing and emerging health care areas. Periodic community dialogue meetings featuring experts on areas like wellness incentives and programs; best practices for optimal diabetes and cardiovascular care measures; and value-based benefit design. Payment reform to ensure a sustainable health care system in Minnesota. Toolkits and purchaser guides on issues such as back pain and health care home. If this is an area of personal interest, or a business concern for [PROSPECT ORGANIZATION NAME], We can find a role for you, or you can focus on attending meetings related to these issues.

2014 Health and Wellness Survey Report
Copyright Minnesota Health Action Group and Second Story Sales Company

Copyright Minnesota Health Action Group and Second Story Sales Company
Minnesota Health Action Group (The Action Group) Member and Non-Member Survey Survey objective. To understand the Minnesota employee benefits marketplace trends and provide a tool for The Action Group’s members and survey participants to benchmark plans. Deliverables. Report from external and internal survey responses comparing and summarizing participant’s views on the following: Plan costs and contributions. Health plan strategy and benefits. Evaluation of Minnesota networks and administrators. Health improvement solutions. Eligibility rules. Thoughts on ways to improve the health care system and Health Reform. Copyright Minnesota Health Action Group and Second Story Sales Company

Participating Organizations Copyright Minnesota Health Action Group and Second Story Sales Company

Characteristics of Survey Participants
27 of The Action Group’s 32 employer members (84%) participated in the 2014 Health and Wellness Survey. Number of Employees in the Twin Cities (12% increase in 2014) 161,894 Number of Employees in Minnesota Outside the Twin Cities* (4% decrease in 2014) 94,166 Total Participants 31 (42% increase in 2014) Average Age 43 *Survey asked for number of employees in Minnesota outside of the Twin Cities. Does not include numbers for one organization. Copyright Minnesota Health Action Group & Second Story Sales Company

Looking back over all years, what has proven to be your organization’s most successful strategy for containing health care benefits expense? continued Full replacement high deductible health plans. Consolidating health plans and changing to consumer-directed plans. Robust Wellness Program. Plan design with cost sharing at the point of service. Consumer Driven Health Plans. Wellness Programs, case management, pharmacy benefit design. Moving away from fee for service to a delivery model based on total cost of care. 1) Directing employees to higher deductible consumer directed health plans ) Adapting our drug formulary to encourage the use of generic options 3) Cash-based wellness incentives. Offering only consumer driven health plan options. Narrow networks. Medical utilization at our own clinics (through a tiered network) and a comprehensive incentive based well-being program. Implementing a Health Reimbursement Account with a high deductible health plan. Copyright Minnesota Health Action Group and Second Story Sales Company

What tactics have you used to control trend increases? (Check all that apply.) Activities focused on consumer education and improving the health of members through wellness initiatives and disease management are the most popular benefit offerings used to control trend increases. These are followed closely by activities focused on increasing deductibles and consumer directed health plans. Employers are most interested in contemplating adding ACOs, spousal exclusion and surcharges, and defined contribution. Copyright Minnesota Health Action Group and Second Story Sales Company

What is your contribution strategy for the future?
Displayed percentages represent percentage of total respondents in given year. The most prevalent contribution strategy for the future is to increase premiums. Copyright Minnesota Health Action Group and Second Story Sales Company

If not offered, are you contemplating, implementing or not interested in offering these benefits? Retail clinics (26), telemedicine (26) and virtual provider visits (26) are the benefits most frequently included in health plans. Of those contemplating adding benefits, private exchange (11), value based plan designs (11), on-site clinics (9), and referenced-based pricing (9) are the most frequently mentioned. Copyright Minnesota Health Action Group and Second Story Sales Company

If utilizing value-based plan designs, which of the following are you rewarding with a richer plan design? (check all that apply) For those employers utilizing value-based plan designs, more than half are rewarding participation in disease management programs with a richer plan design. Copyright Minnesota Health Action Group and Second Story Sales Company

Do you currently offer any health improvement solutions? (Check all that apply). Displayed percentages represent percentage of total respondents in given year. A majority of respondents offer health improvement solutions (28 of 31 organizations). Of the solutions that are offered, health risk assessments are offered by a majority of organizations (87%) with phone condition management programs, online wellness programs and biometric testing being widely offered as well. Copyright Minnesota Health Action Group and Second Story Sales Company

Details From Respondents on Their Health Improvement Vendor(s)
Castlight - Do well with transparency tool, slow at making "fixes" or follow up on requests. Consumers Medical Resources - implemented 4/1; process went extremely well; no other input at this time. Flourish - Program offered through Medica. With Medica's assistance we have been able to expand and customize our program over the past 3-5 years. HealthSource Solutions - Provides easy-to-implement wellness programs and health risk assessment/biometric screening. LA Fitness - Not cooperative, act like they have no idea about our program. MDLive - Implemented 4/1; process went extremely well; no other input at this time. Novu - Just implemented, too soon to know too much, but so far so good. Weight Watchers - Although program works well for our members, administrative processes are clunky at best. WINS - Very easy to work with-they accommodate our various schedules & provide great reporting. Copyright Minnesota Health Action Group and Second Story Sales Company

Detail: PPO Plan Designs: Out of Pocket Maximums and Copayments
The table above shows those organizations that offer the benefit type. NA means the organization did not provide, or the option may not be applicable. Copyright Minnesota Health Action Group and Second Story Sales Company

Meetings 2014 Maternity Care Learning Network Wrap Up
Seventh Annual Leadership Summit Cancer Care and Prevention Community Dialogue: Total Hip and Knee Replacement Improving Patient Safety Closing the Gap in Obesity Management MNBTE Recognition Event Joint Replacement Learning Network/ Wrap Up Roundtable Discussion on Specialty Pharmacy Accountable Care Organizations Specialty Pharmacy Learning Network Diabetes Prevention Summit Wellness Incentive Design and Legal Challenges MNBTE Guiding Coalition MNBTE Champions Best Practices

Toolkits and Purchaser Guides (under the Collaboration tile)
About our Toolkits and Purchaser Guides Choosing Wisely Toolkit Total Joint Replacement Purchaser Guide Maternity and Infertility Purchaser Guide Back Pain and Spine Surgery Purchaser Guide An Employers Guide to Cancer Prevention and Treatment Health Care Home

ENGAGEMENT Consumer Communications and Education Choosing Wisely®
Action Group Toolkits Consumer Tools and Resources MN Diabetes Initiatives Health Literacy Cornerstones4 Care In the area of Engagement, we address consumer communications and education. Some of the projects here are direct-to-consumer toolkits and resources; others involve how best to make purchasing decisions that affect your employees. Our toolkits have been very popular with members, and we are continuously building our library. Examples of topics include, depression, health care home, diabetes, and quality and safety. We also offer a number of resources to educate consumers about how to explore treatment options, how to have effective conversations with their doctors, and how to understand quality and cost decision-making tools.

A Look Ahead Highlights 2015
Whenever possible, have a brief call with the prospect in advance so you are able to come in with a customized version of the presentation. Use open ended questions to discover buyer needs. Sample questions include: What are your strategies and goals for the upcoming year? What do you think the role is for the employer in health benefits? What is working and what is not working with your health care strategy? Highlights 2015

Annual Health and Wellness Benefits Survey 2015
Thanks!! To this year’s content advisors Jon Born, John Faustgen and Joyce Traver February 2 - Survey launch - invitation to participate February SURVEY DUE - final day for submission March 27 - Final Report distributed at Survey Results Meeting (for Action Group member survey participants only) April 10 - Final Report mailed to survey participants unable to attend the meeting

Bridges to Excellence 2015 – Areas of Focus
Maintain focus on diabetes, vascular care and depression As demonstrated by average statewide rates of performance, we have more work to do to increase the number of patients in Minnesota receiving “best care”. Explore with Champions a new basis for reward amounts A significant number of the Champions’ members are receiving “best care”, but at clinics that haven’t met the performance threshold for rewards Explore with Champions whether to increase the reward amount for clinics that meet achievement targets in all three conditions Explore adding new specialty care measures Interested in learning more about Minnesota Bridges to Excellence and how you can join the Champions in driving better care focused on health outcomes? Contact Kris for more information.

Care Delivery Learning Network Employer Input – “continue focusing on Specialty Pharmacy for next Learning Network; begin to put learning to use and take action” Because of complexity, ever changing dynamic field, just scratching the surface Some ideas for consideration “User meetings” with vendors; health plans and PBMs Collective data analysis, possibly with Artemetrx to establish baseline information Invite additional key informants such as physicians, manufacturers, hubs, consumers/patient advocates Learn from each other Benefit plan designs, data analysis findings, innovations, vendor comparison Deeper dives into areas we discovered but didn’t discuss completely

Diabetes Prevention Program
The Action Group has received grant funding from the Minnesota Department of Health to assist in the adoption and implementation of the National Diabetes Prevention Program in four Minnesota communities. We will provide resources, expertise and technical assistance to the selected communities Baseline assessment Learning collaborative Strategic planning Training Toolkit

Ongoing Meetings and Initiatives
8th Annual Leadership Summit – April 17 Employer Roundtable Member Meetings Topic suggestions Community Dialogues Opioids, other Weekly Express Monthly Members Only fyi Social Media Outreach

Doing together what no single organization can do alone
Affordable, predictable health care costs Improved health and health care quality Policies and programs that work for all Employee satisfaction and accountability

A powerful force for positive change
The Action Group is the only Minnesota organization whose sole purpose is to align and represent the collective voice of those who pay the bill for health care – employers, public purchasers and individuals. We drive innovation, collaboration and engagement in ways that improve health and ensure the economic vitality of all Minnesota communities.

Year End Review New Year Preview

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