1. 1 City of Wausau Health Care Cost Containment Planning Meeting July 8, 2010

2. 2 Agenda Introduction Expectations of Committee Health Care Costs Priorities at City of Wausau Wellness Program Components and Resources

3. 3 National Health Care Costs Source: Hewitt Associates, 2009

4. 4 City of Wausau Health Care Costs

5. 5 Components of Cost (2009)

6. 6 Top Prescription Drugs Drug NameClassAmount Paid CopaxoneMS$101,025 NovologDiabetes$78,251 Accu-ChekDiabetes$58,698 LipitorCholesterol$57,613 EnbrelPsoriasis/Arthritis$53,249 ActosDiabetes$48,249 PlavixHeart$46,131 AciphexAcid Reflux$43,141 NiaspanCholesterol$42,787 Adderall XRADHD$41,667 HumiraRheumatoid Arthritis$37,152 NexiumAcid Reflux$36,645 ZetiaCholesterol$34,448 CrestorCholesterol$34,217

7. 7 Wellness Priorities at City of Wausau

8. 8 Low Wellness Visit Utilization 2009 While wellness/routine visit utilization is near norm, the norm is not good. Only 37% of active employee members went in for an annual routine exam in 2009. Almost half of these visits were dependent children (which is good that children are being taken in), but the adults aren’t making their annual exam a priority. Only 42% of active employee members (employees and spouses) over age 50 had their PSA exam in 2009.

9. 9 Claims Due to Unhealthy Behavior (2009)

10. 10 Claims Associated with Prevention, Early Detection and Management (2009)

11. 11 Claims Paid for Members with Chronic Conditions (2009)

12. 12 Average Costs for Members with Chronic Conditions (2009)

13. 13 Priorities Getting preventive care Poor nutrition High blood pressure Physical inactivity

14. 14 Wellness Program Components

15. 15 Wellness Programs Awareness Health Risk Assessments Biometric Testing Health Promotion Campaigns -Monthly Communications >Flu prevention/handwashing >Sun safety -Health Newsletters or Articles -Healthier Vending Machines/Cafeteria -Wellness Fairs -Lunch n’ Learn Programs Behavioral Modification Coaching Disease Management Benefits Preventive Care Coverage (Medical and Dental) EAP Nurseline Interventions Weight Loss -Reimbursements for Weight Loss Program Membership Fees -Weight Loss Challenge Physical Activity -Walking/Activity Challenge -Gym Membership Reimbursement Tobacco Cessation -Coverage for Tobacco Cessation Medications -Reimbursements for Tobacco Cessation Courses -Tobacco Free Workplace Policies -“Smoke Out” Days Healthy Habits/Goal Setting Challenge

16. 16 Potential Programs Health Risk Assessments with Biometric Screenings Onsite periodic blood pressure checks Medication compliance education Stress management education Onsite and printed nutrition education Education on the importance of preventive care

17. 17 Resources for a Wellness Program Security Health Plan Nurseline Educational materials and online resources Health risk assessments Disease management programs: Tobacco addiction, asthma management, diabetes management Cottingham & Butler Educational materials Wellness newsletter Benefit website with health encyclopedia, symptom checker and medication look up Community Resources

18. 18