Title: Introducing Concentra TotalCare and Urgent Care: Solutions for Improving Health Care Accessibility and Affordability in New Hampshire
1Introducing 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)
3What 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.
4The 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
5Perhaps one reason for better overall health in
New Hampshire is a younger population than the
national and New England averages.
6And 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
7Achieving 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.
8New Hampshire employers pay more on average for
health care than the national average.
9Understanding 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
10Understanding 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
11Understanding the Current Health Trend Other
Drivers of Increased Costs?
- Aging population
- Aging workforce
- Lifestyle factors
- Diet
- Physical inactivity
12Understanding 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
13Understanding the Current Health Trend Healthcare
System Fails to Deliver Recommended Preventive
Services
Source CDC
14Understanding the Current Health Trend Worsening
Health Status of Population
And, the problem is going to get worse without
coordinated and effective action
15Understanding 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
16Understanding 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
17Understanding the Current Health Trend Obesity
Epidemic Affects All Age Groups in U.S.
Source CDC, BRFSS
18Understanding the Current Health Trend It is
Only Going to Get Worse
19Understanding 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
20Understanding 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
21Understanding 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
22Understanding 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
23Changing 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
24Changing 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
25The 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.
26One reason for higher costs is that New Hampshire
ranks 12 in hospital emergency room
utilizationindicating unmet consumer needs for
accessibility and convenience.
27Up 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
28Urgent care charges are comparable to that of a
doctors officewith greater accessibilityand up
to 80 less than emergency rooms.
29Urgent 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
30For 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
31Posted Pricing for Self-pay Patients
32Concentra 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.
33Next 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.