NASHO

1
NASHO 5th Annual Leadership SummitAugust 1
2, 2007Four Seasons HotelWestlake Village,
CA
2
VSP Vision Care Direct-to-Consumer Plan
Kate Renwick-Espinosa VP of Marketing, VSP Vision
Care
3
VSP Goals

• Increase Americans access to eyecare
• Promote awareness about importance of eye exams
• Elevate eyecare to integral role in the
  healthcare system

4
Link to Wellness

• Detect symptoms of serious diseases diabetes
  hypertension
• Eye exams nearly four times more frequent than
  physicals
• (61 vs. 16)

5
About VSP

• The nations largest eyecare benefits provider
• 51 million members 1
  in 6 Americans
• 28,000 clients

6
Product Development

• Evaluate new market opportunities
• Consumer research determine coverage levels
• Consider unique distribution alternatives
• Initiate pilot program
• Develop communication plan
• Launch product

7
Market Landscape

• Consumers looking for ways to reduce healthcare
  costs
• Awareness of the importance of prevention and
  early detection

8
Assess Opportunities

• 52 of adult population without vision coverage
• Micro businesses self-employed
• 12.5 million Americans in companies with less
  than 10 employees
• Aging population retirees
• 77 million Boomers one turns 60 every 7 seconds
  for the next 17 years

9
Direct-to-Consumer Plan

• Natural extension of legislative movements
  promoting proactive healthcare
• Launched in April 2007
• Available in 49 states
• Oregon to follow later in 2007

10
Plan Coverage

• VSP Signature Choice Plan
• Annual
• Comprehensive exam
• Lenses
• Frames or Contact Lenses
• Polycarbonate lenses for children
• VSP member discounts

11
Plan Coverage

• Coverage options
• Member
• Member 1
• Member Family
• 31,000 VSP eye doctor access points

12
Plan Administration

• Underwritten by VSP
• Offered through the Consumer Choice Association
• Leverages association channel for national
  consumer reach

13
Plan Administration

• Third party administrator for
• Enrollments
• Billing
• VSP administers
• Membership verification
• Claims
• Customer service on vision coverage

14
Marketing Support

• Direct-to-consumer Web site
• Targeted e-mails
• Direct mail
• Banner ads on key Web sites
• Retiree communications

15
Results

• Increase Americans access to eyecare
• Developed alternate distribution channel
• Expand market share

16
Questions?
17
Alliance HealthCard
18
Corporate Overview

• Founded in 1998 to address the need for
  affordable healthcare, lifestyle, and personal
  protection savings
• Discount programs designed to provide value based
  services to consumers and clients
• Consumer Driven Products
• Offering provider networks and lifestyle savings
  programs that deliver highly-utilized services at
  affordable rates
• Flexible fulfillment programs
• Exceptional customer service

19
Market Demographics

• 100 Million uninsured and underinsured
• 40 Million uninsured and 20 Million underinsured
• Unemployed (10 to 15 million)
• Employed
• Dependents
• 40 Million Medicare underinsured
• Both populations growing rapidly
• Less than 20 have experienced an acceptable
  solution.
• It appears that the Market for this type of
  solution is fragmented, but far from saturated.

20
Regulatory Factors

• What is a DMPO?
• State and Regulatory Requirements
• Staying Compliant
• Legislation and Consumer Advocacy
• Uniformity and rightsizing the Industry

21
The Road Ahead

• Must develop hybrid products that combine the
  protection of limited insured products with the
  value and affordability of Discount Products
• Consumer Driven Design and Pricing
• Creative Financing Tools to provide greater
  access to services when needed
• A need for greater Uniformity in regulatory
  agencies to lighten the burden for credible
  organizations struggling to compete.

22
PBMs - New Approaches to Pharmacy Benefits
Management

• August 2, 2007
• David J. Wierz

23
Overview

• Dynamics in the PBM Market
• Different Benefits
• New Opportunities
• Point of Convergence
• Managing Health and Wealth
• Managing Health and Wealth
• Pivot Ages
• Moving Forward
• Requirements and Roles for PBMs

24
Dynamics of the PBM Market Different Benefits
New Opportunities

• Characteristics of the Covered Population
• Trends in Benefits by Age
• Role of Part D

25
Dynamics of the PBM Market Different Benefits
New Opportunities

• Pivotal Populations
• Age 55 to 65
• Age 20 to 35
• Challenge
• Creating a Viable Benefit
• Managing Health and Wealth

26
Point of Convergence Managing Health and Wealth

• Definition
• Health Management
• Wealth Management
• Overlap
• Implications
• Benefit Design
• Vehicles for Benefits
• Management Tools
• For the Provider
• With the Payer
• Targeting the User

27
Managing Health and Wealth Pivot Ages

• Disparate Goals
• Age
• Income
• Outlook
• Disparate Objectives
• Level of Coverage
• Acceptable Risk
• Expected Exposure
• Financial Implications

28
Pivot Ages Implications for PBM Programs

• Requirements
• Benefits as a Wealth Management Tool
• Integration with Overall Health Management
• Deliverables
• Cash Management Card
• Integrated Care Management Vehicle

29
Moving Forward Requirements and Roles for PBMs

• Cash Management Card
• Access for Payment
• Vehicle for Incentives, Rewards, and Benefits
• Adherence and Compliance
• Persistence
• Structure for Value-Based Benefits
• Differential Co-pays
• Effectiveness Coverage

30
Moving Forward Requirements and Roles for PBMs

• Integrated Care Management Vehicle
• Link to Medical Records
• SMART Applications
• PA
• POS Messaging
• Means for Ongoing patient Engagement and
  Management
• Communication
• Feedback
• Updates
• Iterative Loop

31
Dynamics in the PBM Market Different Benefits
New Opportunities

• Questions?
• Discussion

32
NASHO 5th Annual Leadership SummitAugust 1
2, 2007Four Seasons HotelWestlake Village,
CA