MedCost Benefit Services 2007 Highlights

Claims

• 90% of claims received electronically
• 99% of claims processed with financial and procedural accuracy
• Average claim turnaround of 7 days
• Average payment time of 8.9 days

Call Center

• 74.9% of calls answered within 30 seconds
• 95% of calls resolved on first contact
• Average speed of answer is 25 seconds
• 100% caller satisfaction rating
• 99% of calls audited in real-time

Catastrophic Case Management

• 56% of hospital admissions referred to Case Management
• 55% of referrals were followed
• 99% patient satisfaction rating
• 7:1 return on investment

SmartStarts

• 43% of pregnancies identified as high-risk
• 98% patient satisfaction rating
• 13:1 return on investment

Personal Care Management

• 5% total population recruited
• 82% active participants experienced positive health changes

Personal Care Management Changes Lives


Ronnie McBride
Yadkinville, NC

“Since being enrolled in the Personal Care Management program, I eat better by eating healthy foods. I also watch my weight and eat smaller portion sizes. The program has taught me to take care of myself better. I want to thank MedCost for being there for me when I needed them. They have made everything easy for me to help improve my health.”

Before enrolling in the Personal Care Management (PCM) program in August 2007, Ronnie McBride had poor dietary habits, weighed 190 pounds, and did not exercise. He also suffered from diabetes and had already endured two heart attacks and a quadruple bypass. So, when one of our nurse health coaches contacted him about joining Personal Care Management, he decided to enroll.

Ronnie’s personal nurse health coach started him on an exercise program of walking three times weekly for 30 minutes. She also persuaded him to try a heart healthy diabetic diet and provided sample menus to make it easier. With her encouragement, Ronnie is now walking five times weekly, has maintained a seven-pound weight loss, and has kept his blood glucose levels within a normal range. He also reports missing less time from work due to illness since enrolling in the program, and he continues to set new health goals for himself.

All information shared with MedCost personal health coaches is completely confidential. Ronnie McBride gave MedCost permission to share his story to help others realize the benefits of Personal Care Management.

Many companies have tried to stem rising health care costs by controlling the expenses of employees who suffer from chronic health conditions. This focus on managing illness, however, does little to keep other employees from developing serious health issues. In order to effectively contain health care expenses, employers must implement plans to keep employees as healthy as possible—proactively manage wellness—in addition to reactively managing costs after employees get sick.

According to a recent article from the National Federation of Independent Business, the cost to organizations for employees’ poor health habits is at least $3,000 per employee per year. Unhealthy employee behavior can have other “hidden costs,” too, such as losses in productivity and increased employee turnover. Promoting healthy habits among employees is no longer a nicety; wellness programs are a necessity to impact a company’s bottom line.

MedCost Benefit Services offers integrated programs to help companies effectively manage employees’ health and wellness. The Succeed™ health risk assessment (HRA) identifies health behaviors and associated lifestyle challenges. As part of the assessment, participants are asked to prioritize their top four behavior targets. Based on this ranking, as well as the need, willingness, and confidence to change, participants receive tailored and individualized goals, educational materials, and support for appropriate health and lifestyle management programs. There are four personalized options available: Breathe™ (smoking cessation), Relax™ (stress management), Nourish™ (nutritional counseling), and Balance™ (weight management).

In addition, results from the Succeed™ health risk assessment (HRA) can automatically refer members to the Personal Care Management (PCM) program for review. This program is a uniquely proactive approach to identify individuals who may show early symptoms of or are at risk for developing a serious and costly health issue. Members with a history of certain disease states, abnormal body mass index (BMI), or other risk factors are flagged as possible PCM candidates. The PCM nurse health coaches then have the capability of looking at the member’s HRA results, along with other triggers, such as claims data and pharmacy information, before determining if they will recruit the individual into the program. Members who enroll in PCM receive one-on-one encouragement and education from a personal nurse health coach to manage their conditions.

Studies show that when employees are given information and guidelines to improve self-care, medical costs can be reduced by as much as 17%. MedCost’s integrated programs can identify employees with possible health concerns earlier than ever, before any negative medical events occur.

If your company doesn’t currently offer these employee programs, or has not experienced a high level of employee participation, contact your MedCost representative. He or she can provide additional information, incentive ideas, and materials to promote the programs to employees.

Remember, when its employees are healthier, a company’s bottom line is healthier as a result. Implementing (or reviving) an employee wellness program benefits everyone!

Employees With Workplace Flexibility Have Healthier Lifestyle Habits
(December 11, 2007 WFUBMC press release)

If companies provide workplace flexibility and if employees perceive that flexibility as real, then healthier lifestyle habits are put into action by those employees, according to new research by lead author Joseph G. Grzywacz, Ph.D., of Wake Forest University School of Medicine.

The study, titled “The Effects of Workplace Flexibility on Health Behaviors: A Cross-Sectional and Longitudinal Analysis,” is published in the December 11, 2007 issue of The Journal of Occupational and Environmental Medicine.

“People who believe they have flexibility in their work lives have healthier lifestyles. Individuals who perceive an increase in their flexibility are more likely to start some positive lifestyle behaviors,” Grzywacz said. “This study is important because it reinforces the idea that workplace flexibility is important to workplace health.”

Grzywacz explains that while workplace flexibility is widely believed to be an essential element of effective worksite health promotion programs, there has been little systemic research in support of this belief. Grzywacz said the goal of his study is to improve “understanding of the potential effect of workplace flexibility on worker lifestyle habits.”

Data for the study came from Health Risk Appraisals (HRAs) completed by employees of a large multinational pharmaceutical company. This company is consistently recognized by Working Mother magazine as among the most family-friendly employers in the United States, in large part, because of its commitment to flexibility such as compressed workweeks, flextime, job sharing, and remote or telework. Employees with a wide variety of jobs and responsibilities completed the HRA, including executives, administrative support staff, and warehouse and production workers.

“These weren’t all office workers—that’s an important point, “ Grzywacz said. “This isn’t just about high-level office workers—these people perform a wide variety of tasks within the company.”

The data was analyzed to determine if lifestyle behaviors differ between employees with different levels of perceived flexibility and to identify if changes in flexibility over a one-year time period predicted changes in health behavior. The study focused on frequency of physical activity, engagement in stress management programs, participation in health education activities, healthful sleep habits, and self-appraised overall lifestyle.

“Overall, the results showed that nearly all the health behaviors examined in this study were associated with perceived flexibility,” Grzywacz said. “Although further research is needed, these results suggest that flexibility programs that are situated within a broader organizational commitment to employee health may be useful for promoting positive lifestyle habits.”

Co-authors of the study are Patrick R. Case, B.S., also of Wake Forest, and Fiona A. Jones, Ph.D., University of Leeds, United Kingdom.