1. 2012 State of Reform Health Policy Conference January 4, 2012

2.  Overview of King County Employee Health and Well-Being Program  Results/Program Effects  Lessons Learned  Next Steps 2

3. Supply Side: Work with Puget Sound Health Alliance (PSHA) to improve quality of care, pay for value Demand Side: Improve employee health Increase employee health consumer skills 3

4. Employers, physicians, hospitals, patients,health plans working together to measure and report Best Care + Least Waste 4 SUPPLY SIDE

5.  Improve employee health  Healthy Incentives program—annual wellness assessment and individual action plan  Worksite health promotion—Eat Smart, Move More, Stress Less  Increase employee health consumer skills  Own Your Health Campaign  Community Checkup Report on provider quality 5

6. 6

7. 7 Comparison of original Gold, Silver and Bronze Member Out-of-Pocket Expenses

8. Item KingCare SM Gold 2006-2009 KingCare SM Gold 2010-2012 Group Health Gold 2010-2012 (No Change from 2009) Deductible (medical) $100 per individual $300 per family $300 per individual $900 per family None Coinsurance (medical) 90% In network 70% Out-of-network 85% In network 65% Out-of-network $20 copay for office visits Annual out-of-pocket maximum for member coinsurance (medical) In network services $800 per individual $1,600 per family Out-of-network services $1,600 per individual $3,200 per family No change from 2009 In network services $800 per individual $1,600 per family Out-of-network services $1,600 per individual $3,200 per family $1,000/ individual $2,000/family Prescription drug copays (at pharmacy) $10 generic drugs $15 preferred brand $25 non-preferred brand $7 generic drugs $30 preferred brand $60 non-preferred brand $10 generic drugs $15 preferred brand $25 non-preferred brand 8 New Out-of-Pocket Expense Levels in 2010

9.  Health Matters website  Health Matters Newsletter  Health Promotion Leadership Team  Leadership Forums  Annual surveys/focus groups  Employees and s/partners 9

10.  Gym discount program  Live Well Challenge  Weight Watchers at Work  Farmer’s market  Farm to Work fresh produce delivery  Employee Demonstration/Giving Garden  Healthy vending  Choose well consumer education/Own Your Health campaign  Flu shots  Health Heroes  Lunch and Learn sessions on timely topics 10

11. 11 Employees Improved 12 out of 14 health risk factors.

12. 12 Average Annual Growth Rate of Medical and Prescription Expenditures per Member, 2001-2005 & 2006-2010

13. 13 Based on results in medical and prescription drug claims in 2010 and early 2011, King County was able to reduce the overall Employee Benefits Budget projections for 2011 by $23 and 2012 by $38M. King County Benefits Cost Actual vs. Budget Projections 2010-2012

14. 14

15. 15 Group Health HMO Costs 37% Less Than KingCare SM PPO per Employee per Year

16. 16  No significant difference in the age, gender, education level, smoking, body mass, ethnicity, salary or general health status between members in Group Health and KingCare SM  Group Health provides the most fully integrated staff model health care in the Seattle metropolitan area  Analysis shows less use of brand name drugs, surgery, diagnostic radiation and other preference sensitive treatments in Group Health compared to providers in the KingCare SM plan More Information on Group Health Compared to KingCare SM for the King County Employee Population

17. 17 Healthy Incentives SM Participants Lost More Weight Than a Comparison Group Body Mass Index (BMI)

18. 18 Weight Loss by Obese Members

19.  Women Benefit More Than Men  20-Somethings Don’t Benefit At All  African-Americans Benefit the Most  College Graduates Benefit Less  Healthy Incentives SM successfully managed weight for King County employees, spouses and partners  This is the first study to find significant benefits for a large percentage of employees over a multi-year period 19 Impact On Obesity

20.  Partnership with Labor is essential  Engaged Leadership is critical  Most effective strategy for moderating costs requires 3-part focus  Supply—Improve quality, reduce waste  Demand—better health, smarter consumers  Plan design that rewards both providers and patients to “do the right thing.” 20

21.  New benefit plan  RFP for new wellness vendor  Work with the Puget Sound Health Alliance, Washington State and other partners to improve quality/reduce waste in healthcare “Whether it’s the employee or the employer, it doesn’t matter who gets stuck with the bill if the bill itself is growing exponentially.” King County Executive, Dow Constantine  Continue to engage Leadership  Study causes for reduced PEPM costs 2005-2012 21

22.  Programs: http://kingcounty.gov/employees/HealthMatters.aspxhttp://kingcounty.gov/employees/HealthMatters.aspx  Toolkit: http://kingcounty.gov/employees/HealthMatters/Visitors/HRIToolkit.aspx http://kingcounty.gov/employees/HealthMatters/Visitors/HRIToolkit.aspx  Contacts:  Karleen Sakumoto, Manager, Employee Health and Well-Being, Human Resources Division, Department of Executive Services, karleen.sakumoto@kingcounty.gov karleen.sakumoto@kingcounty.gov  John Scoggins, Health Care Economist, Office of Performance, Strategy and Budget, john.scoggins@kingcounty.govjohn.scoggins@kingcounty.gov 22