1. Healthy Vision 2010 Summit II Paul B. Handel, M.D. VP and Chief Medical Officer Blue Cross and Blue Shield of Texas

2. General Health Statistics Economic Health and Burden of Chronic Disease a 2000, b 2002, c 2003. Categories may overlap. *Direct Costs: Costs that can be traced to or identified with a specific product or procedure. **Indirect Costs: Costs that cannot specifically be traced to an individual service or procedure. Source: Centers for Disease Control and Prevention, 2004d Total CostDirect Cost*Indirect Cost** Diabetes$132 billion b $91.8 billion b $39.8 billion b Heart Disease and Stroke$351.8 billion c $209.3 billion c $142.5 billion c Cancer$171.6 billion b $60.9 billion b $110.7 billion b Tobacco$150 billion$75 billion $80 billion Obesity – Physical Activity - Nutrition $117 billion a $61 billion a $56 billion a

3. What is Health Worth? 35 – 44 Year Olds Over a Decade with Excellent Health Nearly Doubled Wealth to $194,000

4. Those with poor health $9,000 If health declined over the decade LOST money! SmartMoney; March,2006:56-57

5. 50 % of All Cancer Deaths Could Be Avoided By Stopping smoking Eating healthy American Cancer Society WSJ April 6,2006

6. Smoking Cessation Education/Communication Web Based Tools Trained Facilitators Medication

7. HCSC will Be Smoke Free on November 16, 2006

8. Affinity Programs Health Clubs and Gyms Weight Watchers Curves Exercise Equipment

9. Published Research Supports Quantifiable ROI Rates for Wellness Programs Some employers and brokers—unfamiliar with ROI research—expressed that one of the impediments to adding affinity/discount programs was a reported lack of ROI capability or the ability to see an immediate benefit: –Without a method for calculating ROI, employers report that affinity/discount programs just add another operating cost In fact, the preponderance of relevant literature speaks to positive ROI for health promotion programs: –Most experts estimate that it takes 3 years for ROI to begin, with nearly unanimous reports of positive ROI The T.E. Brennan Company’s ROI assessment serves as an example of the published research which quantifies the impact of wellness programs: Source: “Healthcare Costs Worry Employees,” Oct. 31, 2005, Messenger-Inquirer; “Employee Health Promotion Programs: What is the Return on Investment?”, Wisconsin Public Health & Health Policy Institute, Sept. 2005; HR Magazine. Company$ Coors6.15 Kennecott5.78 Equitable Life5.52 Citibank4.56 General Mills3.90 Travelers3.40 Motorola3.15 PepsiCo3.00 Unum Life1.18 Return on Investment (Per dollar ROI for lifestyle programs):

10. “Our resources would be better directed towards improving efforts to prevent illness and manage chronic ailments like diabetes and heart disease.” David Goodman, MD Health Affairs, March/April, 2006