Gail Marcus

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Consumer Driven Care All Tools Under One Model

• Gail Marcus

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Consumerism is Emerging

• The basic requirements are coming into place

1.5 million in consumer products today
None of this even existed in 1999
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This model contains all of the CDH tools health
insurers plan to market
Foundation for the New Era
And in the process of acquiring Definity Health a
leading provider of consumer health solutions
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Company enrolment in all consumer products is
equally strong
Steady Adoption
Over 2.5 million individuals enrolled in
consumer-focused programs by 1/1/05
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The Products Deliver Consumer Empowerment Through
Increased Buying Power

• I can be rewarded for taking care of my health
• Incentives for health risk assessment health
  programs

• I can plan ahead
• Plan Comparison Calculator
• Health Savings Accounts help me save for future
  health needs and assess trade-offs

• I understand costs when making decisions
• Treatment Cost Estimator
• Health Allies

• iPlan gives me real value
• Network discounts for covered medical expenses
• Never pay retail for non-medical
• I pay for discounted services through a
  tax-favored account

• I get guidance on making decisions
• Premium and performance networks
• Health advocacy

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Integrating Consumer Touch Points for
Patient-Centered Decision Making
Premium NetworkSM Info Targeted Communications
Best Physicians
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Consumers do change behaviour
Consumers do Change Behavior
Two-thirds of Consumers report increased
awareness of health choices and costs

• Consumers are more engaged
• 33 higher registration on myuhc.com
• From 300 to 1000 online inquiries/week for
  account balances
• 85 of 2003 enrollees carried a balance into 2004
• 8 Increase in Preventive Services

First year results
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Utilization results are very strong
Smarter Consumer Purchasing
30 Cost Reduction compared to UnitedHeathcares
book of business

• Preferred, in-network professionals, utilized
  over 90 of the time
• ER utilization decreased by 18 - however cost
  per visit went up slightly, indicating they are
  using ER for appropriate care needs

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Success comes from personalizing interventions
Identifying and Stratifying Risks
Employees Complete Health Assessment
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Examples of tailored interventions to support
consumers
Quality and Efficiency
UnitedHealth Performance Program

• Common Conditions
• General PCP/Specialty care
• Chronic conditions

• Specialty Conditions
• Identifies the most significant cost drivers by
  condition
• Physician and facility-driven

• Highly Complex Conditions
• Focused experience
• Academic institutions
• Sophisticated diagnostics and therapeutics
• High per-case cost

• (1/1/05)
• Depression
• Asthma
• Hypertension
• Female Health

Case Frequency

• Cardiac (2004)
• Common Cancer (1/1/05)
• Musculoskeletal (1/1/05)

• Transplants
• Congenital Heart
• Complex Cancer
• Infertility

Case Complexity
11
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