1. Commonwealth of Virginia Employee Wellness Department of Human Resource Management State Employee Health Benefits & CommonHealth Virginia Hospital & Healthcare Association Employee Wellness Academy Richmond, VA October 8, 2013

2. $1 Billion State Employee Health Plan Cost Drivers October 8, 20132  Expensive procedures  Treatment of chronic conditions  Prescription drug therapy cost  Employee lifestyle  Smoking  Physical activity level  Overweight  Average employee age Top Ten Claims Expense Medical Procedures Chronic Conditions Prescription Drugs 47.3% of All Claims Expense 6.7% of All Claims Expense 5.0% of All Claims Expense Note: These areas may not be mutually exclusive

3. Consumer-Focused Health Plan Design Maternity Weight Watchers Smoking Cessation Flu Shots Bariatric Surgery Diabetes Coronary Artery Disease 3October 8, 2013

4. Plan Design Maternity 4 Consumer Action Participate in the Maternity Program Begin the program in the first trimester Get extra dental cleaning Plan Incentive Waive $300 inpatient or $125 outpatient co-pay October 8, 2013

5. Plan Design Weight Watchers Consumer Action Participate in 75% of the classes Plan Incentive Receive 50% reimbursement of class fees paid 5October 8, 2013

6. Plan Design Smoking Cessation Consumer Action Participate in the program Plan Incentive No charge for program 6October 8, 2013

7. Plan Design Flu Shots October 8, 20137 Consumer Action Get a flu shot Plan Incentive No charge for shot

8. Plan Design Bariatric Surgery Consumer Action Participate in the year-long coaching program Attend a Weight Watchers or similar program Plan Incentive Eligible for plan coverage Receive health coaching pre-surgery and post-surgery at no charge Eligible for Weight Watchers 50% reimbursement Waive $300 inpatient hospital or $125 outpatient co-pay 8October 8, 2013

9. Plan Design Bariatric Surgery October 8, 20139 Lifestyle Changes  Improved nutrition  Smaller food portions  Better beverage choices  Increased activity/exercise  More positive coping skills  Increased confidence  More health care engagement  Stopped smoking 80% 81% 78% 65% 62% 59% 57% 8% Health Condition Improvements  Diabetes  Blood Pressure  High Cholesterol *All results from post 12-month survey 50% 46% 15%

10. Plan Design Diabetes October 8, 201310 Consumer Action Annual physical Annual A1C test Participate in disease management program Comply with medications Plan Incentive Tier 1 and Tier 2 medications and supplies at no charge Receive coaching at no charge

11. Plan Design Coronary Artery Disease Consumer Action Participate in the 6 month Health Diagnostic Lab program Receive initial health screening Biometric measurements Blood draw Recommend sharing results with physician Meet with clinical health consultant Get follow-up health screening ~ 6 months later Plan Incentive Receive HDL tests at no charge Receive health coaching based on results at no charge 11October 8, 2013

12. Employee Wellness Program CommonHealth Established 25 years ago 9 home-based regional coordinators across state Travel state to present programs on health, wellness and safety Coordinator in each agency/location 500 agency locations participate 58% employee participation rate, up from 26% in FY 2012 October 8, 201312

13. CommonHealth Programs 3 new programs offered face-to-face annually Coordinates with Health Benefits to select topics Coordinates with Workers Compensation on safety issues Provides special programs upon request October 8, 201313

14. Biometric Measures October 8, 201314  Biometric screenings  Workplace  Doctor’s Office  Lab Corp  Part of Total Population Health  Results available online to employees

15. CommonHealth Challenges October 8, 201315  Growing Younger Bingo Challenge  CommonHealth It’s Your Move – Step Challenge  Just Drive Virginia  Home Safe Home Challenge  Take a Break Quick Start Challenge  Quick State Fitness Challenge  15 Ways to Renew You and Virginia  Outdoor Adventures Trail Quest  Water for Wellness  Take Control of Your Stress  Stretch at Work  Five to Nine to Feel Really Fine

16. Summary Data driven Value-Based Insurance Design (VBID) Short-term cost investment for long-term health improvement resulting in lower cost Continuous improvement Health Plan and Wellness Program coordination Employee Engagement http://www.commonhealth.virginia.gov 16October 8, 2013