The 3rd meeting of the Subcommittee on Wellness of the Blue Ribbon Panel on Public Employee Health Benefits was held on Tuesday, June 28, 2005, at 10:00 AM, in Room 113 of the Capitol Annex. Representative Bob M. DeWeese, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Representative Bob M. DeWeese, Chair; Senator Tom Buford, Representative Harry Moberly Jr.; Milton Mains, Wanda Mitchell-Smith, and J.P. Wiles.
Guests: Christine Wilcoxson, Department for Employee Insurance; Shawn Crouch, Health and Family Services Cabinet; Dale Clemons, Wellness, Inc.; Dr. Jaudon Behrman, Bluegrass Family Health; Dr. Allen Grimes, United Healthcare; Dr. Adewale Troutman, Louisville Metro Health Department.
LRC Staff: Alisha Miller, Terisa Roland.
First on the agenda was a discussion of the 2006 RFP and future changes for the public employee health insurance program. Those presenting were Christine Wilcoxson from the Department of Insurance and Shawn Crouch from the Health and Family Services Cabinet.
Ms. Wilcoxson presented a PowerPoint presentation on the questions required for the 2005 wellness programs and questions which the vendors were asked for the RFP for 2006. The first question was whether the vendor offered Health Risk Assessments (HRAs). Ms. Wilcoxson stated that all of the vendors responded that they provided HRAs. Additional questions included whether there was additional information sent out after HRAs were completed and if specific information was available. All vendors stated that additional information was sent to members based on the results of the HRAs. They also stated that they provide information on wellness, preventative care, physical fitness, menu planning, diagnosis information, and procedure specific information. Ms. Wilcoxson continued by giving detailed information on specific vendor's wellness programs and outlining the questions asked for the 2006 RFP.
Representative DeWeese asked if there was any evidence that wellness programs are successful, and what can the state expect in the way of savings. Mr. Crouch said they looked at some other states and large employers who have self insured plans. He stated it is hard to quantify the savings related to self insured plans because its hard to say that a certain outcome is related to a wellness program and not to disease management or good care from the physician. He then stated, however, that there are studies which show over a long period time that wellness programs end up creating a healthier population.
Representative DeWeese then asked about the incentives that are offered. Ms. Wilcoxson said that they've asked other states and larger employers about them, and they are gathering information on it. She stated that she thought it was a good idea. However with restrictions on the budget, it is now just a question not something that will definitely be done. She also stated the Blue Ribbon Panel might want to look to see if we need to budget money for incentives.
The next presenter was Dale Clemmons of Wellness Inc. and Apple A Day Wellness who presented on wellness programs, incentivizing, and motivating. Mr. Clemmons stated his company has focused on wellness and affecting wellness in the general population through different programs that they put together. He discussed his main product, the Personal Health Development Program or PHD Network and rewards program that they work with to incentivize participants of their wellness program. The PHD program is a web based personal health assessment which tracks progress and provides reports to participants. He stated it also supports incentives and rewards. The program is also available in a paper application. Mr. Clemons went on to say that they focused on ease of use and access to encourage participation. He then pointed out that the program can be tailored and branded specifically to the state of Kentucky instead of the state leasing it from a provider so that the users will actually feel like it is their program.
The next presenter was Dr. Jaudon Behrman with Bluegrass Family Health. Areas discussed focused on their disease management program, prevention, wellness, education resources, and tools.
Regarding disease management programs, the following in-house programs were reviewed: diabetics, cancer, transplantation, maternity and chronic pain. Included in the transplantation program, URN networking and industry cost were discussed. Early identification of high-risk pregnancy and case management were topics discussed in regards to the maternity program.
Also discussed within disease management programs were Lifemasters and RMS. Lifemasters began in January 2005. Lifemasters include the following programs: asthma, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, hypertension, diabetics, and low back pain. Outcomes Impact was also discussed.
RMS focuses on end-stage renal disease and began in November 2001. The following measurements were discussed: effectiveness of dialysis, anemia monitoring, vascular access type, bone disease, cardiovascular disease, lab testing, and hospitalizations.
The following programs were discussed for consideration in the future: rheumatology, osteoarthritis, and cancer. Bluegrass Family Health also offers Life Traxx, web which has information on the following: general health procedures, surgery, medical encyclopedia and dictionary diseases and conditions, as well as drug information. Dr. Behrman also discussed Buddy Check which is a nationwide program endorsed by WLEX 18, Bluegrass Family Health and Nation Cancer Center.
The next presentation was given by Dr. Allen Grimes of United Healthcare. He stated the definition of wellness is the condition of good physical and mental health, but the purpose of disease management is to support the physician/patient relationship, emphasize prevention, utilize evidenced-based medicine and natural specialty guidelines, as well as to evaluate clinical and economic outcomes with the goal of improving overall health.
With United Health Care developed several wellness plans "Getting healthy, Living with illness" and "staying healthy".
United Health Care has a website, Wellness.com which includes unique programs that take a new approach to wellness, programs on nutrition, exercise, smoking cessation, and stress relief as well as discounts on health and wellness products. The goal of United Health Care is access to affordable, quality health care.
Dr. Adewale Troutman, Louisville Metro Health Department was the next speaker. He spoke about the Mayor's Healthy Hometown Movement in Louisville. The program focuses on particularly the epidemic of obesity and type 2 diabetes in children as well as obesity in adults. He said the lack of physical activity and good nutrition in the community is overwhelming. They use the 10,000 steps a day goal from the Center for Disease Control. He distributed brochures regarding this program.
He stated the biggest health problem faced is obesity. He presented a slide show regarding the program.
Representative DeWeese commented that the healthier we become, the less costly it will be.
Ms. Smith asked for a copy of his Power Point presentation for all the committee. She also wanted to know if there was a study on the Latino community, since he discussed a study of the African American population in Louisville. Dr. Troutman said they are working on data collection.
Mr. Mains asked a question regarding the Take Charge Challenge with corporations. He asked if there had been any information on how to include retirees. Dr. Troutman said they are not currently doing anything with retirees, but it would be added later. He said their first focus was getting results with the government workforce.
Representative DeWeese said at the next meeting the subcommittee would be looking at all recommendations. Forms were distributed for members to use as examples.
Representative DeWeese said the presentations prove that wellness and disease management have been proven to work. They do save money. He suggested incentives could be used to go towards co-pays and other plans. He said disease management has to also be there.
There being no other discussion, business concluded and the meeting adjourned at 3:00 pm.