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					Thanks for Joining Us                                                                                                                       1




Today’s Speakers:




   Carol Calvin, RN, MS, CPHQ                                                                            Trisha Horvath, RN, MSN
     National Director Health & Wellness,                                                            Managing Director, Health & Wellness
              UnitedHealthcare                                                                       Strategies, Central & West Regions,
                                                                                                              UnitedHealthcare
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                     UnitedHealth Wellness®
                                                                      “helping                    people lead healthier lives”


      Patricia T. Horvath, RN, MSN                                                                                  Carol Calvin RN MS CPHQ
       Managing Regional Director,                                                                                  National Director, Health and
      Health & Wellness Strategies                                                                                  Wellness Strategies
                   UnitedHealthcare                                                                                 UnitedHealthcare

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Agenda
                                                                                                                                    3




                • Why Wellness?
                • Targeting the Right Customers
                • Overcoming Implementation Barriers
                • Building a Business Case
                • Best Practice - Industry Case Studies
                • Producer Capability Presentation



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    4




                    Why Wellness?




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Why Wellness?
                                                                                                                                    5




                        For every 100 employees, many have lifestyle-
                        related health risk factors:

                          • 66 are overweight or obese
                          • 39 don’t exercise
                          • 33 suffer from stress and anxiety
                          • 29 have hypertension
                          • 21 smoke



  Source: Adapted from Department of Health and Human Services, Centers for Disease Control and Prevention

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Did you know…
                                                                                                                                               6




     Individual employees are your best hope for improving
     quality and cost efficiency

                                                                                                                Factors that affect health
                             10%               Access                                                           are principally behavioral.
                                                                                                                50 - 70% of all diseases are
                                                20%               Genetic                                       associated with modifiable
                                                                                                                health risks – and are
                                               20%               Environmental                                  therefore preventable


                                                                                            50%               Behavior

          Helping individuals to become aware of their modifiable health risks and
             engaged in their personal health is the best way to effect change!
     Source: IFTF, Center for Disease Control and Prevention
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Building a Business Case for Wellness
                                                                                                                                                                         7




  1. Centers for Disease Control & Prevention. Overweight and Obesity. Frequently Asked Questions (FAQs). Costs are estimated for the year 2000.
     http://www.cdc.gov/nccdphp/dnpa/obesity/faq.htm
  2. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity. Health Affairs – Web Exclusive, May 14, 2003; W3:219-
     226. http://content.healthaffairs.org/cgi/reprint/hlthaff.w3.219v1
  3. Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs --- United States, 1995—1999,
     MMWR 2002; 51(14):300-303. http://www.cdc.gov/tobacco/research_data/economics/mmwr5114.highlights.htm
  4. Estimate includes only direct medical costs; indirect costs are not included. Source: Pratt M, Macera CA, Wang G. Higher Direct Medical Costs Associated With
     Physical Inactivity. The Physician and Sports Medicine 2000;28(10):63-70. http://www.physsportsmed.com/issues/2000/10_00/pratt.htm
  5. Hogan P, Dall T, Nikolov P. Economic costs of diabetes in the US in 2002. Diabetes Care 2003;26:917-932.
  6. American Heart Association & National Heart, Lung, and Blood Institute. http://www.americanheart.org/presenter.jhtml?identifier=4475
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Recent Employer Survey Results
                                                                                                                                                                8




    • 2007 Employer Health Benefits Survey: Premiums rose 6.1% for employer
      sponsored health insurance1
    • US Employers significantly underestimate the costs of poor employee health.
      Full cost measures include lost productivity along with direct medical spending
      were four times greater than direct spending2
    • 2008 Hewitt Associates reports that employers identified ―keeping employees
      healthy‖ as top business and workforce issue3
    • 2008: 77% Employers offer formal health and wellness programs4
    • 2008: 71% offer incentives to drive participation and program completion4
    • 2008: 26% Employers measuring wellness program ROI, 83% >1:14
    • Maintaining employee motivation time and measuring program effectiveness
      the top challenges4

    1.   Kaiser/HRET Survey of Employer Sponsored Health Benefits, 007www.kff.org/insurance/7672/index.cfm.
    2.   Loeppke, MD, MPH, Ronald, Michael Taitel, PhD, Dennis Richling, MD, Thomas, Perry, PhD, Ronald C Kessler, PhD, Pam Hymel, MD, MPH and Doris Konicki,
         MHS. ―hea;th and Productivity as a Business Strategy, ― Journal of Occupational and Environmental Medicine, 49 (2007): 712-721.
    3.   Survey Findings: Two Roads Diverged: Hewitt’s Annual Health Care Survey 2008, ―HewittAssociates, www.hewittassociates.com
    4.   Capps, Katherine, Harkey, John B, PhD, Employee Health and Productivity Management Programs: The Use of Incentives, A Survey of Major US Employers,
         June, 2008.


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    9




                    Targeting the Right Customers




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Targeting the Right Customers
                                                                                                                                    10




Characteristics of Success

   1. Commit to your employees’ health
          Identify and communicate senior level support
          Identify champions and create wellness committee

   2. Create a ―company culture of wellness‖
         Adopt a cultural of health and wellness
         Provide time and incentives for employees to participate

   3. Launch Health Assessment campaign
          Evaluate results to identify and target health risks and needs

   4. Develop and implement a worksite strategic plan
         Turnkey and online wellness programs
         Care24 worksite education
         Other programming as indicated


   5. Evaluate, measure and celebrate success!
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Targeting the Right Customers
                                                                                                                                    11




What Can Get in the Way of Success
          • Senior Level Support
          • Culture of Wellness
          • Budget/Incentives
          • Designated Wellness Champion(s)
          • Wellness Committee
          • Computer Access
          • Communication Strategy
          • Commitment to Data Collection, Strategic Planning
            Measurement
          • Maintain Employee Motivation




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Worksite Wellness Strategies
                                                                                                                                                             12




          Quality of Work-Life                                                                                                       Health & Productivity
                                                                           Traditional Approach
                                                                                                                                        Management

                         Fun                                            Primarily Health Focused                                    Includes Productivity

              Activity Focused                                          Low-Mod Risk Reduction                                      Strong Risk Reduction

                    Voluntary                                        Limited High Risk Reduction                                     Includes High Risk

            No Personalization                                                       Voluntary                                       Mandated Activities
         Minimal-No Incentives                                           Limited Personalization                                       Highly Personal

              Employees Only                                              Limited-Mod Incentives                                    Includes Dependants
                No Evaluation                                        Limited Dependant Offerings                                     Rigorous Evaluation
                                                                              Limited Evaluation                                      Highly Integrated
                                                                         Limited-Mod Integration


               Morale Oriented                                                 Activity Oriented                                       Results Oriented


                      No ROI                                                       Limited ROI                                                ROI
      Source: Larry Chapman-Methods for Determining Economic Return

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Best Practice Solutions
                                                                                                                                                              13




                    Health Promotion Intervention                                                         Associated estimated/average ROI
       Health Assessment                                                            As a stand alone intervention -- is a necessary intervention in
                                                                                    order to determine population health risk and health risk
                                                                                    prevalence to target appropriate interventions.
       Glucose Screening                                                            $586 per individual $29 per capita based on 1996 dollars1


       Adult Immunization (Influenza)                                               $46.85 for every adult immunized2


       Smoking Cessation                                                            $3500 in medical costs and $1700 in lost productivity per smoker3


       Hand Sanitizer (Upper Respiratory)                                           $134 annual direct medical & payroll expenses associated with
                                                                                    respiratory illness4

       Physical Activity                                                            Medical costs for physically inactive adults average $1,7125


       Weight/Nutrition Management                                                  Individuals average $395 more annually than normal weight
                                                                                    individuals6

       Self-Care (24/7 NurseLine)                                                   NurseLine produces an average ROI of $2.50 for every $1.00
                                                                                    invested7


   The estimated cost figures represent literature research on the effect of each risk category independent of all other risk categories and comorbidities.

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                                                                                                                                    14




                    Building a Business Case




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Building a Business Case for Wellness
                                                                                                                                    15




        Small investments can make a tremendous difference…

             • For each one-point improvement in an
               employee’s health assessment risk, individual
               claims costs may fall as much as $56 per
               individual employee.
             • Companies save more money by preventing
               health risks.
             • Costs for an employee who moves into a higher
               risk category of illness or disease increases by
               $350 per individual/year.



  Source: Dee Edington, Director of the Health Management Research Center of the University of Michigan


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Business Case for Wellness
                                                                                                                                                                      16




  Source: Aldana SG. Financial impact of health promotion programs: A comprehensive review of the literature. American Journal of Health Promotion 2001;15:296-320.


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Methods to Determine ROI
                                                                                                                                                                        17




                         Name                                           Brief Description                                                Limitations
   Extrapolated External Studies                              Uses economic return measures                              Projected return
                                                              from peer reviewed literature.                             Bias
                                                                                                                         Difficult to find ―good fit‖ reference.
   Economic Conversion of Risk                                Reference article that documents the                       Projected return
   Change                                                     additional economic cost associated                        Bias
                                                              with elevated behavioral risk.                             Limited to the documented risk factors
                                                                                                                         Limited to historical cost/risk calculations
   Proxy Utilization Projections                              Self-Reported claims or health care                        Time period variances
                                                              utilization (baseline from year over                       Limited to HA
                                                              year)                                                      Bias
   Pre and Post Participant                                   Comparison of medical claims of                            Participant instability
   Comparisons                                                participants only                                          Can not correct for benefit design
   External Comparison of Control                             Similar to above but includes                              Requires claims
   Groups                                                     comparison of non-participants                             Relies on enrollment stability
   Multiple Regression Analysis                               Statistical method for measuring                           Requires claims
                                                              effects of independent variables                           Requires individual data
                                                                                                                         Require sophisticated statistical analysis

      Source: Larry Chapman-Methods for Determining Economic Return

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
  8 Strategies for Measuring ROI                                                                                                    18




         •           Identify Your Health Care Costs
         •           Determine Your Projected Increase
         •           Budget for a Comprehensive Program
         •           Learn from the Best
         •           Deliver a Comprehensive Program
         •           Measure Your Health Culture
         •           Measure Objective and Subjective Outcomes
         •           Provide Consistent Follow-up




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Methods of ROI Forecasting
                                                                                                                                    19




ROI calculator for health care costs can help determine
whether an investment in a wellness program makes sense




 Source: Aldana and Adams www.wellsteps.com
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
ROI Case Study Overview
                                                                                                                                          20



       Name: Customer ABC
       Customer Type: Educational Institution
       Benefit Design: Fully Insured
       Members / Subscribers: 500 / 221
       Wellness Councils of America (WELCOA) Award Status: Silver

       Choosing Appropriate Interventions:
       Customer ABC, in conjunction with its UnitedHealthcare representative, chose
       interventions that were most appropriate to their population based on data collection.
       (Health Assessment and Employee Interest Survey) to target the following worksite
       wellness activities (non-incented programs):

       Program Type & Participation Rates
                                         Program Type                                                               Participation Rate
                 Physical Activity                                                                                                  8%
                 Weight Management                                                                                                  26%
                 Stress Management                                                                                                  14%
                 Adult Flu Clinic                                                                                                   56%
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
ROI Case Study Outcomes, continued
                                                                                                                                    21



  Physical Activity:
  • Average employee who engages in regular physical activity costs $144 per member
    per year. Average employee who is at risk for limited physical activity cost $322 per
    member per year.
  • Potentially reduced ―at risk‖ costs by 16 employees.
  • Invested a total of $1600 toward physical activity worksite programming.
  • Potential medical dollars saved -$5,152 resulting in cost benefit ratio of 1:3.        Estimated
                                                                                        Short-Term ROI
  Stress Management:                                                                   • Based on first
                                                                                         year results
  • Average employee who has limited risks of stress cost $369 per member per year.
    Average employee who is at risk for stress costs $570 per member per year.         • Used extraction
  • Potentially reduced ―at risk‖ costs by 25 employees.                                 methodology
  • Invested a total of $849 toward stress management worksite programming.              cost calculation
  • Potential medical dollars saved -$14,250 resulting in cost benefit ratio of 1:16.    from Health
                                                                                         Enhancement
  Weight Management:                                                                     Research
  • Weight management program resulted in total pounds lost x 6 sessions 500 lbs (an     Organization
    average of 19.2 lbs per participant).                                                (HERO)8
  • According to the HERO database, the average employee who engages in a healthy        database.
    diet costs $345 per member per year.
  • Average employee who is at risk for body mass index (BMI) 25 - 29 (overweight)
    costs $542 per member per year.
  • Potentially reduced ―at risk‖ costs by 26 employees.
  • Invested a total of $7,572 in worksite weight management programming.
  • Potential medical dollars saved -$14,092 resulting in a cost benefit ratio of 1:2.


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
References
                                                                                                                                    22




        1.          Anderson, D. et al. (2000) The Relationship Between Modifiable Health Risks and Group-level Health
                    Care Expenditures. American Journal of Health Promotion. Sept/Oct Vol. 15. No. 1

        2.          Rothberg MB, Rose DN. Vaccination versus treatment of influenza in working adults: a cost-effectiveness
                    analysis. Am J Med. 2005;118:68-77.

        3.          Center for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life
                    Lost, and Economic Costs—United States, 1995–1999. Morbidity and Mortality weekly Report 2002;
                    51(14): 300-03.

        4.          Goetzel RZ, Health, Absence, Disability and Presenteism Cost Estimates of Certain Physical and Mental
                    Health Conditions Affecting U.S. Employees. J Occupy Evviron Med. 2004;46:398-412

        5.          Goessel et al. ―The relationship between modifiable health risks and health care expenditures; an analysis
                    pf the multi-employer HERO health risk and cost database‖ Journal of Occupational and Environmental
                    Medicine (1998) (40) (10); 1-12.

        6.          Strum, R. ―The effects of obesity, smoking and drinking on medical problems and costs‖ health Affairs
                    (2002), 12 (2), 245-253.

        7.          OptumHealth 2006

        8.          The HERO database contains a complete health care claims history for nearly 50,000 employees, with a
                    total of nearly 115,000 life-years of claims experience. Encompassing six large private and public sector
                    employers from across the U.S., the employees in this database are a representative cross-section of the
                    U.S. workforce. The database includes demographic characteristics, health assessment results, health
                    care plan enrollment, and health care claim records. Outcome results for wellness programs vary and are
                    dependant on employer/employee engagement and company culture.




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    23




                    Best Practice – Industry Case Studies




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Industry Best Practice
                                                                                                                                                                      24




     PepsiCo                                                                                      Steelcase
     Program:                                                                                      Program:
     • Offered a $75 Mastercard prepaid debit                                                      • High risk employees targeted for risk
       card to any employee who participated in                                                      reduction activities
       a health assessment.
                                                                                                   • 2 to 4 health risks had 75% higher
     • For employees who needed follow-up                                                            medical costs than those of lower risk
       help, the company offered $100 to                                                             employees.
       workers who attended classes on
       smoking cessation, diabetes                                                                 Results / Projections:
       management, high risk pregnancy or                                                          • High risk employees who improved their
       depression.                                                                                   habits via the company’s wellness
                                                                                                     program and became low risk, lowered
     Results:                                                                                        their medical insurance costs by an
     • 70% of the 33,500 employees                                                                   average of $618.00/yr.
       participated.
                                                                                                   • If all high-risk employees changed their
     • For every $1 the company invests, it
       sees a $1.50 to $2.00 return.                                                                 lifestyles to become low risk, the
                                                                                                     projected savings could add up to $20M
          Source: HR Specialist Compensation & Benefits, National Institute of
                                                                                                     over three years.
          Business Management, March 2008- Special Edition

                                                                                                        Source: Ozminkowski et al. J Occup Environ Med 2002;44:21-9
                                                                                                        and Goetzel et al. J Occup Environ Med 2002;44:417-24



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Industry Best Practice
                                                                                                                                              25




    Travelers Corporation                                                                          BP America
    Program:                                                                                       Program:
    • Travelers health promotion programs                                                          • 100k employees
      were focused on proper use of the ER,
                                                                                                   • ―Help Yourself to Health” program
      smoking cessation, substance abuse,
                                                                                                     included health education programs,
      and exercise
                                                                                                     fitness evaluations, fitness center
                                                                                                     construction and community
    Results:                                                                                         memberships, health communications,
    • $3.40 return on every $1.00 invested in                                                        biometric screenings, and EAP & Safety
      health promotion                                                                               program integration
    • Saving $7.8M in benefits cost
                                                                                                   Results:
                                                                                                   • ROI $3.00 on every $1.00 invested
    Source: Ozminkowski et al. J Occup Environ Med 2002;44:21-9
    Goetzel et al. J Occup Environ Med 2002;44:417-24




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
  Industry Best Practice                                                                                                                                                 26




   Johnson and Johnson                                                                            Fieldale Farms
    Program:                                                                                       Program:
    •       $500 premium incentive for completing                                                  • Offered 4,200 employees onsite screenings
            health risk assessments                                                                  and risk reduction programs for cardiovascular
    •       Program cost - $200.00 per employee                                                      disease
                                                                                                   • Gift card reward given participants in screening
    Results:                                                                                       • 2.5% of healthcare budget allocated to
    •       5,500 participated in the program and                                                    outreach
            completed the assessment                                                               • Program ran for 12 years
    •       9% decrease in number of employees
            with high cholesterol and 3% reduction                                                 Results*:
            in number of employees with high blood                                                 • Annual per employee healthcare costs were
            pressure                                                                                 $3,052 -- less than half of the national average
    •       Saved $378 per employee by lowering                                                      of $6,900 in manufacturing employees
            absenteeism                                                                            • Annualized healthcare cost increases over the
    •       Medical expenses for the program                                                         12 years were 2.5% -- compared with 12%
            participants decreased by about $225                                                     nationally and 17.8% in the State of Georgia
            per employee per year over four year
            period                                                                                       Source: Matson-Koffman et al., American Journal of Preventive
                                                                                                         Medicine, 2005; 29 (5S1): 113-121

        Source: Ozminkowski et al. J Occup Environ Med 2002;44:21-9 and
        Goetzel et al. J Occup Environ Med 2002;44:417-24

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
   Industry Best Practice                                                                                                                                                     27




    USAA                                                                                           General Motors
     Program:
                                                                                                    Program:
     • 22k Employees
                                                                                                    • 192k employees
     • USAA’s ―Take Care of Your Health‖ program
                                                                                                    • General Motors’ LifeSteps health promotion
       addresses a variety of health issues through                                                   program began 12 years ago and today
       more than 20 different workplace initiatives,                                                  covers 1 million current and retired
       including:                                                                                     employees and their dependents.
              On-site health clinics, fitness centers and                                          • The program uses health educators and
               personal trainers                                                                      online and mailed HRAs to help employees
              Smoking cessation and weight management                                                make better lifestyle choices.
               programs                                                                             • HRA results are mailed back to participants
              Healthy food choices available in the cafeterias                                       with customized information and advice.
               and vending machines
                                                                                                    Results:
     Results:                                                                                       • Annual insurance savings of $42 per
     • In 2005, 68.5% of employees participated in                                                    participant
       at least one of these wellness programs                                                      • ROI estimated $2 to $3 return in the form of
     • While USAA has not determined savings for                                                      increased productivity and reduced
                                                                                                      absenteeism.
       all of its programs, they have reduced
       workplace absences and produced an                                                           • 2004 University of Michigan study sampled
                                                                                                      23,490 GM employees grouped into normal
       estimated three-year savings of more than                                                      weight, overweight and obese categories.
       $105 million                                                                                   The study demonstrated the importance of
     • In 2006, USAA won the C. Everett Koop                                                          physical activity in a wellness program, as
       National Health Award, which recognizes                                                        moderately active (exercising one to two
       excellence in health risk reduction and cost                                                   times/week) and very active (exercising three
       reduction programs                                                                             or more times/week)
Source:                                                                                                Source:The Business Case for Corporate Wellness, General Motors, The
http://healthproject.stanford.edu/koop/USAA/USAA%20Koop%20Award%20NR%20FNL.pdf                         Coomonwealth Fund, 2004
 Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
 Industry Best Practice                                                                                                                          28




   H-E-B                                                                                            Dell
     Program:                                                                                      Program:
     • 65k employees                                                                               • 19k employees
     • The ―Healthy at H-E-B‖ wellness initiative                                                  • Dell has a comprehensive health and
       targets unhealthy lifestyle behaviors of                                                      wellness program, ―Well at Dell.‖
       employees.                                                                                    Employees choose and build their own
     • Each voluntary participant receives a                                                         health plans; participate in on-site
       financial incentive for completing an HRA.                                                    wellness programs such as healthy
     • H-E-B’s programs are focused on disease                                                       pregnancy and lifestyle coaching; and
       prevention rather than treatment, although it                                                 have access to disease management
       also includes a disease management                                                            programs. Dell also has a 24-hour health
       service                                                                                       hotline that is answered by a registered
                                                                                                     nurse.
     Results:
     • Forty-four percent of the grocer’s employees                                                Results:
       participated in the first year; by the fourth                                               • Since Well at Dell began in 2004,
       year, 79 percent were on board.                                                               program participants have experienced
     • H-E-B’s health care costs were rising by 25                                                   reduced cost increases - primarily due to
       percent annually before the program began,                                                    reduced inpatient admissions.
       but increased by just 2.9 percent in 2006,
       and actually fell by 3.7 percent in 2005
     www.txworksitewellness.org/documents/powerpoint/sa3_common.ppt
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                                                                                                                                    29




                    Producer Capability Presentation




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UnitedHealth Wellness®
                                                                                                                                    30

―helping people lead healthier lives”



       How to use this presentation:
                Know your customer’s characteristics, goals and where they fit
                 along the wellness implementation continuum
                Focus on strategies not just capabilities
                Use as few slides as possible
                Include slides on Why, What and How
                Include only what’s relevant for your audience:
                      • CFO: Use financial and outcome focused slides
                      • Little computer access: focus on worksite vs online solutions
                      • Widespread virtual companies: focus on online solutions, email
                        campaigns, virtual challenges. Avoid worksite programs.
                      • Address special interests first, don’t lose your audience
                      • Consider using best practice case studies to illustrate success


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Agenda                                                                                                                              31




                                 Value of Wellness

                                 Paths to Wellness

                                 Employer Tools

                                 Next Steps




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The Value of Wellness
                                                                                                                                    32




             Influences health behaviors

             Identifies high risk health needs

             Increases productivity

             Reduces absenteeism

             Improves employee satisfaction

             Manages escalating health care costs



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Why Wellness?
                                                                                                                                    33




                    For every 100 employees, many have lifestyle-
                    related health risk factors…

                          • 66 are overweight or obese
                          • 39 don’t exercise
                          • 33 suffer from stress and anxiety
                          • 29 have hypertension
                          • 21 smoke


          Source: Adapted from Department of Health and Human Services, Centers for Disease Control and Prevention


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Did you know…
                                                                                                                                               34




     Individual employees are your best hope for improving
     quality and cost efficiency
                                                                                                                Factors that affect health

                                               Access                                                           are principally behavioral.
                             10%
                                                                                                                50 - 70% of all diseases are
                                                                                                                associated with modifiable
                                                20%               Genetic
                                                                                                                health risks – and are
                                                                                                                therefore preventable
                                               20%               Environmental


                                                                                            50%               Behavior

                   Helping individuals to become aware of their modifiable health risks and
                      engaged in their personal health is the best way to effect change!
Source: IFTF, Center for Disease Control and Prevention
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
UnitedHealth Wellness Overview
                                                                                                                                                               35




  Awareness tools
                                                                                                                                    Education tools
  • Health Assessments
    and Reporting                                                                                                                   • Health Assessment
                                                                                                                                      personalized health
  • Personal Health                         Create                                                        Educate &                   report
    Record                                 Awareness                                                       Inform
                                                                                                                                    • Healthy Mind
  • Onsite Screenings                                                       Encourage                                                 Health Body Newsletter
                                                                                &
                                                                                                                                    • myuhc.com resources
                                                                             Reward
                                                                                                                                    • Care24SM Worksite
                                                                                                                                      training programs


                                                                                Support
                                                                                Behavior
                                                                                Change
                              Behavior support
                              • Online Health Coach programs and myuhc.com trackers and tools

                              • Preventive care reminder program

                              • Health and wellness discounts
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                                                                                                                                    36




              UnitedHealth Wellness:
              Create Awareness




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Awareness
                                                                                                                                    37




     Everything begins with the Health Assessment…

           52 questions

     15-20 minutes to complete
     Available in English and Spanish
     Available Online and Paper*
     Integrated with Online Health Coaching
           and Care CoordinationSM
     Integrated with PHR
     Individual Profile Report




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Awareness
                                                                                                                                    38




 Personalized Health Profile Report includes:

 Overall wellness score

 Top three focus areas

 Targets health measures

 Personalized goals




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Awareness
                                                                                                                                    39




    Know Your Numbers includes:

     Cholesterol/HDL
     Cardiac Ratio
     Blood Pressure
     Glucose
     Body Mass Index
     Blood Pressure
     Integrated with PHR and HA
     Outcome Aggregate Reporting




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Awareness
                                                                                                                                    40




    Personal Health Record
 • Online, portable access to
   personal health information

 • Stores external information:
        Claims, Medication, Labs
        Biometric screenings

 • Stores self-entered information

 • Provides alerts on medication
   interactions

 • Customizable reports

 • Lifelong access


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    41




              UnitedHealth Wellness:
              Educate and Inform




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Educate
                                                                                                                                    42




 Personalized content and tools on myuhc.com

         •   Messages of encouragement
         •   Online Health Coaching information
         •   Health reminders
         •   Educational articles




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Educate
                                                                                                                                    43




     • Depression, stress, anxiety,
       ADHD or other mental
       health conditions                                                      www.liveandworkwell.com
     • Work and life balance,
       stress management,
       change in the workplace

     • Locating childcare, summer
       camps, schools and
       colleges

     • Eldercare resources,
       finding nursing homes and
       assisted living centers

     • Alcohol and drug abuse,
       eating disorders, grief and
       loss

     • Financial and legal
       resources
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Educate
                                                                                                                                                               44




Healthy Mind, Healthy Body e-Newsletter
                                                                                                                          2.3 Million users enjoy content
                                                                                                                          based on five topics that they
                                                                                                                          choose including:
                                                                                                                             • Healthy Living and Well-Being
                                                                                                                             • Family and Children’s Health
                                                                                                                             • Men’s Health
                                                                                                                             • Women’s Health
                                                                                                                             • Asthma
                                                                                                                             • Cancer
                                                                                                                             • Diabetes
                                                                                                                             • Healthy Back
                                                                                                                             • Heart Health

      Members can register online at www.uhc.com/myhealthnews
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Educate
                                                                                                                                    45




 Healthy Pregnancy Program Features:

• No cost for
  UnitedHealthcare enrollees

• Pregnancy assessment to
  identify special needs

• Identification of pregnancy
  risk factors and enhanced
  care needs

• 24-hour toll-free access to
  experienced nurses

• Customized maternity                                                   http://mypregnancymanual.com/uhc
  educational support



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Educate
                                                                                                                                    46




            Care24SM Training Programs


        Topics address wellness and other health and well-being issues that may
        impact your employees:

        Balancing Work and Home                                                                   Health and Well-Being
        Wellness & You                                                                            Healthy Living

        Smoking Cessation                                                                         Aging Well
        Stress Management                                                                         Why Diets Don’t Work



      WebEx format available for some programs to assist with meeting logistic
      needs. Depending upon coverage selected, may be an additional charge



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    47




                UnitedHealth Wellness:
                Supporting Behavior Change




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Behavior Change                                                                                                                     48




  Online Health Coach on www.myuhc.com
  Five-week, evidence-based
  behavior change programs:

        • Diabetes
        • Exercise
        • Heart health
        • Nutrition
        • Smoking cessation
        • Stress
        • Weight loss

                                                              Coaching and tailored messaging based on
                                                    health assessment, stage of change, and participation
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Behavior Change
                                                                                                                                    49




  Online tools, calculators and trackers include:

 • Symptom Checker
 • Risk Assessment Quizzes
 • Waist to Hip Calculator
 • Children’s Growth
      Calculator
 • Calcium Calculator
 • Adult Food Pyramid
 • Cost of Drinking Calculator
 • Children’s Food Pyramid
 • Cost of Smoking
      Calculator



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Adult Flu Clinics
                                                                                                                                                                             50




 Did You Know flu shots
 result in:

 • 57% reduction in lost workdays.

 • An estimated $46.85 saved per
   every vaccinated employee.




Available as a buy up option. Clinic
minimums require at least 40 participants.
 Source:Nichol KL, Lind A, Margolis KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med. 1995;333:889-893.
 Rothberg MB, Rose DN. Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis. Am J Med. 2005;118:68-77.
 Prevention and Control of Influenza. Recommendations of the Advisory Committee on Immunization Practices. Available at: www.cdc.gov/mmwr/preview/mmwrhtml/rr55e628a1.htm.
             Accessed July 2006.
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Turn-Key Programs
                                                                                                                                    51




    Complimentary programs that are ready when you are…




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Behavior Change
                                                                                                                                    52




       Preventive care reminders help
       members keep on track with
       preventive care

       Schedule preventive mailings for
       treatments or screenings of:

              • Breast Cancer Screening
              • Cervical Cancer Screening
              • Diabetes Screening
              • Immunizations

              • Cardiovascular Risk



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Health Discount Program
                                                                                                                                    53




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Health Discount Program
                                                                                                                                    54




                                                                                               …a robust network with value!




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    55




                UnitedHealth Wellness:
                Encourage and Reward




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Health Rewards Work
                                                                                                                                                   56




      Our experience with Health Rewards
      demonstrates that “incentives do work”

         •      70% completion rates of Health
                Assessment with incentives
                compared with 10% completion with
                no incentives*

         •      31% completion of Wellness
                Coaching programs with incentives
                compared to 3% completion of
                groups with no incentives*

         •      Adherence to Disease Management
                programs increased by 2% points
                among users while dropping slightly
                among non-users.


  *Results from a 2007 Uniprise client study where employer groups representing nearly 40,000 members were analyzed compared to book of business
  results for health assessment and online health coach completion statistics.

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Health Reward Packages
                                                                                                                                                 57




     Health Rewards — Clinical Incentive Solutions

       Clinical Incentive options align with the health continuum

                   Staying Healthy                                       Getting Healthy                                   Living with Illness
                                                                        Health Assessment
        Preventive screenings                                      • QuitPower®                                    Disease Management
           Annual physical                                                                                               Diabetes
           Mammography                                            • Healthy Pregnancy
                                                                                                                          Asthma
           Prostate Cancer Screening                                 Program
           Colon Cancer Screening                                                                                        COPD
                                                                                                                          Heart Failure
        Worksite Wellness                                                                                                 CAD
           Know Your Numbers
           Adult Flu
        •Online Health Coach
        •Standard Wellness Coaching



Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Health Reward Features
                                                                                                                                               58




        Integrated Health Reward Tracking & Management

     Features: Health Rewards Package –
          • Integrated user interface for
          • Health Assessment
          • Coaching modules
          • Disease Management

     Reward Fulfillment Services –
          •     Retail Gift Cards
          •     HRA deposits
          •     Debit (Stored Value) Cards
          •     Checks                                                                                  Sample from myUHC.com private portal
          •     HSA & HIA Integration – 2009 Pilot


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    59




                UnitedHealth Wellness:
                Economic Impact




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
  Wellness Dollars and Cents
                                                                                                                                    60




     Small investments in supporting healthier lifestyles
     can make a tremendous difference….

          • For each one-point improvement in an
            employee’s health assessment risk,
            individual claims costs may fall as much
            as $56 per individual.

          • Companies save more money by
            preventing health risks.

          • Costs for an employee who moves into a
            higher risk category of illness or disease
            increases by $350 per individual/year.




 Source: Dee Edington, Director of the Health Management Research Center of the University of Michigan

Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Economics and The Literature                                                                                                                                61




      The Employer Health Benefits Survey showed that premiums rose
       6.1% for employer sponsored health insurance in 2007,

      A growing body of research supports a long-term return of $3 to $8
       for every $1 invested for a comprehensive, well-designed health
       promotion program.2

      Offering a range of options — campaigns, contests, print materials,
       online programs, along with incentives — is a proven strategy for
       keeping healthy people healthy



  1 Towers Perrin, 2007 Health Care Costs Survey,
  2006,www.towersperrin.com/tp/jsp/masterbrand_webcache_html.jsp?webc=HR_Services/United_States/Press_Releases/2006/20060926/2006_09_26.htm.
  2 Anderson DR, Serxner SA, Gold DB; Conceptual Framework, Critical Questions, and Practical Challenges in Conducting Research on the inancial Impact of
  Worksite Health Promotion; American Journal of Health Promotion, 2001, volume 15:5, pages 281-288.


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    62




                 UnitedHealth Wellness:
                 Employer Tools




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Employer Reporting
                                                                                                                                    63




 Employer Summary Reports

         • Available for any group with 50
           completed health assessments
         • Year 1/Year 2 Comparison Health
           Assessment Participation
         • Incentive Fulfillment Report*
         • Available upon request
         • HIPAA compliant




 *Available with buy-up health reward incentive administration programs                 .
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Communication Resource Center
                                                                                                                                                      64




                                                                                                                                    Toolkits on key
                                                                                                                                    cost-driving
                                                                                                                                    topics




               Articles and
               planning tools
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Communication Tools
                                                                                                                                    65




                                                                                             • CD Format

                                                                                             • Getting Started Tools and
                                                                                               Templates

                                                                                             • Employee Engagement
                                                                                               Resources: Turnkey Solutions

                                                                                             • Workplace Wellness
                                                                                               Campaigns

                                                                                             • Promotional Tools and Health
                                                                                               Fair Materials


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
                                                                                                                                    66




                UnitedHealth Wellness:
                Take the next steps




Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Next Steps
                                                                                                                                    67



  1. Commit to your employees’ health
         Identify and communicate senior level support
         Identify champions and create wellness committee


 2. Create a ―company culture of wellness‖
        Provide time and incentives for employees to participate



 3. Launch Health Assessment campaign
        Evaluate results to identify health needs


  4. Develop and implement a worksite strategic plan
           Turnkey and online wellness programs
           Care24 worksite education
           Plan cultural health changes

  5. Evaluate, measure and celebrate success!


Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
Summary
                                                                                                                                         68




                   It’s All About …
                   • Helping individuals stay healthy

                   • Helping companies save on costs

                   • Helping find solutions that may bring more
                     affordable health care to everyone




                                                                        Feel Good.
                                                                              Be Healthy.
                                                                                                                                    SM
                                                                                   Live Well.
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.
UnitedHealth Wellness® (Fully Insured and ASO)
                                                                                                                                                                 69




                        Health Assessment                                                                           NurseLineSM and Care24SM
•   Online via myuhc.com®                                                                        •     24/7-365 access to nurses or master’s level counselor
•   English or Spanish                                                                           •     Health education
•   Integrated with Care Management                                                              •     Medical Triage
•   Personal health profile                                                                      •     On-site educational programs
                                                                                                 •     6 free hours per year
                   Online Health Coaching
                                                                                                 •     Wide range of health and lifestyle topics
•    Programs designed to motivate and encourage the                                             •     Requires pre-registration of 15 participants
     adoption of healthy behaviors.
•    Programs include: exercise, weight, nutrition, stress,                                                     Preventive Care Reminders*
     tobacco cessation, diabetes Lifestyle, heart health
     lifestyle                                                                                   •     Direct-mailed reminders to individuals
                                                                                                 •     Reminders include: childhood immunizations, colorectal,
                   Personal Health Record                                                              adolescent immunizations, women’s health, diabetes
                                                                                                       and coronary artery disease
•    Individual management of health care utilization
•    Pre-populated with limited medical and pharmacy claims                                                        Health Discount Program
•    Portable
                                                                                                 •     Discounts on health and wellness related products and
         Health and Wellness Publications                                                              services
                                                                                                 •     Discounts range between 5-50%
Healthy Mind, Healthy Body e-Newsletter
                                                                                                 •     Popular discounts include: Jenny Craig, Global Fit gym
• Monthly publication                                                                                  discounts, tobacco cessation, fitness apparel, lasik
• Bi-annual ―hard copies‖                                                                              surgery and more.
• Individual selection of up to five health topics
Confidential property of UnitedHealth Group. Do not distribute or reproduce without the express permission of UnitedHealth Group.

				
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