June 18-19, 2009 | Hyatt Regency Chicago

Sponsored by

Successful Strategies to Increase Employee Utilization

of Health Benefits

Donald Molenaar, MD, MPHMedical Director

Bayer

Bryan Loy, MD, MBAMarket Medical Officer

Humana

Cancer Screening at Caterpillar

Michael Taylor MD FACPMedical Director for Health PromotionCaterpillar IncJune 18, 2009

Caterpillar Inc

• Self-Insured• 150,000 covered lives• $650M annual spend on health care• Average age of employee 41• Annual turnover <10%

Risk/CostSharing

Quality

Healthy & productive workforce

Better Return Best ReturnMinimal Return

Productivity as a Business Advantage

Health Promotion Program

• Health Risk Assessment*• Online tools*• Health Promotion exams*• Food Services Management

Health Promotion Program

• Tobacco cessation program• Onsite health coaches*• Lifestyles for Health• Work.Life.Solutions

Principles of screening

• Follow expert guidelines for recommendations• Remove all financial barriers• Measure participation • Track outcomes• Screen for cervical, breast and colon cancer

Cervical Cancer Screening

• Age 18-65, 46% have been screened in 3 yrs• 55 new cancers in 2008• Prevalence 7/1000

Breast Cancer Screening

• For age >40, 60% screened in last 2 yrs• 2711 active cases• Prevalence 49/1000• Incidence declined by 46%* in last 4 yrs

*not yet validated

Colorectal Cancer Screening

• 38% of those eligible have been screened• On average, 228 new cases in each of last 5 yrs• Quality improvement program started July

2007

New approach with MDs and hospitals

• Agree on quality measures• Composite quality measure – 8 factors• Global fee paid to hospital• Pilot in our major Illinois markets

Composite measure8 measures

• Appropriate indication for screening• Appropriate patient selection (ASA class)• Document cecum reached• Void of serious complications

Composite measure8 measures

• Assess quality of bowel prep• Withdrawal time recorded• Polyp type and size reported-7 parameters• Appropriate follow-up recommendation

Quality measures

• Need to achieve all 8 measures• Currently, 50% of exams meet composite• 10-80% range • Will become basis for tiered payments

Quality measures

• Composite measured for all colonoscopies• Implement process for all • Public reporting• Outcomes based P4P

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