USAA Wellness Investing In Employees and Building the Wellness - PowerPoint PPT Presentation

USAA Wellness Investing In Employees and Building the Wellness Culture Peter Wald MD, M.P.H Enterprise Medical Director January 2016

USAA 2006 C. Everett Koop National Health Award-sole winner  Comprehensive, multi-discipline, and integrated health & productivity management program (http://www.sph.emory.edu/healthproject)  Multiple local Wellness awards 2005-2014 (Healthiest Employer, SA Healthy Worksite Recognition, Local Chambers of Commerce, etc) Diversified financial services company  The leading provider of competitively priced financial planning, insurance, investments, and banking products to members of the U.S. military and their families.  10+ million members rely on the convenience and accessibility of USAA financial products backed by industry-leading service.  Business Week #1 Customer Service 2007 and 2008  Business Week #2 Customer Service 2009 and 2010 Employees are the “secret sauce” of our competitive advantage 2 .

Menu-Wellness Journey and Strategy Wellness Strategy How we do it Measures and Successes Future Directions- Internal and External 3 .

What-Wellness and our Benefits Strategy We want to maximize health and quality of life for employees and their families so we can better serve our members. We are “investing” in our employees and building a wellness “culture” for the long term.  Culture is what employees “hear” and what they “see”  Wellness is tightly integrated with routine Medical and Retirement Benefits We are actively creating and supporting behavior change.  Our focus is employee productivity  Keeping employees healthy through primary prevention (Wellness) Management commitment is the single most important factor for success.  We monitor program efficacy Executive management briefed before implementation that there is a 3- 5 year delay for financial returns. 4 .

How-Targeting employee risk groups Three domains: Physical, Financial and Emotional Health Balance Health Wealth Population Well At Risk Sick / Unwell Keep well people well Increase awareness Improve condition of Goal and response level sick people 5 .

Prevention is our Primary Strategy Physical Financial Emotional    Health Risk Assessment Financial HRA Emotional HRA   (HRA) Build a Plan Community Volunteerism Primary    Wellness Programs Maximize your match Flexible Work    Joint Safety and Auto-enrollment in Recharge (Well)  Ergonomics Target funds Interpersonal Skills    On-site Clinics Financial planning Work-Life Balance   Pharmacy and Medical Targeted messaging Programs Secondary  prevention tiers Employee Assistance  Centers of Excellence Program (EAP) (At-Risk)    Individual Health Targeted remedial Work-Life Referral Tertiary  Management classes Mental Health and  Time Off Programs Substance Abuse (Sick)  Transitional Duty Benefits 6 .

Wellness Messages Don’t Smoke Be Active Eat Right Prevention “Brand” strategy. Always on message, but always simple 7 .

Strategic Wellness Model Wellness Partners Wellness  Safety  Clinical services  Fitness and Recreation  Integrated disability management  Food services  Wellness programs.  Communications  Data warehouse  Company store  Corporate Real Estate Multiple Outsourced Vendors  USAA is the integrator.  Assembled “Best of Breed” program  Individually selected by RFP process.  Completely internal selection process 8 .

Key Program Elements Identity/Brand Health Risk Assessments Health Promotion Tools and Interventions Financial Incentives On-site Services and the “Built Environment” Healthy Food Services Population Data Analysis-Total Cost & Employee Trends Building the “Wellness Culture.” 9 .

Specific Examples Population Targeted  Preventive benefits ($300/y)  Individual Health Management  Wellness benefits ($350/y)  BMI Reduction  Smoking Cessation and Weight Management  Integrated disability mgmt  HRAs and biometrics  Transitional duty  Ergonomics Assessments  On-site fitness rebate (25/50/75%)  “Healthy Points”  Wellness breaks  Recreation and nontraditional fitness  Calorie balance tool Intervening  Workplace safety (Be Safe)  Healthy food services (The 4 P’s )  Tobacco-free campus 10 .

Snapshot-USAA population health summary (2014) Healthy employees use less resources  85% of employees use 20% of resources  12.5% of employees use 40% of resources  2.5% of employees use 40% of resources 50-80*% of total costs are related to behaviors associated with preventable diseases  Smoking Indicators for high risk conditions. Glucose >100 7.0%  Physical Inactivity Cholesterol>240 5.0%  Poor nutrition/obesity Cholesterol>200 28.0%  Inattention to preventive practices Blood pressure>120/80 21.0% BMI >25 69.0% *Modifiable Behavioral Factors as Causes of Death JAMA. 2004 BMI >30 35.0% 11 .

Measures- Sustaining Management Commitment to Wellness Satisfaction Participation Risk factor reduction Economic impact Short-term gains in productivity and disability sustain management commitment to longer-term gains that result from healthier employees . 12 .

Context: HRA Participation 18,510*** 20,000 18,133 15,673 14,563 15,050 16,000 12,836 10,319 12,000 10,020* 7,982 8,000 4,884** 4,000 0 2003/ 2005 2006 2007 2008 2009 2010 2011 2012 2013 2004 * Represents two campaigns: Sept 03 and Feb 04 ** No incentives offered *** Fitness Equipment incentive ended 12/31/09 Participation increases employee awareness and ability to respond to risks. 13 .

Context: Successful Healthy Points Participation 11,062 34.8% 43.3% of 12,000 of 31.7% population population 28.1% of 10,000 8,350 of population 7,410 population 6,476 8,000 6,178 6,000 4,000 2,000 0 2009 2010 2011 2012 2013 14 .

USAA Population BMI and Risk Factors BMI has recently increased with a flat long term trend 90.0% Risk Factors 80.5% Average BMI 80.0% 29.6 69.1% Percentage of Employees 70.0% 29.4 24% Reduction 29.2 60.0% Average Risk Factors 29.0 50.0% 28.8 T1 28.6 40.0% 29.4 28.4 T2 29.0 26.4% 30.0% 28.2 28.7 28.7 28.6 28.6 28.0 17.7% 28.3 20.0% 27.8 27.6 10.0% 4.5% 1.8% 0.0% Low (0 - 2 Moderate (3 - High (5+ Risks) 4 Risks) Risks) 15 .

Bending the cost curve … $2,000 Employee 1.7% annual $1,800 increase Dependent $1,600 3.8% annual increase $1,400 Dep (Adjusted) $1,200 3.5% annual increase $1,000 Background $800  Full replacement CDHP $600  Same health plan for $400 both groups  No Wellness services $200 delivered to dependents $- vs. full suite of services Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 to employees 2006 2007 2008 2009 2010 2011 2012 2013 2014 Employee Dependent Dependent (Adjusted) Comprehensive wellness services flatten cost curve for this large employee population Adjusted for Inflation 16 .

Controlling Lost time… 7 Lost Work Days/100 6 STD LTD WC 1.5% Annual Decrease 5 Employees 4 3 WC 8.7% Annual Decrease 2 1 LTD 0 12.0% Annual Decrease Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2006 2007 2008 2009 2010 2011 2012 2013 2014 110 Lost Work Days/100 STD Background 100  Transition Duty, medical Employees 90 case management and 80 safety interventions.  Work and non-work 70 related disability managed 60 in same system Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 2006 2007 2008 2009 2010 2011 2012 2013 2014 Integrated Disability Management services reduce all disability lost time 17 .

Working Closely to Deliver Primary Prevention for Injury Reduction Ergonomics Evaluation Totals by Location 5169 total ergo evaluations from Jan. 1-Jun 18, 2013 Short url on Connect: go\ergo Targeted interventions for RMI’s and Slips, Trips and Falls - Leveraging the Wellness Culture 18 .

Integrated Disability Management for 2014 Better management of cases  $6.38M returned to business Transitional Duty  441 completed Physical Demand Job Audits  283 jobs covering 83% of employees  Standardized and ready to go Job Adjustments  506 completed At Work, Focused and Productive 19 .

Context: Turnover Member Contact Retention Non-Member Contact Retention 2013 2013 91% 92% 98% 97% 97% 97% 89% 89% 90% 97% 96% 96% 88% 96% 85% 85% 86% 95% 83% 84% 94% 94% 94% 81% 81% 82% 93% 93% 80% 78% 92% 76% 91% Enterprise Phoenix San Antonio Tampa Enterprise Phoenix San Antonio Tampa Fitness Rebate No Fitness Rebate Fitness Rebate No Fitness Rebate The retention rate for employees who receive a rebate (at least 50 visits in a single year) is higher than retention for both member contact and non-member contact employees 20 .

Context: “Built Environment” Communication Solutions  What messages do the physical environment send? Are they all aligned?  Create a “surround sound” environment of Wellness messages  Foster wellness communities  Include fiscal and emotional wellness  Provide financial incentives 21 .