1. King County Health Reform Initiative LABOR- MANAGEMENT PARTNERSHIP

2. Health care environment 13,000 employees 30,000 plan members Strong Labor Unions – 92 separate bargaining units Dwindling tax base, rising public expectations Comprehensive medical, dental, vision 2012: Health plan costs will double under status quo to $300+ Million

3. Health care reform strategy Address both demand and supply side market failures King County’s efforts with employees reduce demand for health care by improving employee health King County works with Puget Sound Health Alliance to improve the quality of care in the region, reducing costs that come from ineffective treatment

4. Healthy Incentives SM Benefits Design Focused on individual employees and family members Wellness Assessment Individual coaching to change risk factors Disease management resources Nurse advice line Smoking cessation programs Healthy Workplace Funding Initiative Weight Watchers at Work Gyms Discounts

5. How Healthy Incentives SM works

6. Healthy Incentives SM Design Out-of-pocket level (KingCare SM plan) Annual deductible Gold$100/person $300/family Bronze$500/person $1,500/family Out-of-pocket expense level examples

7. Healthy Incentives SM Results 90% of eligible employees and spouse/domestic partners took the wellness assessment 95% of members who completed the wellness assessment have enrolled in their individual action plans Early lessons—success built on –One full year of outreach and education before the wellness assessments/individual action plans began –Large enough financial incentive –Collaborative process with the unions

8. Negotiations History and Framework Joint Labor Management Insurance Committee King County labor coalition

9. Challenges Representation of member and union interest that were in direct opposition to the economic, political and collective bargaining trends.

10. Management-Labor Negotiations Importance of sharing accurate and reliable cost data.

11. Labor – Labor Negotiations Reaching consensus while still addressing the needs of individual unions.

12. Outreach and Education Bringing members to a point where they are ready for change Tools –Health committee subgroup Key messages –Financial incentives –Health benefits –King County still compares favorably to other large employers in the state

13. Outreach and Education How Healthy Incentives comapres to other large employers: No premium share Gold, out of pocket expenses lower Lower prescription drug benefits than a typical employer plan

14. Impact of Program on Employees Culture of wellness has emerged at the county. Participation in programs to support the initiative is high –Weight Watchers at Work –Gym Discounts –Healthy Workplace Funding Initiative Impact on corrections officers

15. Empower the Individual “I hear people talking about health all the time now”. Caroline Whalen, DES, Deputy County Administrative Officer

16. Empower the Individual “I looked, and starting in January I’ve lost 22 pounds and it’s been things like walking on the treadmill, rowing machine, it’s been walking and watching my diet”. Ron Sims, King County Executive

17. Empower the Individual “... I drive [bus] and sit all the time.... I guess I can make it [aerobics class] so I can be healthy”. Angelina Knight Transit Operator, Ryerson Base

18. Empower the Individual “Really an exciting time because our employer is encouraging this healthy attitude... I love it!”. Esther Day Public Health

19. Empower the Individual “You just start to feel healthier, mentally as well as physically, and that’s been a really big lift for me”. Carolyn McKee PAO, Criminal Division