Koop Award Winner Nationwide Mutual with Kathleen Herath

Kathleen HerathAVP — Health and ProductivityNationwide

Nationwide Case StudyNationwide Case Study

July 13, 2011

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auto and homeowners insurance

insurance for motorcycles, boats, vehicle fleets, businesses and mobile homes

home equity and home mortgage lines of credit

traditional life and variable life insurance

annuities

retirement plans

mutual funds

specialty investments

business cost management

health and productivity management (NBH)

excess and surplus insurance

Nationwide – Who We Are

Diversified insurance and financial services organization

My life. My choice. My health.Nationwide Internal Health and Productivity

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My life. My choice. My health.

• A program of engagement not compliance

• Relies on trusted advisor relationship to help associates better monitor and maintain their health

• Integrated services revolve around associate

• Features strong leadership and communications support

• Outreaches to the right associates at the right time; when they’re most likely to make changes

• Referral pathways built between all offerings to increase participation– Associates seen in the clinics can be enrolled directly into

telephonic courses, disease management, behavioral health etc.– Associates on disability can be enrolled directly into disease management

(same nurse), screened for depression, etc.

• Allows for continual monitoring of successes and key learnings for program improvements


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NBH Health Portal• My Health website• Associate Resources• Brown Bag Lunches• Healthy Resource

Link

NBH Lifestyle Behavior Coaching

Telephonic and web-based coaching courses as well as self directed modules of learning

NBH Disease Management

CAD, CHF, Diabetes, Maternity Management, Oncology (others courses available with self-referral (i.e. Asthma, Depression, Back Pain)

NBH Health AssessmentIncludes:• Domestic violence and

depression outreach questions• Health Screening for health

assessment biometric data

NBH Absence Management• TOPS (Time Off Planning Service)

— absence tracking system (captures100% of all absences, medical or otherwise)

• STD/LTD Appreciative Inquiry• Pandemic/Communicable Illness Tracking• FMLA/State FMLA and State Disability

Nationwide Associate

Behavioral Health• Work Place Onsite Counseling (10 sites)• Domestic Violence/Depression Referrals• Community Based Counseling• 24-hour Telephonic Counseling• Convenience Services• Dedicated Website with robust services

Occupational Health Primary Care Centers

• Clinical Services• Dedicated Lactation Areas• Free Onsite Flu Shots• Ergonomic Evaluations• Educational Seminars• Mobile Mammography• Allergy Shots, First Aid• Health Fairs, Health Screenings• Executive Health Physical

Program

Health Plan and Design• Wellness Incentives• STD/LTD Participation in

Disease Management Requirement• 100% Preventive Care Coverage• Sick Leave changed to

PTO/STD model

Concierge Services• Health Advocacy • Life Resource

Counselors

Wellness Center • Free Onsite Fitness Centers• NBH Walking Program• Fitness Center Discounts

w/Payroll Deductions

The My Health Model



$25 HRA deposit

$25 HRA deposit

$260 HRA

Incentives and Outcomes

$260 HRA or HSA

$260 decrease on the cost of health care coverage

$260 decrease on the cost of spouse health care coverage

Year 1

Requirements

Incentive

RequirementsRequirementsRequirementsRequirements

•Health Assessment with a coaching call•Wellness program

Incentive IncentiveIncentive

•Health Assessment•Wellness program

$260 HRA deposit

$260 decrease on cost of healthcare coverage

•Health Assessment•Wellness program

Incentive

•Health Assessment•Wellness program•Spouses Included for health assessment

•Health Assessment•Wellness program•Spouses Included for health assessment and wellness program

$260 HRA or HSA

$312 decrease on the cost of health care coverage

$312 decrease on the cost of spouse health care coverage

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Year 2 Year 3 Year 4 Year 5

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My Health Promotion

Variety of communication materials used – brochures, table tent, posters, dedicated web site and buttons.

Consumerism –message educates associates about how much Nationwide cares about them

Associate Testimonials – associates share their success stories, which are featured on posters, single page handouts and a dedicated web page.

Materials change each year – while the My Health branding remains constant, material content is updated with each year’s launch.

Leadership Call to Action – working with leadership to create a call to action, followed by leadership support.


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Dedicated website – used to communicate and promote all aspects of My Health.

My Health Champions – support and spread the program efforts across all demographic and geographical locations.

Healthy Holiday Challenge – encourage associates to continue their healthy lifestyle choices/changes during the holiday season.


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Learnings for Keeping Communications Fresh

• Leverage key insights from program champions• “Get to the point” with your message• Use a mix of communications (print, electronic, brown bag luncheons,

video, face-to-face meetings)• Share employees’ success stories• Leverage current trends and share relevant information

– Introduced a new search engine for helping associates locate local farmers markets

• Look for ways to leverage health messages in other company sponsored programs – Diversity & Inclusion – Life Insurance Sales


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Occupational Health

Worksite

Integrating Behavioral Health

Disability and Disease Management

Health Assessments

Wellness Programs


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Benefit Design Best Practices

• Highest level of specialty

• Partial disability plan provision

• Changes to work unit budget process

• Disease Management

• HSA / HRA incentive structure

• Preventive Dental Care Preventive



Integrated Scorecard Measurement• Health Plan prior year/current year/trend

– Enrollment– Claims – Cost (including pharmacy)– Hospital Days/ER Visits/Urgent Care/PCP Visits/Specialist Visits

• Participation– Nurse Advisor– Web Based Information– Health Risk Assessment/ Lifestyle Behavior Change– Disability Management; STD/LTD/WC/FMLA/Disease Management– Associate Assistance Program– Occupational Health Clinics

• Satisfaction– Nurse Advisor– Web based Information– Health Risk Assessment/Lifestyle Behavior Change– Disability Management; STD/LTD/WC/FMLA/Disease Management– Associate Assistance Program– Occupational Health Clinics

• Clinical and Utilization Values– Nurse Advisor– Health Risk Assessment/Lifestyle Behavior Change– Disability Management; STD/LTD/WC/FMLA/Disease Management– Associate Assistance Program– Occupational Health Clinics

• Savings/ROI– Nurse Advisor– Lifestyle Behavior Change– Associate Assistance Program– Disability Management; STD/LTD/WC/FMLA/Disease Management 12

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CARE Report: Business Leader

C

A

R

E

Claims Cost

Absence & Productivity Losses

Risk Profile

Education and EnrollmentMy life. My choice. My health.

Nationwide Internal Health and Productivity

State of Health

*”Do Nothing” annualized each year Low-Risk 1.0 and High-Risk 0.4 source Oswald Companies,

State of Health Comparison Year 1 to Year 5 Trend

Year 1 - Nationwide Associate “State of Health”

45% 23% 26%

Low Risk High RiskModerate Risk Chronic Disease

6%

Maintain Health Improve Health Manage Health

Year 5 - Nationwide Associate “State of Health”

61.0% 24.1% 8.8%

Low Risk High RiskModerate Risk Chronic Disease

6%

Maintain Health Improve Health Manage Health

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Outcome Data

• EAP• Productivity• Biometrics• Lifestyle • Absence and Disability

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Our Best Practices

• Focus on the associate experience– Ease of use for population; referral pathways between programs and integrated services that

revolve around associate

• Create programs that address the holistic view of an employee’s health and absence activity

• Associate surveys show satisfaction improved, enrollment rates increased,

outreach completed earlier and disability durations have decreased– Use your employees to improve the employee experience

• Evaluate outcomes for both risk reduction and claims savings– Increased employee understanding of condition and benefits– Improved outcomes along the entire health continuum

• Integrate behavioral health into all aspects of the programs


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Nationwide Health & Productivity Awards2010• National Business Group on Health - 2010 Best Employers for Healthy Lifestyles- Platinum Award Winner

•This award, by the National Business Group on Health, acknowledges and rewards organizations that have responded to the urgent need to improve their workers' health, productivity and quality of life.

•APEX Award for Health & Productivity Innovation•The Apex Award program recognizes the best designed health care benefits strategies and programs of innovative employers, brokers and consultants who are working to improve the health care experience for consumers.

•Sharp Brains Brain Fitness Innovation Silver Award•The Awards celebrate outstanding pioneers applying neuroplasticity-based research and tools in the ‘real world’. Recognizes organizations devising and implementing results-oriented, scalable initiatives demonstrating commitment to the brain fitness of organization clients, members, patients, students or employees.

•American Heart Association's Start! Fit-Friendly Company - Platinum Achievement•Platinum-level recognition is for companies that fulfill all the gold-level criteria and demonstrate at least one behavior change specified, achieve at least one cost savings outcome specified and have achieved a positive return on investment.

2009•C. Everett Koop National Health Award

•The most prestigious award for health improvement programs, requiring strong documentation of both health improvement and cost savings. Given to work site programs that have soundly documented improved health and decreased medical costs

•American Heart Association's Start! Fit-Friendly Company - Platinum Achievement•Platinum-level recognition is for companies that fulfill all the gold-level criteria and demonstrate at least one behavior change specified, achieve at least one cost savings outcome specified and have achieved a positive return on investment.

•Integrated Benefits Institute & National Business Coalition on Health Award for Employer/Employee Innovation in Health & Productivity•Recognizes leadership in the area of health and productivity and honors an employer that has worked with its employees to develop, implement and measure an innovative health and productivity initiative.

2008•American Heart Association's Start! Fit-Friendly Company - Platinum Achievement

•National Business Group on Health - Best Employers for Healthy Lifestyles - Gold Award My life. My choice. My health.

Nationwide Internal Health and Productivity

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Thank You

Contact information:

Kathleen [email protected]


Economy & Finance

Koop Award Winner Nationwide Mutual with Kathleen Herath