Introducing Concentra TotalCare and Urgent Care: Solutions for Improving Health Care Accessibility and Affordability in New Hampshire - PowerPoint PPT Presentation

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Introducing Concentra TotalCare and Urgent Care: Solutions for Improving Health Care Accessibility and Affordability in New Hampshire

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Title: Introducing Concentra TotalCare and Urgent Care: Solutions for Improving Health Care Accessibility and Affordability in New Hampshire


1
Introducing Concentra TotalCare and Urgent
CareSolutions for Improving Health Care
Accessibility and Affordability inNew Hampshire
  • Presented by
  • Joe Castorina, M.D., MPH
  • Regional Medical Director
  • Tony Silva,
  • Regional Sales Manager

2
(No Transcript)
3
What well discuss today
  • Current health care environment in New Hampshire.
  • Understanding the current health trends
    throughout the country
  • Changing Behavior through a Worksite Health
    Improvement Program
  • How Urgent Care expands accessibility and
    affordability of care
  • How your employees can benefit from Concentra
    Urgent Care
  • Next steps.

4
The State of Personal Health in New Hampshire
  • New Hampshire ranks well in several measures of
    personal health
  • 2 in overall child health status
  • 7 in rate of personal exercise
  • 42 in rate of overweight/obese persons
  • 45 in rate of hospital admissions
  • 45 in rate of occupational fatalities
  • 47 in rate of motor vehicle deaths

Source Kaiser Family Foundation, statehealthfacts.org, 2008.
5
Perhaps one reason for better overall health in
New Hampshire is a younger population than the
national and New England averages.
Source State Master, 2009.
6
And even though overall health measures look
good, there is still room for improvementespecial
ly in regards to national ranking on
  • Illicit drug use 3
  • Cancer incidence 15
  • Cigarette smoking 18
  • High cholesterol 23

Source Kaiser Family Foundation, statehealthfacts.org, 2008.
7
Achieving and maintaining good personal health is
important in controlling future health care
costs, because New Hampshire leads the nation in
employer-paid health insurance coverage.
Source Kaiser Family Foundation, statehealthfacts.org, 2008.
8
New Hampshire employers pay more on average for
health care than the national average.
Source Kaiser Family Foundation, statehealthfacts.org, 2008.
9
Understanding the Current Health Trend Rising
U.S. Healthcare Costs
Billions of Dollars
Source Centers for Medicare Medicaid Services
Spending expected to increase from 2.3 trillion
in 2007 to 4 trillion in 2015.
Source National Coalition on Health Care
10
Understanding the Current Health Trend What is
Driving the Increase in Healthcare Costs
  • Medical innovation
  • Pharmaceuticals - Specialty/Biotech
  • New technology and specialized testing
  • Reimbursement and coverage
  • Increasing numbers of uninsured or under-insured
  • Cutbacks in Medicare/Medicaid reimbursement
  • System issues
  • Inefficiencies and fragmented care
  • Medical errors and quality
  • Practice challenges
  • Defensive medical practice
  • Preventive care not valued

11
Understanding the Current Health Trend Other
Drivers of Increased Costs?
  • Aging population
  • Aging workforce
  • Lifestyle factors
  • Diet
  • Physical inactivity

12
Understanding the Current Health Trend Increasing
Health Insurance Premiums
  • Increases in health insurance premiums have
    ranged from 6 to 13 since 2000
  • Source Kaiser Family foundation
  • Chronic illness (heart disease, diabetes, and
    obesity) account for 75 of health care costs.
  • Source APHA

13
Understanding the Current Health Trend Healthcare
System Fails to Deliver Recommended Preventive
Services
Source CDC
14
Understanding the Current Health Trend Worsening
Health Status of Population
And, the problem is going to get worse without
coordinated and effective action
15
Understanding the Current Health Trend Changes
in Dietary Practices
  • Over the past 20 years
  • Calories rose 22 from 3200 to 3900 per day
  • Snacks as portion of daily calories increased
    gt50
  • Proportion of food eaten away from home doubled
  • Food processing has replaced complex grains with
    refined carbohydrates and simple sugars
  • Portion sizes grown by 25 50

16
Understanding the Current Health Trend The
Growing Problem of Obesity
15 states reported obesity rates from 10 to 14
none greater than 14
28 states reported obesity rates from 25 to 29,
and three states gt 30
17
Understanding the Current Health Trend Obesity
Epidemic Affects All Age Groups in U.S.
Source CDC, BRFSS
18
Understanding the Current Health Trend It is
Only Going to Get Worse
19
Understanding the Current Health Trend New Cases
of Diabetes Among U.S. Adults- Age 18-79 Years
? 3 fold in 25 years
Source CDC Natl Health Interview Survey and ADA
2007
20
Understanding the Current Health Trend Proportion
of Adults with Diagnosed Diabetes by State
2005
1994
Diabetes prevalence rose from 3 in 1984 to 7 in
2004 among US Adults. Source NDSS, CDC,
NHIS and ADA 2007
21
Understanding the Current Health
Trend Obesity-related Illness and Disease
  • Type II Diabetes
  • Stroke
  • Cardiovascular Disease
  • High Blood Pressure
  • High Cholesterol
  • Pulmonary Disease
  • Sleep Apnea
  • Respiratory Problems
  • Cancers
  • Acid Reflux Disease
  • Psychological/Social Effects
  • Gallbladder Disease
  • Bladder Control Problems
  • Uric Acid Kidney Stones
  • Gout and osteoarthritis
  • Reproductive Issues
  • Women pregnancy complications, irregular
    menstrual cycles
  • Men - infertility
  • Musculoskeletal problems

Sources Weight Awareness and the Centers for
Disease Control and Prevention
22
Understanding the Current Health Trend Obesity
Impacts Health and Productivity Costs
  • Associated with
  • 39 million lost work days
  • 239 million restricted days
  • 90 million bed days
  • 63 million physician visits1
  • Major contributing factor in workers comp
    injuries
  • Accounts for gt9 of the total costs of work
    absenteeism2
  • Costs U.S. companies 13 billion/year
  • 8 billion attributable to health care
  • 5 billion attributable to sick leave, life
    insurance, disability insurance, absenteeism, and
    presenteeism3

Source 1Obesity Research 1998 , 2JOEM 2007,
3NBGH 2006
23
Changing Behavior through a Worksite Health
Improvement Program Worksite Solutions that Work
  • Understand the Production of Disease Identify
    health risks and prevent disease and
    complications
  • Identify Employees At Risk Determine those with
    risks of becoming ill or contracting a disease
  • Intervene to Promote Healthy Behaviors Assist
    employees to lower risk and improve outcomes
  • Effectively Engage Employees Communicate health
    as a priority, build awareness and reinforce
    health

Health Promotion and Communication Health Risk
and Biometric Screening Health Education,
Coaching and Monitoring Policies, Benefits, and
Incentives
24
Changing Behavior through a Worksite Health
Improvement Program TotalCares Program Design
Elements
  • Implementation
  • Program Design and Logistics
  • Communications Plan
  • Incentive Coordination
  • 2) Know Your Numbers
  • Health Risk Assessments (electronic/paper)
  • Personal Wellness Profile
  • Biometric Testing
  • 3) Education and Coaching
  • Employee Health Portal (web tools)
  • Health Coaching (Onsite/Telephonic)
  • Education and Coaching (Onsite/Web-based)
  • 4) Manage and Measure
  • Employer Web Portal/Reporting
  • Measurements
  • Executive Consultation Meetings

25
The higher costs of health care in New Hampshire
are borne by employers and employees with health
insurance. New Hampshire health insurance
premiums are the highest in the country.
Average Family Coverage Premium per Enrolled Employee For Employer-Based Health Insurance, 2006 Average Family Coverage Premium per Enrolled Employee For Employer-Based Health Insurance, 2006 Average Family Coverage Premium per Enrolled Employee For Employer-Based Health Insurance, 2006 Average Family Coverage Premium per Enrolled Employee For Employer-Based Health Insurance, 2006 Average Family Coverage Premium per Enrolled Employee For Employer-Based Health Insurance, 2006

  NH NH US US
Employee Contribution 26 3,298 25 2,845
Employer Contribution 74 9,388 75 8,536
Total 100 12,686 100 11,381
Source Kaiser Family Foundation, statehealthfacts.org, 2008, Public Policy Institute of New York State http//www.ppinys.org/reports/jtf/healthinsurance.html
26
One reason for higher costs is that New Hampshire
ranks 12 in hospital emergency room
utilizationindicating unmet consumer needs for
accessibility and convenience.
Source Kaiser Family Foundation, statehealthfacts.org, 2008.
27
Up to 75 of hospital emergency room cases could
be treated in a lower acuity setting like Urgent
Carefor far less money.
Urgent Care Services
  • Routine Illness
  • Seasonal Allergies
  • Ear Infections
  • Sinus Infections
  • Colds/Flu
  • Rash
  • Urinary Tract Infection
  • Health Screenings
  • X-Ray Services
  • Minor Injuries
  • Sprains/Strains
  • Cuts/Scrapes
  • Fractures
  • Back Injuries
  • Simple Lab Tests
  • Vaccinations

28
Urgent care charges are comparable to that of a
doctors officewith greater accessibilityand up
to 80 less than emergency rooms.
Care Option Co-Pay Retail Price Availability Visit Length
Doctors Office 20 75 to 125 Days or weeks until an open appointment. 60 minutes
Urgent Care 30 85 to 179 Walk-in service no appointment necessary. 60 minutes
Emergency Room 100 350 to 800 24 Hours, 7 Days 3 hours or longer
29
Urgent Care Benefits to Employees and Employers
  • Benefits to Employees
  • Available when patients cannot get into primary
    care
  • Immediate medical attention for non-emergent
    conditions
  • Capabilities beyond a typical primary care
    office, including x-ray and procedures such as
    suturing
  • No appointment ever necessaryjust walk in
  • Shorter wait times
  • Lower out-of-pocket costs
  • One consolidated bill
  • Benefits to Employers
  • Reduced absenteeism from illness or caring for
    sick family members
  • Increased productivity from early diagnosis and
    treatment
  • Decreased utilization of hospital emergency rooms
  • Greater control over group health costs

30
For patients with in-network insurance,
Concentra will collect the co-pay and any patient
financial responsibility at time of service, and
submit the claim directly to the carrier on the
patients behalf.
Insurance Plans Accepted
Aetna Integrated Health Plan
BCBS NH InterPlan
BeechStreet NPPN
Cigna PHCS/MultiPlan
Cofinity ppoNext
Evolutions Preferred Network Access
First Health Prime Health Network
Fortified Provider Network Three Rivers Provider Network
Galaxy TriCare HealthNet
Great West UniCare
Harvard Pilgrim Health Plan United/Pacificare
Health Management Network USA Managed Care Organization
Humana
31
Posted Pricing for Self-pay Patients
32
Concentra ConcentiveA solution for uninsured,
out-of-network and part-time/seasonal employees,
uncovered dependents, and for employees in the
90-day new employee benefits waiting period.
33
Next Steps
  • Concentras management team, Tony Silva, is
    available for appointments to review strategies
    and options for your clients.
  • Concentra will help develop a communication plan
    to educate employees as to the availability and
    benefits of urgent care.
  • Concentra will provide collateral including maps,
    posters, flyers, and Concentive to support the
    communication plan.
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