Property of Honda of America, Mfg., Inc. 0 Honda of America, Mfg., Inc. Kevin Decot, Senior Staff Administrator — Wellness Team Manager Oct 13, 2010 2010

Property of Honda of America, Mfg., Inc.1

Honda of America, Mfg., Inc.Kevin Decot, Senior Staff Administrator — Wellness Team Manager

Oct 13, 2010

2010 Health Educator’s Institute


Soichiro HondaSoichiro Honda

1906 - Born in Komyo Village (now Tenryu City), Iwata County, Shizuoka Prefecture, Japan

1989 - Inducted into Automotive Hall of Fame

1948 - Founded Honda Motor Company

1959 - Established first overseas subsidiary, in Los Angeles

(1906 – 1991)

Our Founder- Mr. Honda


Management Policies

Company Principle

•Respect for the individual and The Three Joys

Basic Principles

•Maintaining a global viewpoint, we are dedicated to providing products of the highest quality, yet at a reasonable price for worldwide customer satisfaction.

•Proceed always with ambition and youthfulness.

•Respect sound theory, develop fresh ideas and make the most effective use of time

•Enjoy your work and encourage open communication

•Strive constantly for a harmonious flow of work

•Be ever mindful of the value of research and endeavor

Company Philosophy


“Action without philosophy is a lethal weapon. Philosophy without

action is worthless.”

Soichiro Honda

“Action without philosophy is a lethal weapon. Philosophy without

action is worthless.”

Soichiro Honda

Mr. Honda’s Personal Philosophy


Honda is a “Mobility” Company

Marysville Auto PlantMarysville Auto Plant

East Liberty Auto PlantEast Liberty Auto Plant

Anna Engine PlantAnna Engine Plant

Honda of America Mfg., Inc.Honda of America Mfg., Inc.

Acura TL

Accord Coupe

Acura RDX

Accord Sedan

CR-V Element

Accord Crosstour

4-Cylinder

6-Cylinder

Drive shaft, brakes

• Total number of associates= 10,115• Total number of spouses= 7,411

•Total Covered Lives= 30,615

“The red circles are your red blood cells. The white circles are your white blood cells. The brown circles are donuts. We need to talk.”

Laughter is Great Medicine!Laughter is Great Medicine!


Integrated Strategy

Health Care Plan Design Destination Wellness Workforce Stability

Strengthen Competitiveness…Sustainability

• Leverage Existing Commitment (90+)

• Organization• Employment• Benefits

• Instill consumerism through an account-based health care plan design using a health reimbursement account

• Establish a culture and mindset of wellness through integrated programs, with participation determining health care plan eligibility (“Active” or “Passive”)

• Strengthen daily workforce availability through policy and program modifications

Desired Outcome (ROI)


Health Care Plan Design


Plan Design

Each Associate’s Health Plan Features are Determined by Their Level of Participation in the Program

Annual Health Fund (Health Reimbursement Account)

Amount based on single/family status and wellness participation• Active associate receives $1K/3K• Passive associate receives $500/$1,500

After health fund is used

Deductible

Amount based on single/family status• Active associate: $250/$625• Passive associate: $375/$940

After deductible

Out-of- Pocket

Associate pays 10% of cost until out-of-pocket (OOP) max• Active associate: $1,000/$2,750• Passive associate:$1,500/$4,125

*Implemented in Apr

2007

PWA Completion

(HRA)

Wellness Engagement+

= Active Healthcare Plan

No PWA Completion(No HRA)

Non-Wellness Engagement

andor

= Passive Healthcare Plan


Plan Design Key Points

•Any balance remaining in health fund can be carried over to next year

•At retirement, remaining balance in health fund can be used as post retirement medical credits

•All preventive care is paid 100% & is not deducted from health fund account

•Prescription drug co-pays are not included in health fund


Associate Medical Cost Sharing

Associates currently pay no premium cost


Destination Wellness


SupportiveEnvironment

Awareness

Behavior (Cultural) change

LifeStyle

Change

Wellness Model

Wellness Initiative Business Drivers Aging Workforce

Double Digit Medical Inflation

Diet & Lifestyle of children are accelerating healthcare issues

New drugs, more drugs = Increased utilization potential

Lack of Consumerism

Inappropriate Healthcare Utilization

Business Drivers for WellnessHAM Workforce Aging Simulation

Scope: Direct Workforce (TL & PA)

Timeframe: Beginning of 9th, 10th, & 11th M idterm Comparison

0

50

100

150

200

250

300

350

400

450

19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71

Age

Current (7/15/03) Begin 9th MT (4/1/05) Begin 10th MT (4/1/08) Begin 11th MT (4/1/11)

Current (7/15/03) Avg. Age = 41.76

Begin 9th MT (4/1/05) Avg. Age = 43.24



Assc Data as of : 7/ 15/ 03

I ssued: 7/ 31/ 03

File Loc. : ADM Staffing - Org. Mngment

Assumptions* T otal P opulation: +/ - 0

* Reti r ement: A l l wi th 10yr s @ Age 62

P r oduc ti on A s s oc s :* T ur nover : 2% Y r ly

T eam Leader / P r od. Staff

* T ur nover : 1% Y r ly

* P r omotion to E xempt: 5% Y r ly

Data Backgr ound

+

$


Strategy Blueprint

80%

20%

5%

25%

15%

55% Lack of engagement Group

Catastrophic illness Group -HAM should support them

Healthy Group ----OK

Focus on this Group!!Focus on this Group!!

Covered Life

$

Focal PointFocal Point

Medical Cost

Engage

Manage

Maintain

•Proactive

•Care of Health System

•Proactive

•Care of Health System

•Reactive

•Traditional Healthcare

System

•Reactive

•Traditional Healthcare

System

o o

Strategy PhilosophyStrategy Philosophy

Strategy CharacteristicsStrategy Characteristics

…Voluntary Involvement

…Sustainability

…Cost Sharing

HAM- 2020

…No premiums…Utilization based impact

…Catastrophic protection

…Integrated

•Cost of Healthcare

1•Participation• Utilization

2DriversDrivers

•Lack of Consumerism

3


Genba SupportGenba Support

Focus on Production

Characteristics

MAPELP

AEP


<Proactive>Expand Work Hardening (beyond)frame assembly

Injury Prevention Activities

Collaborate w/Mfg Safety to analyzePlant specific issues

Job demand analysis (JDA)

Conditioning for high physical stressProcesses and/or limited rotations areas

<Reactive>Inclusion of stretching & strengthening activities to the Early Intervention Program (EIP)

Injury Recovery Activities

Incident Investigations w/ nurses

Conditioning for associates in Active& Post Medical Programs

<Proactive>

Wellness Promotion Activities

Collaborate w/Admin to analyze Plant specific Health Promotionopportunities

Promote DW events & activities throughout plants

Develop a DW representative Network<Proactive>Promote Safety Awareness activities

Associate Education Activities

Collaborate w/Dept. Safety todevelop team specific trainings

Develop dept. specific stretching programs

Genba Support Summary

Create an “Associate-Centric” model at the Genba to promote health and wellness of associates, reduce injuries and improve workforce stability.

Create an “Associate-Centric” model at the Genba to promote health and wellness of associates, reduce injuries and improve workforce stability.


PAST HISTORY

Incident rate high in first 90 days(from 2006 & 2007 data)

• New Assoc placed on hard jobs• No f/up after initial placement• Little training on job process• Little technique or reinforcement

Physically unprepared for work environment

54%

PATH FORWARD

68% Reduction in New Associate Safety Incidents First 90 days after placement (FY2006 / FY2008)

Cost Avoidance = $2,900,000

Before After1. Training Format

How to best provide our Associates with the necessary tools for success

Time

1-3 mos

4-10 mos

11-36 mos

37> mos

26%

Sprains & Strains + CTD = 80% Ttl incidents

Sp

rain

s &

Str

ain

s

CT

W

Training

Work sim

OJT

Physical

Follow up & Evaluation

On the Job(OJT)

Training

AssemblyOrientation

Training

Job Selection

Work Simulation

Physical Conditioning

770

2. Program Components

3. Program Results

+

Work Hardening ROI Proposition / Example


Selection Criteria:• Mfg/Dept request (restricted associates and/or limited rotations)• Physician request (plan of care)• Current RTW participant (TWA participants)

ECP Outline:• 2-3 days/week 8 week program• Pre & post assessment

Enhanced Conditioning Program Selection Process

Conditioning Process Overview


Components of Enhanced Conditioning Program

* Help increase endurance and

strengthen the heart

* Help elongate the muscle and improve

Range Of Motion (ROI)

FlexibilityFlexibility

* Increase abdominal & low back strength in

order to help stabilize/protect the

spine & torso region.

* Increase overall body strength through

gradual overload on musculoskeletal system

CardiovascularCardiovascular

CoreCoreResistanceResistance


Genba Enhanced Conditioning Program Room


ECP Results for Marysville Auto Pilot

0

20

40

60

80

100

AssociateA

AssociateB

Resting Heart Rate

Pre

Post

*Associate A= 7% Positive Decrease*Associate B= 15% Positive Decrease

*Associate A= No Change*Associate B= 1% Positive Change

-30

20

70

120

170

220

AssociateA

AssociateB

Body Weight

Pre

Post

0

50

100

150

AssociateA

AssociateB

Blood Pressure

Pre Systolic

Pre Dystolic

Post Systolic

Post Dystolic

*Associate A= 18% Positive Change in Systolic 13% Positive Change in Dystolic

*Associate B= 5% Positive Change in Systolic

*Associate A= 14% Positive Decrease*Associate B= 21% Positive Decrease

0

10

20

30

40

AssociateA

AssociateB

Shoulder Flex

Pre

Post


ECP Results for Marysville Auto Pilot

0

5

10

15

20

AssociateA

AssociateB

Hamstring Flex (Reach)

Pre

Post

*Associate A= 3% Positive Increase*Associate B= 32% Positive Increase

*Associate A= 36% Positive Change*Associate B= 100% Positive Change

0:00:00

0:00:43

0:01:26

0:02:10

0:02:53

AssociateA

AssociateB

Plank Hold Time

Pre

Post

0:00:00

0:07:12

0:14:24

0:21:36

0:28:48

AssociateA

AssociateB

1-Mile Walk

Pre Systolic

Pre Dystolic

*Associate A= 18% Positive Decrease *Associate B= 19% Positive Decrease

<ECP Pilot Results>

•Flexibility Average improvement of 18% in Hamstring & Shoulder Flex

•Cardiovascular Average improvement of 11% in resting heart rate

•Core Strength Average improvement of 68%

<ECP Pilot Results>

•Flexibility Average improvement of 18% in Hamstring & Shoulder Flex

•Cardiovascular Average improvement of 11% in resting heart rate

•Core Strength Average improvement of 68%


Targeted ProgramsTargeted Programs


Wellness Culture Transformation Overview

Component83Ki

2006

84Ki

2007

85Ki

2008

86Ki

2009

87Ki

2010

88Ki

2011

89Ki

2012

Characteristic (Culture)

Stages

• Educate• Aware• Preparation

• Contemplate• Begin

Engagement

Core

Actions• Assoc

• Spouse

•Strengthen Engagement•Action

•Commitment•Intrinsic Motivation

Wellness is Everyone’s ResponsibilityWellness is Everyone’s ResponsibilityWellness Culture is EmbracedWellness Culture is EmbracedIntroduce Wellness as Priority & Destination Culture

Introduce Wellness as Priority & Destination Culture

Tactical StrategicParadigmChange

PWA – Get Acquainted PWA - Baseline PWA - Update PWA - Update PWA - Update

PWA - Baseline PWA - Update PWA - Update PWA - Update

PWA

PWA

Passports to Wellness Activities

Passports to Wellness Activities

Maintain

Fitness

Preventive Care

PWA

Passports Categories

PWA

Passports to

Wellness

•Assoc

•Spouse

PWA - Update

PWA - Update

PWA - Update

PWA - Update

*Motivate individual engagement in the care

of their health

Maintain

Education &

Awareness

Support

ive

Envir

on

.

Awareness

Behavior (Cultural)

change

LifeLifeStyleStyle

ChangeChange

Wellness Model Passports Menu

Targeted Programming


Ed

ucatio

n


Fitn

ess


Preven

tive

<Passports to Wellness Summary>

•Education= 20 activities offered at wellness centers and/or e-based

•Preventive= 8 various medical exams/screenings (including blood draw)

•Fitness= 10 activities through wellness centers and 1 e-based

<Passports to Wellness Summary>

•Education= 20 activities offered at wellness centers and/or e-based

•Preventive= 8 various medical exams/screenings (including blood draw)

•Fitness= 10 activities through wellness centers and 1 e-based

39 Total Activitie

s


Wellness Speaker Series

Live Fit Education

Series

Lunch & Learns

Financial Fitness

“Community” Gardens

Relaxation Programs

Diet/Nutrition Programs

Community Outreach

Community-based

Behavioral Counselors

Farmers Market

Exercise Program Change

Urgent Care Services

Targeted Programs Image


Communication/MarketingCommunication/Marketing


Communication & Awareness HighlightsInitiative Accomplishments

•Communication SAP •Strategic action plan for communication developed and implemented per fiscal year

–Targeted Messaging–Thematic approach

•Wellness Website •Deployment of Destination Wellness website for associates and family members

–Portal to Health Mgt Ctr–On-line resource for health and wellness information

•New Hire Orientation •Wellness component added to each new hire orientation

–Associate accountability–Health/Wellness resources

•Destination Wellness

Newsletter

•Quarterly Destination Wellness newsletter mailed to associates

–Peer Testimonials–Program Information (requirements)–“Health Dividend”

Item Description Jan '10 Feb '10 Mar '10 Apr '10 May '10 Jun '10 Jul '10 Aug '10 Sep '10 Oct '10 Nov '10 Dec '10 Jan '11 Feb '11 Mar '11 88Ki

Ne

wsle

tte

r

Po

stc

ard

Po

ste

r

Pre

sh

ift

HN

N

WIN

G

DW

We

bsite

Co

mm

re

p m

tg

Oth

er

*PWA/P2W Completion

*On-site Blood Draw Activity

*Annual Enrollment (Benefit Plan)

*PWA/P2W Appeals

*Health & Wellness Targeted Communications

*DW Website ~Routine Content ~Program Cycle Related

*Post Cards ~Completion Status ~Passive Enrollment

*Preshifts

*Posters

*Newsletters

*Health Dialog Activity ~Outreach Mat'l ~Inplant Medical Rx ~HD Marketing

*Plant HR Communication Activity ~Posters ~Bulletin Boards ~Trg/Awareness Days

KEY

ACTIVITIES

87Ki/88Ki

Destination Wellness Communication Calendar of Events for 2010/2011

GENERAL

HNN & WING (Corp Affairs= Primary)

8/152/27 WWC/AWC

2009/2010 Program Cycle (PWA + 100 points)

8/15

2010/2011 Program Cycle (PWA + points)

4/24 WWC/AWC

5/19HMIN

7/24 WWC/AWC

11/510/20Pre-Conf

Conf

-2011 Benefit Plan

- Routine Content Management *2010/11 Program

NEW

*Not Complete

mid-Jun End Julmid-Sep

*Passive

Appeal

<Mar>-You're in Control-WebMD Enhancements-On-site Blood Draw

#1

<Jun>-Program Reminder-Health Dividend -Peer Testimonial-Future P2W Reqt's

#2

<Sep>-2010/2011 Reqt's (P2W)-System Enhancements-Health Dividend~ con't-Healthcare Reform Impact?

#3

<Feb>-PWA Analysis-WebMD Enhancements-Testimonial

#4

Health Dialog Outrech Activity: Preference sensitive, high risk, hospital discharges, etc.

Rx- In-plant medical use of "Rx" pad for lifestyle modifications (including health coaching)

-HD Marketing Dev

-Deploy HD Marketing per plan

Plant Communication Activity (see detailed plan)

Deploy per detailed plan

Deploy per detailed plan

On-siteBlood Draws

AEP On-siteBlood

RemindOn-siteBlood

Wellness Fair & DW

Remind

2- Mos Left

2- Weeks Left

1 Week Left

2010-2011

Program

On-siteBlood Draws

RemindOn-siteBlood

Wellness Fair

Remind

FitnessReimburse


Communication/Marketing Strategy

HNN- HAM Internal CCTVAnnounce Events and Health/Wellness Info

Posters/Flyers•Announce Events and KeyInformation

Destination Wellness Web-site

•Portal to web-based resources•“What’s New section” (advertising)

•Food Service Info•Financial News

Destination Wellness Representatives

Share information with dept./team members

Communication&

Marketing


Workforce Stability


Workforce Stability Initiatives

Change minimum attendance standard from 98%99%

Policy Changes

$

Medical Management Programs

Early Intervention Program (massage therapy)

Modified Work Program

Occ therapy on-site

Urgent care services on-site

Process/Design Improvements

Implement Ergo guidelines for R&D

Top “10” Ergo Processes

Manufacturing Innovation (e.g. adjustable workstations)

Leadership/Associate Training

Behavior based training

*Wellness team members directly collaborating with Manufacturing and Medical on line side investigations, ego training, early intervention programs, etc.


• ROI- How are we doing?


Wellness ROI Components

RO

I

•Indirect Cost-Workforce Stability

•Direct Cost-Medical Claim Cost

-Workers’ Comp Cost

•Health Risk-Cost Association

-Engagement

•Utilization of Healthcare-Consumerism (Plan usage)

•Verifiable Metrics for Measuring Value of Destination Wellness


Summary of Workforce Stability Initiatives

Item Desired Outcome Result Trending

LOA• Reduction in

(occ and non-occ) leaves

Workers’ Comp• Reduction in

workers’ comp claims

Metric Result Trending

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Pap Smear Mammogram PSA Colorectal Screening All Health Screens


0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


4.9% 4.7% 4.7%4.3%

4.9%

2005 2006 2007 2008 2009

LOA %

1,7371,554

1,171897

405

2005 2006 2007 2008 2009

WCs' Claims


HAM Medical Cost Trending

-10%

-5%

0%

5%

10%

15%

20%

25%

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

HAM Nat'l Avg Gen Inflat

*Began Active/Passive

Healthcare Fund


•Destination Wellness Participation Trend

91%87% 86% 87%

70%

80%

90%

100%

2007 2008 2009 2010

DW Participation- Active Healthcare Plan

Active

91%87% 86% 87%

70%

80%

90%

100%

2007 2008 2009 2010

DW Participation- Active Healthcare Plan

Active=Leading Industry Level

•Over 15,000 associates and spouses qualified for the Active Healthcare plan in 2011

•Summary data shows positive improvement in key health metrics such as total cholesterol, glucose and blood pressure

•Participation in preventive healthcare is increasing

•Over 15,000 associates and spouses qualified for the Active Healthcare plan in 2011

•Summary data shows positive improvement in key health metrics such as total cholesterol, glucose and blood pressure

•Participation in preventive healthcare is increasing


2009

Associate

HAM'sAvg. Total

Cholesterol

HAM'sAvg.HDL

HAM's Avg.LDL

HAM's Avg.

Triglyceride

HAM's Avg.

Glucose

HAM's Avg.

Diastolic BP

HAM's Avg.

Systolic BPNormative Values < 200 60+ <100 <150 <100 <80 <120

20 - 29 170 53 97 112 88 76 12030 - 39 186 50 111 127 90 77 12040 - 49 192 50 115 140 94 78 12350 - 59 192 51 115 139 97 79 12560+ 188 51 111 131 96 78 127All Females 192 62 109 106 90 75 118All Males 190 47 115 146 95 79 124All Associates 190 50 113 136 94 78 123

2007

Associate

HAM'sAvg. Total

Cholesterol

HAM'sAvg.HDL

HAM's Avg.LDL

HAM's Avg.

Triglyceride

HAM's Avg.

Glucose

HAM's Avg.

Diastolic BP

HAM's Avg.


25 - 29 192 58 107 118 95 81 13130 - 34 204 57 118 125 97 82 13035-39 206 56 121 132 99 82 129

40 - 44 206 55 122 135 100 82 13045 - 49 209 55 125 135 103 83 13150 - 54 206 55 122 143 105 83 13355 - 59 207 56 119 137 106 84 13660 - 64 195 54 111 141 106 82 133

All Females 208 66 118 141 99 80 127All Males 205 52 122 116 103 84 133All Associates 206 55 121 135 102 83 131

•Considering all the variables that may occur when gathering biometrics, 2009 overall data appears to show a healthier trend for HAM associates.

200 9

200 7

2009 VS 2007 Associate Biometric Data


2009

Spouse

HAM'sAvg. Total

Cholesterol

HAM'sAvg.HDL

HAM'sAvg.LDL

HAM'sAvg.

Triglyceride

HAM's Avg.

Glucose

HAM'sAvg.

Diastolic BP

HAM's Avg.


20 - 29 184 56 104 124 87 72 11330 - 39 180 56 103 114 89 73 11540 - 49 189 56 110 122 92 75 11850 - 59 194 55 113 132 97 77 12360+ 191 54 109 141 102 77 126All Females 188 58 108 118 91 74 117All Males 188 45 114 155 100 79 126All Spouses 188 56 109 123 93 75 119

2007

Spouse

HAM'sAvg. Total

Cholesterol

HAM'sAvg.HDL

HAM'sAvg.LDL

HAM'sAvg.

Triglyceride

HAM's Avg.

Glucose

HAM'sAvg.

Diastolic BP

HAM's Avg.


25 - 29 192 64 107 108 95 75 11930 - 34 197 61 112 115 95 76 12135-39 196 60 111 112 97 77 120

40 - 44 199 59 115 118 97 76 12145 - 49 202 59 116 125 98 76 12250 - 54 205 58 121 132 103 79 12755 - 59 201 57 117 130 103 78 12660 - 64 196 57 107 130 102 79 128

All Females 200 61 115 118 98 76 122All Males 197 49 115 144 107 82 131All Associates 200 59 115 122 99 77 123

155

•Overall trending for HAM spouses seems to be healthier with regard to biometric data

200 9

200 7

2009 VS 2007 Spouse Biometric Data


There appears to be a correlation between risk and claims dollars in the case of Chronic Illness and Hypertension

•Members with 1 *Chronic illness consistently cost almost 3X more per month than non-chronic*Note: Chronic defined as DX of Asthma, Diabetes, COPD, CHF and CAD

•Members with high blood pressure cost 2X more per month than those with normal blood pressure

DW Strategies to Positively Impact: •Risk Reduction•Disease Mgt (Health Dialog)•Passports to Wellness•Wellness Center Education Programs•Health Mgt Ctr Modules•Hypnotherapy

DW Strategies to Positively Impact: •Risk Reduction•Passports to Wellness•Healthy Food Initiative•Health Mgt Ctr Modules•Hypnotherapy

$0.00

$500.00

$1,000.00

0 1

Chronic IllnessCost per Member

2007

2008

2009

$301

$283

$296

$850$845

$950

$0.00

$200.00

$400.00

$600.00

$800.00

No Yes

HypertensionCost per Member

2007

2008

2009

$285

$266

$290

$700$656

$657

HAM’s Cost for Health Risks: 2007-2009


There appears to be a correlation between risk and claims dollars in the case of Exercise and Coping with Stress

•Associates who don’t exercise cost HAM 3-4X more per month than heavy exercisers

•Associates who don’t cope well with stress cost HAM

almost twice as much.

DW Strategies to Positively Impact: •Risk Reduction•Passports to Wellness•LIVE IT 365+•Health Mgt Ctr Module•Initiating/Maintaining the Courage•Biggest Loser

DW Strategies to Positively Impact: •Risk Reduction•Passports to Wellness•Healthy Food Initiative•Health Mgt Ctr Modules- Stress and Emotional Health•Hypnotherapy

$0.00

$500.00

$1,000.00

$1,500.00

Non-Exerciser Light Exerciser Heavy Exerciser

Exercise LevelCost per Member

2007

2008

2009

$1146$1181

$999

$389$376

$405$274

$269$306

$0.00

$200.00

$400.00

$600.00

$800.00

Coping w ell Not coping w ell

StressCost per Member

2007

2008

2009

$367$350 $372

$639 $648$628

HAM’s Cost for Health Risks: 2007-2009


NI CU Measurement

# NI CU

Admissions 2009

Total #

Deliveries 2009

NI CU Rate 2009

NI CU Rate 2008

NI CU Rate 2007

NI CU Rate 2006

NI CU Rate 2005

NI CU Admissions

15 217 6.9%

3.4% 8/ 235

3.9% 12/ 304

5.4% 17/ 317

5.2% 19/ 366

Migraines 1) Objective – To monitor migraines through leave data 2) Defi nition – Measurement of migraines through leave data is the average number of leave hours taken by those associates taking leave f or migraines. 3) Calculation Total # of leave hours taken f or migraines # associates taking leave f or migraines 4) Source: Leave Department Migraines

Measurement

Total # Leave Hrs

taken f or Migraines

2009

# of Associates taking leave hours f or Migraines

2009

Avg # of Leave Hours per Associate

2009


2008


2007


2006

Leave hours 11,616 169 68.7 hrs/ assoc. 144.3 hrs/ assoc 125.7 hrs/ assoc 118 hrs/ assoc (both intermittent and continuous)

NI CU Measurement

# NI CU

Admissions 2009

Total #

Deliveries 2009

NI CU Rate 2009

NI CU Rate 2008

NI CU Rate 2007

NI CU Rate 2006

NI CU Rate 2005

NI CU Admissions

15 217 6.9%

3.4% 8/ 235

3.9% 12/ 304

5.4% 17/ 317

5.2% 19/ 366

Migraines 1) Objective – To monitor migraines through leave data 2) Defi nition – Measurement of migraines through leave data is the average number of leave hours taken by those associates taking leave f or migraines. 3) Calculation Total # of leave hours taken f or migraines # associates taking leave f or migraines 4) Source: Leave Department Migraines

Measurement

Total # Leave Hrs

taken f or Migraines

2009

# of Associates taking leave hours f or Migraines

2009


2009


2008


2007


2006

Leave hours 11,616 169 68.7 hrs/ assoc. 144.3 hrs/ assoc 125.7 hrs/ assoc 118 hrs/ assoc (both intermittent and continuous)

ER Utilization 1) Objective – To monitor appropriate utilization of ER Services 2) Defi nition – The ER utilization rate is the ratio of the number of claimants utilizing the ER relative to the number of members eligible to utilize the ER during the reporting year. 3) Calculation - # claimants identifi ed as utilizing the ER during the current reporting year # members identifi ed eligible to utilize the ER during the current reporting year 4) Source - E-Plan Sponsor Monitor, Level C, Utilization – Stats f or Emergency Room Services; Trend Report by Acct Structure by Month Emergency

Room

Measurement Unique # Claimants

2009

# Members

2009

Utilization Rate 2009





ER utilization 5,102 31,615 16.1%

15.6% 5354/ 34309

16.2% 5,829/ 36,014

18.4% 6784/ 36913

19.5% 7295/ 37495

High Cost Claimants 1) Objective – To monitor the number of high risk newborns 2) Defi nition – The NI CU rate is the ratio of the number of NI CU admissions relative to the number of total deliveries during the reporting year. 3) Calculation – # NI CU admissions during a reporting year

Total # of deliveries during a reporting year 4) Source - E-Plan Sponsor Monitor Reporting, Level C, Clinical - Maternity Services

ER Utilization 1) Objective – To monitor appropriate utilization of ER Services 2) Defi nition – The ER utilization rate is the ratio of the number of claimants utilizing the ER relative to the number of members eligible to utilize the ER during the reporting year. 3) Calculation - # claimants identifi ed as utilizing the ER during the current reporting year # members identifi ed eligible to utilize the ER during the current reporting year 4) Source - E-Plan Sponsor Monitor, Level C, Utilization – Stats f or Emergency Room Services; Trend Report by Acct Structure by Month Emergency

Room

Measurement Unique # Claimants

2009

# Members

2009






ER utilization 5,102 31,615 16.1%

15.6% 5354/ 34309

16.2% 5,829/ 36,014

18.4% 6784/ 36913

19.5% 7295/ 37495

High Cost Claimants 1) Objective – To monitor the number of high risk newborns 2) Defi nition – The NI CU rate is the ratio of the number of NI CU admissions relative to the number of total deliveries during the reporting year. 3) Calculation – # NI CU admissions during a reporting year

Total # of deliveries during a reporting year 4) Source - E-Plan Sponsor Monitor Reporting, Level C, Clinical - Maternity Services

# of members identifi ed with back conditions as specifi ed above 4) Source - E-Plan Sponsor Monitor, Level D, Back Surgeries MCC Sub 0002 dx group #243 2006; Back dx group # 243 2006; Back Claimants Dx Group #243 2006 Back Measurement Utilizing

Members 2009

I dentifi ed Members

2009

2009 I ndex

2008 I ndex

2007 I ndex

2006 I ndex

2005 I ndex

Back Surgeries 109 4785 2.3% 3.0% 149/ 4,937

3.1% 163/ 5,187

3.1% 169/ 5,370

3.1% 171/ 5,496

I maging 1,766 4785 36.9% 27.0% 1,334/ 4,937

28.8% 1494/ 5187

28.0% 1503/ 5370

27.3% 1502/ 5,496

Total 1,875 9,570 19.6% 15.0% 1,483/ 9,874

16.0% 1657/ 10374

15.6% 1672/ 10740

15.2% 1673/ 10992

Pharmacy 1) Objective – Monitor the utilization rate of Nexium. 2) Defi nition – The utilization rate ref ers to the ratio of the number of claimants using the Proton Pump I nhibitor drug Nexium vs the number of members eligible to use the drug. 3) Calculation - # Claimants utilizing Nexium # Members identifi ed as eligible (Age 19+) 4) Source - E-Plan Sponsor Monitor, Level D – Membership 2006; Nexium Claimants 2006; Nexium Measurement # Claimants

2009 # Members

2009 Utilization Rate 2009





Nexium 1467 19,725 7.4% 5.3% 1831/ 34309

5.4% 1,954/ 36,014

4.0% 1487/ 36913

3.4% 1258/ 37495

# of members identifi ed with back conditions as specifi ed above 4) Source - E-Plan Sponsor Monitor, Level D, Back Surgeries MCC Sub 0002 dx group #243 2006; Back dx group # 243 2006; Back Claimants Dx Group #243 2006 Back Measurement Utilizing

Members 2009


2009

2009 I ndex

2008 I ndex

2007 I ndex

2006 I ndex

2005 I ndex

Back Surgeries 109 4785 2.3% 3.0% 149/ 4,937

3.1% 163/ 5,187

3.1% 169/ 5,370

3.1% 171/ 5,496

I maging 1,766 4785 36.9% 27.0% 1,334/ 4,937

28.8% 1494/ 5187

28.0% 1503/ 5370

27.3% 1502/ 5,496

Total 1,875 9,570 19.6% 15.0% 1,483/ 9,874

16.0% 1657/ 10374

15.6% 1672/ 10740

15.2% 1673/ 10992

Pharmacy 1) Objective – Monitor the utilization rate of Nexium. 2) Defi nition – The utilization rate ref ers to the ratio of the number of claimants using the Proton Pump I nhibitor drug Nexium vs the number of members eligible to use the drug. 3) Calculation - # Claimants utilizing Nexium # Members identifi ed as eligible (Age 19+) 4) Source - E-Plan Sponsor Monitor, Level D – Membership 2006; Nexium Claimants 2006; Nexium Measurement # Claimants

2009 # Members

2009 Utilization Rate 2009





Nexium 1467 19,725 7.4% 5.3% 1831/ 34309

5.4% 1,954/ 36,014

4.0% 1487/ 36913

3.4% 1258/ 37495

# leave hours taken f or intermittent and continuous leave w/ primary dx grp of 160 # associates taking leave f or primary dx grp of 160 4) Source - E-plan Sponsor Monitor, Level D, Depression Dx Group # 160 Specialist 2007; Depression Claimants Dx Group #160 All 2007 f or claims data. Leave inf ormation gathered f rom Leave Coordination group. Claims Data Depression Measurement Utilizing

Members 2009


2009

2009 I ndex

2008 I ndex

2007 I ndex

2006 I ndex

2005 I ndex

I npatient Admissions 31 1126 2.8% 3.2% 40/ 1235

.83% 11/ 1323

.27% 4/ 1,447

1.9% 28/ 1,404

ER Visits 37 1126 3.3% 4.8% 60/ 1235

.83% 11/ 1323

2.62% 38/ 1,447

2.7% 39/ 1,404

Total Utilization Rates 68 2252 3.0% 4.0% 100/ 2470

.83% 1.5% 2.4%

Leave Data Depression, Anxiety, Stress

Measurement Leave Hours 2009


2009

2009 Hours Per Leave

Assoc.

2008 Hours Per leave

assoc

2007 Hours per leave

assoc

2006 Hours per leave assoc.


Leaves 24,715 174 142.0/ assoc. 191.8/ assoc 185.3/ assoc 162.4/ assoc 201.5/ assoc. (both intermittent and continuous)

Back 1) Objective – Monitor # of claimants with specifi c diagnosis group codes seeking imaging and surgery treatments. 2) Defi nition – The surgery and imaging index f or back conditions is the ratio of the # of surgeries and imaging claims f or claimants with the f ollowing primary diagnosis codes: 839.0 – 839.59; 806.70; 805.0; 733.13; 805; 806; 846; 847; 756.1 – 756.19; 737; 739.2 – 739.4; 213.2; 213.6; 720; 721; 722; 724; 723; 922.3; 922.31; 925.2; 926.11 3) Calculation – # of surgeries and imaging f or claimants identifi ed with back conditions as specifi ed above

# leave hours taken f or intermittent and continuous leave w/ primary dx grp of 160 # associates taking leave f or primary dx grp of 160 4) Source - E-plan Sponsor Monitor, Level D, Depression Dx Group # 160 Specialist 2007; Depression Claimants Dx Group #160 All 2007 f or claims data. Leave inf ormation gathered f rom Leave Coordination group. Claims Data Depression Measurement Utilizing

Members 2009


2009

2009 I ndex

2008 I ndex

2007 I ndex

2006 I ndex

2005 I ndex


.83% 11/ 1323

.27% 4/ 1,447

1.9% 28/ 1,404

ER Visits 37 1126 3.3% 4.8% 60/ 1235

.83% 11/ 1323

2.62% 38/ 1,447

2.7% 39/ 1,404

Total Utilization Rates 68 2252 3.0% 4.0% 100/ 2470

.83% 1.5% 2.4%

Leave Data Depression, Anxiety, Stress

Measurement Leave Hours 2009


2009

2009 Hours Per Leave

Assoc.

2008 Hours Per leave

assoc

2007 Hours per leave

assoc



Leaves 24,715 174 142.0/ assoc. 191.8/ assoc 185.3/ assoc 162.4/ assoc 201.5/ assoc. (both intermittent and continuous)

Back 1) Objective – Monitor # of claimants with specifi c diagnosis group codes seeking imaging and surgery treatments. 2) Defi nition – The surgery and imaging index f or back conditions is the ratio of the # of surgeries and imaging claims f or claimants with the f ollowing primary diagnosis codes: 839.0 – 839.59; 806.70; 805.0; 733.13; 805; 806; 846; 847; 756.1 – 756.19; 737; 739.2 – 739.4; 213.2; 213.6; 720; 721; 722; 724; 723; 922.3; 922.31; 925.2; 926.11 3) Calculation – # of surgeries and imaging f or claimants identifi ed with back conditions as specifi ed above

4) Source - E-Plan Sponsor Monitor, Level D – “Allergy Dx Group #001 Specialist 2007”, “Allergy Claimants Dx Group #001 All 2007” Allergy

Measurement

Members Utilizing Specialist

2009

I dentified Members w/Disease

Burden 2008

2009 I ndex

2008 I ndex

2007 I ndex

2006 I ndex

2005 I ndex

1 Specialist Offi ce Visits

706 1536 46.0% 45.0% 748/ 1663

60.93% 457/ 750

43.6% 914/ 2,097

39.33% 868/ 2,207

Hypertension 1) Objective – Monitor the average blood pressure of HAM associates who participate in PWA completion and include biometric data. 2) Defi nition – The average blood pressure is the sum of the systolic readings divided by the number of readings over the sum of the diastolic readings divided by the number of readings obtained in the annual PWA biometric data. 3) Calculation - Sum of systolic readings/ # readings (Avg. Systolic Reading) Associate or Spouse Sum of diastolic readings/ # readings (Avg. Diastolic Reading) Associate or Spouse 4) Source - Self -reported biometric data included on PWA (Web MD). Report will calculate average systolic/ diastolic

Measurement 2009 Associate Average Rate

2008 Associate Average Rate


2009 Spouse Average Rate



Systolic

120 123

131 118 119

123

Diastolic 77 78 83 75 75 77 Depression 1) Objective – Monitor depression through claims and leave data 2) Defi nition – The utilization index is determined by calculating the ratio of the number of members identifi ed with depression relative to those utilizing specifi c healthcare services. Measurement of depression through leave data is determined by calculating the number of leave hours per associate taking leave f or depression. 3) Calculation - # members w/ depression utilizing specifi c healthcare services # members w/ depression based on claims’ primary dx

4) Source - E-Plan Sponsor Monitor, Level D – “Allergy Dx Group #001 Specialist 2007”, “Allergy Claimants Dx Group #001 All 2007” Allergy

Measurement

Members Utilizing Specialist

2009

I dentified Members w/Disease

Burden 2008

2009 I ndex

2008 I ndex

2007 I ndex

2006 I ndex

2005 I ndex

1 Specialist Offi ce Visits

706 1536 46.0% 45.0% 748/ 1663

60.93% 457/ 750

43.6% 914/ 2,097

39.33% 868/ 2,207

Hypertension 1) Objective – Monitor the average blood pressure of HAM associates who participate in PWA completion and include biometric data. 2) Defi nition – The average blood pressure is the sum of the systolic readings divided by the number of readings over the sum of the diastolic readings divided by the number of readings obtained in the annual PWA biometric data. 3) Calculation - Sum of systolic readings/ # readings (Avg. Systolic Reading) Associate or Spouse Sum of diastolic readings/ # readings (Avg. Diastolic Reading) Associate or Spouse 4) Source - Self -reported biometric data included on PWA (Web MD). Report will calculate average systolic/ diastolic

Measurement 2009 Associate Average Rate






Systolic

120 123

131 118 119

123

Diastolic 77 78 83 75 75 77 Depression 1) Objective – Monitor depression through claims and leave data 2) Defi nition – The utilization index is determined by calculating the ratio of the number of members identifi ed with depression relative to those utilizing specifi c healthcare services. Measurement of depression through leave data is determined by calculating the number of leave hours per associate taking leave f or depression. 3) Calculation - # members w/ depression utilizing specifi c healthcare services # members w/ depression based on claims’ primary dx

Diabetes Measurement

Desired I mpact

2009 Utilizing

Members

2009 I dentified Members

2009 Utilizing I ndex





Lipid Profi le 614

1139 53.9% 53.5% 611/ 1141

51.54% 685/ 1135

48.90% 512/ 1,047

48.32% 447/ 925

ER Visits 25

1139

2.2%

2.1% 24/ 1141

1.85% 21/ 1135

2.19% 23/ 1,047

2.27% 21/ 925


1.32% 15/ 1135

1.72% 18/ 1,047

1.29% 12/ 925

652 3417 19.1% 18.9% 18.23% 17.61% 7.30% Asthma

Measurement Desired I mpact

2009 Utilizing Members







ER Visits 80

1040 7.7% 6.2% 68/ 1103

6.81% 81/ 1189

7.65% 104/ 1,360

7.85% 112/ 1,426

I npatient Admissions 7 1040 .6% 1.2% 13/ 1103

1.18% 14/ 1189

1.54% 21/ 1,360

1.33% 19/ 1,426

87 2080 4.2% 3.7% 3.99% 4.60% 4.64%

Disease Burden Focus Allergy 1) Objective – Monitor the rate of appropriate medical care f or those associates/ dependents identifi ed with allergy claims utilizing primary I CD9 Dx Group code 001. 2) Defi nition – The allergy index is the ratio of the number of those members identifi ed through claims data under the care of an allergy specialist to those total members identifi ed with this disease burden during the reporting time f rame. 3) Calculation - # of identifi ed members under the care of an allergy specialist Total # identifi ed as members with allergy claims (I CD9 Dx Grp Code 001) during 2007

Diabetes Measurement

Desired I mpact

2009 Utilizing

Members







Lipid Profi le 614

1139 53.9% 53.5% 611/ 1141

51.54% 685/ 1135

48.90% 512/ 1,047

48.32% 447/ 925

ER Visits 25

1139

2.2%

2.1% 24/ 1141

1.85% 21/ 1135

2.19% 23/ 1,047

2.27% 21/ 925


1.32% 15/ 1135

1.72% 18/ 1,047

1.29% 12/ 925

652 3417 19.1% 18.9% 18.23% 17.61% 7.30% Asthma

Measurement Desired I mpact

2009 Utilizing Members







ER Visits 80

1040 7.7% 6.2% 68/ 1103

6.81% 81/ 1189

7.65% 104/ 1,360

7.85% 112/ 1,426

I npatient Admissions 7 1040 .6% 1.2% 13/ 1103

1.18% 14/ 1189

1.54% 21/ 1,360

1.33% 19/ 1,426

87 2080 4.2% 3.7% 3.99% 4.60% 4.64%

Disease Burden Focus Allergy 1) Objective – Monitor the rate of appropriate medical care f or those associates/ dependents identifi ed with allergy claims utilizing primary I CD9 Dx Group code 001. 2) Defi nition – The allergy index is the ratio of the number of those members identifi ed through claims data under the care of an allergy specialist to those total members identifi ed with this disease burden during the reporting time f rame. 3) Calculation - # of identifi ed members under the care of an allergy specialist Total # identifi ed as members with allergy claims (I CD9 Dx Grp Code 001) during 2007

HEALTH SCREENS Health Screens

Desired I mpact

Eligible Population Definition

Eligible Population

2009

# Claimants

2009

% Participation

2009

% Participation

2008

% Participation

2007

% Participation

2006

% Participation

2005

Pap Smear

Aetna Specifi cations

10,189 5,140 50.4% 48.9%

5,229/ 10,697 44.83%

4,954/ 11,050 43.91%

4900/ 11,160 39.31%

4,395/ 11,179

Mammogram


6,963 3,794 54.5% 55.3%

3,927/ 7,101 48.00%

3,380/ 7,042 44.97%

3,069/ 6,825 39.83%

2,610/ 6,553

PSA


3,501 1,009 28.8% 28.5%

978/ 3,429 15.82%

511/ 3,231 11.11%

323/ 2,907 8.68%

225/ 2,591

Colorectal Screening


6,370 936 14.7% 14.0%

884/ 6,326 9.32%

553/ 5,936 6.31%

338/ 5,359 4.70%

225/ 4,788

40.3% 39.9% 34.48% 32.87% 29.69%

Gaps in Care - Compliance/Outcomes

1) Objective – To monitor gaps in appropriate utilization of healthcare services f or those associates and their dependents identifi ed as members with diabetes and asthma. 2) Defi nition – Gaps in care index 1 is the ratio of all members identifi ed as having diabetes and asthma (I CD9 Dx group number(s) 175 and 22) and, of those identifi ed, those with claims f or I npatient Admissions or Emergency Room treatment during the year. Gaps in care I ndex 2 is the ratio of those members identifi ed as having diabetes under I CD9 dx group number 22 and those receiving treatment f or lipid profi le. 3) Calculation Method

I ndex 1 - Diabetic/ Asthmatic members with I npatient or ER MCC during current year Diabetic/ Asthmatic members included in I CD9 Dx Group Numbers(s) 175 and 22 with claims during current year

I ndex 2 - Diabetic members receiving treatment f or Lipid Profi les during current year Diabetic members included in I CD9 Dx Group Number 22 with claims during current year 4) Source – EPSM Level D: Diabetes Claimants 2005, 2006, 2007;Diabetes Claimants 2005, 2006, 2007 w MCC 001 003; Diabetes Claimants-Lipid Profi le 2005, 2006, 2007; Asthma Claimants 2005, 2006, 2007; Asthma Claimants 2005, 2006, 2007 w MCC 001 003;

HEALTH SCREENS Health Screens

Desired I mpact


Eligible Population

2009

# Claimants

2009

% Participation

2009

% Participation

2008

% Participation

2007

% Participation

2006

% Participation

2005

Pap Smear


10,189 5,140 50.4% 48.9%

5,229/ 10,697 44.83%

4,954/ 11,050 43.91%

4900/ 11,160 39.31%

4,395/ 11,179

Mammogram


6,963 3,794 54.5% 55.3%

3,927/ 7,101 48.00%

3,380/ 7,042 44.97%

3,069/ 6,825 39.83%

2,610/ 6,553

PSA


3,501 1,009 28.8% 28.5%

978/ 3,429 15.82%

511/ 3,231 11.11%

323/ 2,907 8.68%

225/ 2,591

Colorectal Screening


6,370 936 14.7% 14.0%

884/ 6,326 9.32%

553/ 5,936 6.31%

338/ 5,359 4.70%

225/ 4,788

40.3% 39.9% 34.48% 32.87% 29.69%

Gaps in Care - Compliance/Outcomes

1) Objective – To monitor gaps in appropriate utilization of healthcare services f or those associates and their dependents identifi ed as members with diabetes and asthma. 2) Defi nition – Gaps in care index 1 is the ratio of all members identifi ed as having diabetes and asthma (I CD9 Dx group number(s) 175 and 22) and, of those identifi ed, those with claims f or I npatient Admissions or Emergency Room treatment during the year. Gaps in care I ndex 2 is the ratio of those members identifi ed as having diabetes under I CD9 dx group number 22 and those receiving treatment f or lipid profi le. 3) Calculation Method

I ndex 1 - Diabetic/ Asthmatic members with I npatient or ER MCC during current year Diabetic/ Asthmatic members included in I CD9 Dx Group Numbers(s) 175 and 22 with claims during current year

I ndex 2 - Diabetic members receiving treatment f or Lipid Profi les during current year Diabetic members included in I CD9 Dx Group Number 22 with claims during current year 4) Source – EPSM Level D: Diabetes Claimants 2005, 2006, 2007;Diabetes Claimants 2005, 2006, 2007 w MCC 001 003; Diabetes Claimants-Lipid Profi le 2005, 2006, 2007; Asthma Claimants 2005, 2006, 2007; Asthma Claimants 2005, 2006, 2007 w MCC 001 003;

Preventive Care 1) Objective – To monitor preventive care utilization f or HAM associates and their dependents 2) Defi nition – The preventive care utilization index is the % of participation in each preventive care category calculated by dividing the number of claimants by the number of “eligible members” in each preventive care category. Preventive care services are those that assist in the assessment of risk, early diagnosis and intervention of disease. Typically these services are age and/ or gender based. “Eligible members” defi nitions vary and are specifi c to each preventive care category. 3) Calculation Method – Number of actual claimants in a specifi c preventive care category Number of eligible members in a specifi c preventive care category 4) Source(s) – Aetna EPSM Level C – Preventive Care; EPSM Level C – Cost and Utilization by Major Dental Categories of Service; EPSM Level C – Trend Report by Account Structure by Month; VSP Client Utilization Report HEALTH CHECKS

Health Check

Desired I mpact


Eligible Population

2009

# Claimants

2009

% Participation

2009

% Participation

2008

% Participation

2007

% Participation

2006

% Participation

2005

Baby Well Checks


743

564

75.9%

79.4% 674/ 849

77.35% 782/ 1,011

74.17% 784/ 1,057

70.71% 821/ 1,161

Childhood Well Checks


12,477

5,057

40.5%

39.8% 5312/ 13,333

39.39% 5,611/ 14,246

37.16% 5,503/ 14,810

33.93% 5,229/ 15,410

Adult Well Checks


21,600

9,144

42.3%

33.7% 7,579/ 22,489

14.38% 3,340/ 23,229

8.55% 1,999/ 23,393

6.77% 1,586/ 23,412

Childhood I mmun.


743

543

73.1%

71.02% 615/ 849

71.02% 718/ 1,011

68.59% 725/ 1,057

65.46% 760/ 1,161

Routine Dental Exam

Annual Average # Members

31,615

23,223

73.5%

69.16% 23,728/ 34,309

65.01% 23,413/ 36,014

64.17% 23,689/ 36,913

63.30% 23,723/ 37,495

Eye Exam Annual Average # Members

31,615 17889 56.6% 51.2% 17,594/ 34,309

42.20% 15,198/ 36,014

41.28% 15,210/ 36,913

31.62% 14,829/ 37,495

98793 56420 57,1% 52.3% 43.97% 41.97% 40.39%

Preventive Care 1) Objective – To monitor preventive care utilization f or HAM associates and their dependents 2) Defi nition – The preventive care utilization index is the % of participation in each preventive care category calculated by dividing the number of claimants by the number of “eligible members” in each preventive care category. Preventive care services are those that assist in the assessment of risk, early diagnosis and intervention of disease. Typically these services are age and/ or gender based. “Eligible members” defi nitions vary and are specifi c to each preventive care category. 3) Calculation Method – Number of actual claimants in a specifi c preventive care category Number of eligible members in a specifi c preventive care category 4) Source(s) – Aetna EPSM Level C – Preventive Care; EPSM Level C – Cost and Utilization by Major Dental Categories of Service; EPSM Level C – Trend Report by Account Structure by Month; VSP Client Utilization Report HEALTH CHECKS

Health Check

Desired I mpact


Eligible Population

2009

# Claimants

2009

% Participation

2009

% Participation

2008

% Participation

2007

% Participation

2006

% Participation

2005

Baby Well Checks


743

564

75.9%

79.4% 674/ 849

77.35% 782/ 1,011

74.17% 784/ 1,057

70.71% 821/ 1,161

Childhood Well Checks


12,477

5,057

40.5%

39.8% 5312/ 13,333

39.39% 5,611/ 14,246

37.16% 5,503/ 14,810

33.93% 5,229/ 15,410

Adult Well Checks


21,600

9,144

42.3%

33.7% 7,579/ 22,489

14.38% 3,340/ 23,229

8.55% 1,999/ 23,393

6.77% 1,586/ 23,412

Childhood I mmun.


743

543

73.1%

71.02% 615/ 849

71.02% 718/ 1,011

68.59% 725/ 1,057

65.46% 760/ 1,161

Routine Dental Exam

Annual Average # Members

31,615

23,223

73.5%

69.16% 23,728/ 34,309

65.01% 23,413/ 36,014

64.17% 23,689/ 36,913

63.30% 23,723/ 37,495

Eye Exam Annual Average # Members

31,615 17889 56.6% 51.2% 17,594/ 34,309

42.20% 15,198/ 36,014

41.28% 15,210/ 36,913

31.62% 14,829/ 37,495

98793 56420 57,1% 52.3% 43.97% 41.97% 40.39%

BASELI NE METRI CS – Reported in 86ki Account Structure Utilized (Labor Rate Structure- HAM only) Med/ Rx Aetna 657189-20-001 HAM actives (prior to 2005) 657189-20-100 HAM COBRA (prior to 2005) 657189-23-001 HAM POSI I Actives 657189-23-100 HAM POSI I COBRA 657189-23-003 AHF HAM (prior AHF) 657189-23-005 AHF COBRA (prior AHF) 657189-25-003 AHF HAM Active (began 04/ 01/ 2007) 657189-25-005 AHF COBRA (began plan 4/ 1/ 2007) 657189-26-003 AHF HAM Passive (began 01/ 01/ 2008 657189-26-005 AHF COBRA

724864-20-011 AGB Expats 724864-20-100 AGB Expats COBRA Dental Aetna 657458-20-001 HAM Actives Dental 657458-20-100 HAM Dental COBRA 724867-20-003 AGB Expats Dental 724867-20-100 AGB Expats Dental COBRA

Vision VSP 12-022801-001 Reporting Year(s) Data Current year - Calendar year 2009 Prior year – Calendar year 2008 (Unless otherwise specifi ed) .

BASELI NE METRI CS – Reported in 86ki Account Structure Utilized (Labor Rate Structure- HAM only) Med/ Rx Aetna 657189-20-001 HAM actives (prior to 2005) 657189-20-100 HAM COBRA (prior to 2005) 657189-23-001 HAM POSI I Actives 657189-23-100 HAM POSI I COBRA 657189-23-003 AHF HAM (prior AHF) 657189-23-005 AHF COBRA (prior AHF) 657189-25-003 AHF HAM Active (began 04/ 01/ 2007) 657189-25-005 AHF COBRA (began plan 4/ 1/ 2007) 657189-26-003 AHF HAM Passive (began 01/ 01/ 2008 657189-26-005 AHF COBRA

724864-20-011 AGB Expats 724864-20-100 AGB Expats COBRA Dental Aetna 657458-20-001 HAM Actives Dental 657458-20-100 HAM Dental COBRA 724867-20-003 AGB Expats Dental 724867-20-100 AGB Expats Dental COBRA

Vision VSP 12-022801-001 Reporting Year(s) Data Current year - Calendar year 2009 Prior year – Calendar year 2008 (Unless otherwise specifi ed) .

Core Metrics

From the Core Metrics, DW built the initial Targeted

Strategies

Core metrics are indices developed to monitor specific areas of

healthcare representative of DW’s goals.


Utilization Trends: 2005 – 2009

Metric Desired Outcome

Result Trending

Health Checks:• Baby Well Checks• Child Well Checks• Adult Well Checks• Child Immunizations• Dental Exams• Eye Exams

Health Screens:• Pap Smear• Mammogram• PSA• Colorectal Screening

Fact: Participation in preventive health screenings is trending upward. This is a positive behavioral change for HAM.


0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%



0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


Health Checks

Health Screens


Expectation 2005 2006 2007 2008 2009

Health Checks 40.4% 42.0% 44.0% 52.3% 57.1%

Health Screens 29.7% 32.9% 34.5% 39.9% 40.3%

Gaps in Care - Diabetes 7.3% 17.6% 18.2% 18.9% 19.1%

Gaps in Care - Asthma 4.6% 4.6% 4.0% 3.7% 4.2%

Disease Burden - Allergy 39.3% 43.6% 60.9% 45.0% 46.0%

Disease Burden - Hypertension

Disease Burden - Depression 201.5 hrs 162.4 hrs 185.3 hrs 191.8 hrs 142.0 hrs

Disease Burden -Back 15.2% 15.6% 16.0% 15.0% 19.6%

X

Pharmacy 3.4% 4.0% 5.4% 5.3% 7.4%X

ER Utilization 19.5% 18.4% 16.2% 15.6% 16.1%

HCC 5.2% 5.4% 3.9% 3.4% 6.9%

Migraines 118 hrs 125.7 hrs 144.3 hs 68.7 hrs

Core Metrics ScorecardAppropriate Utilization of Healthcare


0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Not intending to takeaction in next 6 mos

Intending to take actionin next 6 mos

Intending to take actionin next 30 days

Acting now < 6 mos. Acting now > 6 mos.

Readiness to Change - Manage My Weight Better

2007

2008

2009

0%

10%

20%

30%

40%

50%

60%

Not intending totake action in next 6

mos

Intending to takeaction in next 6 mos

Intending to takeaction in next 30

days


Readiness to Change - Quit Smoking

2007

2008

2009

0%

5%

10%

15%

20%

25%

30%

35%

40%

Not intending totake action in next 6

mos


Intending to takeaction in next 30

days


Readiness to Change - Increase Cardiovascular Exercise

2007

2008

2009

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Not intending to takeaction in next 6 mos


Intending to takeaction in next 30 days


Readiness to Change - Improve Diet

2007

2008

2009

Readiness to Change

•The shift from “planning to” to “action” has begun in the HAM population (engagement)

“Plan To”

“Action”“Plan To”

“Action”

“Plan To”

“Action”

“Plan To”

“Action”


HR

Issu

eO

rga

niza

tion

al Iss

ue

Wellness

HAM’s Responsibility

•Benefit Component

Everyone’s Responsibility

•Human Capital Component

ParadigmChange

Traditional Model

Genba Stability

Culture

Wellness Investmen

t

Health & Productivity

Manpower

Stability

Right Parts

….R

ight Perso

n, Health

y Pers

on

Spend Money on Care of Health

Spend Money on Healthcare

Rx

Chronic Disease

Labor Cost

Expense

Destination Wellness Summary

Current

Acc

ele

rate

d

Ideal

Miti

ga

ted

Health Risk Continuum

Health Risks XX

Low Medium High Low Medium High


Closing Thoughts

• Develop long-term image (5-10 years)

• Assemble team with PASSION

• ID Wellness Champions as agents of change

• Communicate-Market: What’s in it for me?

• Embrace setbacks and forge ahead

• Establish baseline and measure against yearly

• Remember…Culture will eat strategy for breakfast every day!


Thank You

Documents

Property of Honda of America, Mfg., Inc. 0 Honda of America, Mfg., Inc. Kevin Decot, Senior Staff Administrator — Wellness Team Manager Oct 13, 2010 2010