1. MEDICAL SCHEMES – A VEHICLE TO IMPROVE EMPLOYEE HEALTH Jane Ball - Medscheme

2. TACKLING POOR HEALTH – A BUSINESS IMPERATIVE Absenteeism costs the local economy between R12bn and R16bn annually. Productivity losses associated with chronic diseases cost up to 400% more than the cost of treating the diseases themselves. For a company to perform well, it needs healthy people. The fewer healthy people you have, the worse your business outcomes.

3. THE IMPACT OF POOR HEALTH ON ABSENTEEISM days lost per 100 work days for high risk employees day for employees with low risk health status 12 VS 1

4. POOR PRODUCTIVITY AND ABSENTEEISM IS LINKED Higher absenteeism amongst self-reported unproductive employees Rate of Absenteeism

5. WHAT COULD BE HAMPERING SUCCESS? Stand-alone interventions –no data integration EAP Absenteeism Mgt Wellness Days Health Portal Medical Scheme Generic offering with insufficient focus on the needs of specific groups Little published evidence to inform programme design –ROI not usually calculated –no link to healthcare outcomes

6. FLU VACCINATION CAMPAIGNS SHOULD BE TARGETED Resource Utilisation Band 5 fewer sick days (per 100) for high risk employees who vaccinated No flu vaccine Flu vaccine Rate of Absenteeism

7. EFFECTIVE HIV MANAGEMENT REDUCES ABSENCE DAYS AfA – doing well AfA – doing poorly 40 35 30 25 20 15 10 5 0 Absence Days / Employee Absenteeism is 50% lower for employees who are doing well when compared with employees who are doing poorly -50%

8. LESSONS LEARNT, BEST PRACTICE SUGGESTIONS Alignment, Integration Data analysis and actuarial modelling – risk stratification to focus resources Clinical pathways implemented by committed healthcare professionals Empowering employees for self- management Coordinated, effective implementation of initiatives Ongoing measuring and monitoring of outcomes The medical scheme should be a key weapon in the employer’s arsenal

9. WHY FOCUS ON VALUE TO THE EMPLOYER?

10. Chronic medicine adherence should be promoted through medical scheme initiatives and employer wellness initiatives EMPLOYERS SHOULD ENCOURAGE CHRONIC MEDICINE ADHERENCE High risk employees without a chronic registration show a higher rate of absenteeism than adherent employees registered on the chronic programme 18.0% 16.0% 14.0% 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% Rate of Absenteeism 0 - 40%40 - 60%60 - 80% 80 - 100% Medicine Adherence

11. CARE COORDINATION “Care coordination is a conscious effort to ensure that all key information needed to make clinical decisions is available to patients and providers. It is defined as the deliberate organization of patient care activities between two or more participants involved in a patient’s care to facilitate appropriate delivery of health care services.”

12. Initiatives to improve coordination of care have a direct impact on absenteeism levels – across all risk categories Resource Utilisation Band (RUB) Employees with a low level of coordination Employees with a medium level of coordination Employees with a high level of coordination 20% 15% 10% 5% 0% 0 1 2 3 4 5 Rate of Absenteeism WELL COORDINATED CARE - LOWER ABSENTEEISM RATES Source: Medscheme Health Intelligence Unit

13. 0.5 fewer absence days per employee in the treatment group – on time that would have been spent in hospital alone PATIENT CENTRED DISEASE MANAGEMENT REDUCES HOSPITALISATION Predictive modelling is used to identify beneficiaries with multiple chronic conditions and a high chance of hospitalization in the next year. Active disease management for these individuals. Impatient admission cost savings R445.90 plpm Impatient admission rate 85 per 1000 intervened lives Hospital average length of stay 0.54 days

14. CONCLUSION

15. THANK YOU