Consumer Driven Health Care

1. Isn’t it time someone created a healthier health plan? We thought so, too.

2. The Facts are Startling 50% of health care costs and premature death, illness and disability are due to health behavior-related conditions “ Health” and “health care” are only remotely related – 35% of all health care costs are wasteful or inefficient 75% of surgical procedures are elective and 1/3 of all elective surgeries are unnecessary Only 50% of high dollar claimants can be predicted from claims from one year to the next Sources: IFTF/CDC MBGH/Juran Institute Rand Corporation

4. Focus on Health Improvement Incentives Matter

5. $50 account allocation for online completion (limited to one/family each year) $200 added to account for mastering HealthModels for each enrolled family member Goals achieved with knowledge, skills and functional provider-patient relationship $100 added to account for enrollment for each eligible family member Participation in Personal Health Coach program Engaging with Personal Health Coach to identify goals, educate and manage their disease Identify, Improve Risk & Care Integrated & Incentivized Strategy Identify Health Risk Assessment Engage Personal Health Coach Enrollment Graduate Competency Mastery with Personal Health Coach

11. Focus on Health Improvement Why Should We Care About Behaviors?

13. Risk Factors – Controllable or Modifiable 1 American Heart Association 2 What Healthy People Know Reasonable portions; 5 or more servings of colorful fruits and vegetables, nuts and two whole grains daily; Fish twice per week; Mono- and polyunsaturated oils (olive or soybean) 2 Poor Nutrition 65% are overweight, 30% clinically obese Walk as if late for an appointment, Takes a minimum of 10 minutes for health benefit, Add 3 brisk 10 minute walks per day 2 Physical Inactivity About 21 million diabetics in US; 95% are Type 2 diabetes; 80% of Type 2 diabetes directly related to being overweight, obese (diabesity) Diabetes Quit before 30, no change in lifespan . . On average; On average, smokers live 10 years less 2 Tobacco Use Improved diet, exercise, quit tobacco use 1 High blood cholesterol Improved diet, exercise, quit tobacco use, moderate alcohol 1 High blood pressure

15. Health Management – Personal Health Coach Observed strong correlation between offering incentives, enrollment and cost trend. -3.2% 6.0% Cost Trend 4.0% 2.0% Avg. Enrollment in PHC Program Incentives No Incentives -3.8% 7.1% Cost Trend > 3% Enrollment w/PHC < 3% Enrollment w/PHC

16. Health Management – Health Assessment Observed strong correlation between offering incentives and completion of health risk profile. There appears to be an emerging correlation between completion and cost trend. -1.2% -0.1% Cost trend 38.1% 1.2% Completion Rate Incentives No Incentives -2.3% -0.9% Cost trend > 50% Completion Rate < 50% Completion Rate

17. Consumer Support Online Health Site and Tools

18. Online Tools and Services Available Health tools Linkage to Personal Health Coach Health Assessment Claim Detail

19. Compare Hospital Costs Information that is more meaningful to consumers

20. Prescription Drug Cost Estimator

21. Compare Rx Costs at Local Pharmacies

23. What’s Next Continued Innovation

27. Results

29. Positively Impacting Costs $2,200 $2,400 $2,600 $2,800 Per Member Per Year 2004 Pre Lumenos 2005 Industry Trend 2005 With Lumenos + 8% – 9% $2,521 $2,723 $2,299