Proposal for
Table of Contents Executive Summary...3 Solutions... Pricing... Capabilities... Company Overview... Spectrum of Solutions... Member Communications... Getting Started... For more information, please contact: Cynthia K. Persico, CEAP, MHS Regional Vice President, EAP+Work/Life Solutions HealthAdvocate 904.680.0372 cpersico@healthadvocate.com
Section 1 HealthAdvocate Executive Summary 3
HealthAdvocate Executive Summary Health Advocate is pleased to present this proposal. It describes our innovative, personalized and fully integrated employee and employer solutions that are designed to save time and money, increase productivity and improve health outcomes. The contents include key features of our programs and the Health Advocate advantage the capabilities of our highly trained operations staff and experienced management team, our pricing structure, state-of-the-art systems technology, complete turnkey communications program and streamlined installation process. The purpose of the proposal is to clearly demonstrate how Health Advocate has achieved unparalleled success in helping individuals navigate the complex healthcare and health insurance systems, improve their health and become more effective healthcare consumers, as well as how we help Human Resources departments administer important programs. The Health Advocate Advantage Health Advocate s key distinguishing factor is the outstanding personalized and dedicated attention provided by our entire team of highly trained Personal Health Advocates, Wellness and Chronic Care Coaches, EAP+Work/Life counselors and healthcare, benefits and insurance experts, as they help employees and their families resolve complex issues, improve their health and meet their long-term health goals. We get to know their needs so we can get the right answers, no matter how complicated or how long it takes. This personalized attention extends across all issues and programs, whether it s locating the right doctor, connecting them to the right benefits so they don t fall through the cracks, resolving an uncovered medical bill, or providing them with coaching to help them reach their optimal health. With help from our dedicated Personal Health Advocates and other experienced experts, your employees can remain fully productive, health outcomes improve, medical costs are reduced and the quality of your employees overall healthcare experience is enhanced. About Us Health Advocate, Inc., a subsidiary of West Corporation, is the nation s leading healthcare advocacy and assistance company serving more than 10,000 clients. We offer a range of solutions to lower healthcare costs, increase productivity and improve outcomes. West Corporation is a leading provider of technology-driven communication services. We Look Forward To Becoming Your Partner Our staff is poised to work closely with your organization to help you and your employees save time and money. We invite you to visit our office and take a tour of our operations, to see first-hand how our dedicated team can help you maximize your benefits. 4
Executive Summary Solutions Snapshot Health Advocate s personalized employee and employer-based solutions offer a comprehensive approach that provides one-source support across a continuum of needs. Our employee solutions help employees improve their health, make more informed healthcare decisions, better balance work and life demands, connect to the right benefits and lower their medical bills. Our complementary employer solutions support Human Resources departments in achieving streamlined administration for a wide range of key programs. Below is a brief description of the solutions offered in this proposal. Additional information about our entire suite is available in the Spectrum of Solutions section at the back of this proposal. EAP+Work/Life Program The EAP+Work/Life Program offers employees short-term counseling and support for a range of personal, family and work/life problems. This early intervention service helps reduce the need for more costly mental health services, decrease absenteeism and improve productivity. The program also includes unlimited manager consultation to address workplace productivity issues and critical incidence planning, conflict resolution and other organizational issues. Medical Bill Saver Our skilled negotiators work with providers to help lower employees non-covered, post-service medical and dental bills over $400, for significant savings. Employees are not charged any upfront fees to use this service. 5
Section 2 HealthAdvocate Solutions 6
HealthAdvocate TM EAP+Work/Life What is the Health Advocate EAP and Work/Life program? The EAP+Work/Life Program offers employees short-term counseling and support for a range of personal, family and work/life problems. This early intervention service helps reduce the need for more costly mental health services, decrease absenteeism and improve productivity. The program also features unlimited manager consultation to address workplace productivity issues and critical incidence planning, conflict resolution and other organizational issues. Services are available in over 150 countries for employees working outside the U.S. How does the EAP and Work/Life program work? Employees can call Health Advocate s toll-free number for confidential, short-term professional counseling, focusing on coping skills for a full range of emotional, family and work-related issues. If needed, the employee can be referred to ongoing treatment or special care. Employees can also call the same number for one-on-one help to locate work/life services for concerns across the lifespan, from adoption to eldercare. As a complement to the personalized program, they may log on to the website to search for work/life information including provider databases and articles on a range of topics. If necessary, employees can be easily transitioned to our Core Health Advocacy service for personalized help to resolve a full range of healthcare and insurance-related issues. Who is eligible? Our EAP and Work/Life program assists employees, their spouse and dependent children, as well as their parents and parents-in-law. Employers and employees find our expanded eligibility coverage valuable, as senior issues increasingly impact the workplace. 7
HealthAdvocate EAP+Work/Life What are the features of the EAP and Work/Life program? Short-term counseling focused on coping strategies (see pricing page for specific options included) Licensed counseling for stress, depression, family issues, substance abuse and more Referral for long-term counseling or specialized care, as needed Work/life specialists locate, determine availability for eldercare, childcare, legal and other support services Access to website to self-search work/life provider databases, articles, webinars and onsite seminars Unlimited HR or management consultations to address sensitive employee issues Critical incident planning and initial disability consultations involving mental health or substance abuse Reports on effectiveness of EAP program In-person or telephonic counseling, 24-hour emergency service and other features available to employees working outside the U.S. Promotional and employee communications available in multiple languages Global Account Managers and local liaisons for large employers Seamless integration with Core Health Advocacy service to help find the right doctor or specialist, schedule earliest appointments, untangle medical bills, clarify coverage and more What are the benefits of the EAP and Work/Life program? One-source service access Intervenes and helps resolve issues in earliest stages Reduces need for more costly mental health services Helps employees balance work/life demands Improves productivity, reduces costs Decreases turnover and absences; fewer labor disputes Unlimited manager consultation to address workplace productivity issues Personalized assistance available to employees working outside the U.S. Seamless integration with Core Health Advocacy service Saves time and money 8
HealthAdvocate TM Medical Bill Saver What is the Health Advocate Medical Bill Saver program? The Medical Bill Saver program offers our expertise to negotiate lower costs on employees non-covered, post-service medical and dental claims on bills of $400 and over, for significant savings. Employees are not charged any upfront fees to use this service. Medical Bill Saver supports consumer-driven health plans, reduces employee out-of-pocket costs, and offers financial relief to both employers and employees. How does the Medical Bill Saver program work? When an employee calls our toll-free number about a non-covered medical or dental bill over $400, they will be directed to send or fax the bill to one of Health Advocate s skilled negotiators who knows the ins and outs of billing practices. We will work on the employee s behalf, regardless of insurance or benefit status. Using fee benchmarking databases, the negotiator works with the provider to get a discount that can help the employee save hundreds, and sometimes even thousands, of dollars. Employees receive a Savings Result Statement summarizing the outcome. Who is eligible? Our Medical Bill Saver program assists employees, their spouse and dependent children, as well as their parents and parents-in-law. Employers and employees find our expanded eligibility coverage valuable, as senior issues increasingly impact the workplace. 9
HealthAdvocate Medical Bill Saver What are the features of the Medical Bill Saver program? Experienced special negotiation team Negotiations for non-covered medical and dental bills of $400 and over Use of critical pricing trend information, fee benchmarking databases Easy-to-read Savings Results Statement provided to employee summarizing negotiation Provider sign-off on payment terms and conditions Seamless integration with Core Health Advocacy service for help with complex conditions, insurance issues, finding the right providers, preparing questions to ask the doctor and much more. What are the benefits of the Medical Bill Saver program? Safety net for employees with consumer-driven health plans and health spending accounts Successful track record achieving significant savings Educates employees about covered and non-covered services Can lead to smart healthcare decisions Expedites rapid payments to providers, generating larger discounts Case Study Bill Charged... $5,032 Negotiated Discount... 50% Resolution: Health Advocate worked with the provider to significantly reduce the bill. Reduces medical claims and burden on HR staff Increases employee productivity Turnkey communications promote awareness and utilization Seamless integration with Core Health Advocacy service Member Savings* $2,516 *The savings on case studies cannot be guaranteed. Results may vary. 10
Section 3 HealthAdvocate Pricing 11
HealthAdvocate Pricing The pricing for the programs included in this proposal are as follows: Programs Cost EAP+Work/Life(1-6 Sessions) + Telephonic EAP + Medical Bill Saver $0.95 PEPM Notes Eligibility: The fee covers eligible employees, their spouses, dependent children, parents and parents-in-law, except as otherwise noted. Communications Materials: Health Advocate will provide our standard communication materials to the client for distribution to employees enrolled in the program. Covered Employee Lives: Based on a population of 8,200 employees. 12
Pricing EAP+Work/Life Services The Health Advocate Basic EAP Service A 24-hour Emergency Hot Line. Unlimited Telephonic Critical Incident Stress Debriefing Support. Professional telephone evaluation for the nature and scope of employee personal problems, and referral, if needed, to appropriate professional counseling or other necessary care; this referral, which is offered by Health Advocate, may or may not be utilized by the EAP Member. In Person Sessions ( Sessions ) assessment and short-term problem resolution by network of qualified EAP consultants. ThenumberofSessionsisavailableupto6perissueperyear. Case management for in-patient and out-patient treatment. Unlimited Telephonic Manager Consultations. Access to Health Advocate Telephonic and Web Based Support for Work/Life Services Childcare: Child Care Centers, Family Child Care Homes, Nanny Agencies, Summer Camps, Babysitter Tips, Community Resources. Eldercare: Nursing Homes, Assisted-Living Facilities, Independent Living Facilities, Home Healthcare, Hospice, Respite Care, Geriatric Care Managers, Senior Centers, Adult Day Care Centers, Community Services and Resources. Legal: Family Law Issues, Real Estate, Criminal Matters, Estate Planning, Motor Vehicle, Elder Law. Financial: Debt Management, Budgeting, College Funding, Retirement Strategies, Life Insurance Needs. Unlimited Telephonic and Web Based Consultation. Available Worldwide Assists employees living/working outside the U.S. 24-hour emergency service for employees and eligible family members Toll-free hotlines or collect call numbers available Telephonic or in-person counseling provided in English or the local language Network of local multi-disciplinary counselors in over 150 countries Promotional and employee communications available in multiple languages Global Account Managers and local liaisons for large sites Reporting Statistical management reports will be provided to Client showing aggregate EAP activity. 13
Pricing Employee Awareness Client agrees to take reasonable steps to encourage and promote employee awareness and utilization of the EAP Services, including providing periodic program reminders and other related communications and reinforcement of the availability of these Services. Health Advocate EAP Seminars and Workshops $250 per hour plus travel and related expenses. Health Advocate EAP seminars and workshops effectively empower employees and managers with takeaway skills and behavioral techniques, making an immediate difference in on-the-job performance. Critical Incident Stress Debriefing - Trauma Assistance $275 per hour plus travel and related expenses. Health Advocate EAP will meet and/or assist with the Critical Incident Stress Debriefing (CISD) Team if a disaster or crisis occurs. Health Advocate EAP has designed specific crisis debriefing protocols to assist in any matter. Organizational Development TBD based on the needs of the organization. Today s business climate must continuously adapt to meet the needs of an increasingly complex environment. These forces can affect productivity, absenteeism, turnover and job satisfaction. To minimize these effects, organizations must be able to analyze present performance, predict future challenges, and modify current systems and practices when needed. Substance Abuse Professional (SAP) Evaluations Fee-for-service: $350 to $500 per case. Health Advocate EAP will provide substance abuse evaluations for all DOT violations. Health Advocate EAP is committed to keeping companies in compliance with the Drug Free Workplace Act (PL 100-690) and the specific Department of Transportation (DOT) regulations, Part 382. 14
Section 4 HealthAdvocate Capabilities 15
HealthAdvocate Capabilities Below is a brief summary of our capabilities that support the offerings in this proposal. Health Advocate has invested in a highly trained, highly experienced and ever-growing team of healthcare and wellness experts. Our investment also includes the latest, integrated telephone and database technologies that enable us to provide outstanding service to our clients. Health Advocate is committed to offering state-of-the-art upgrades, refinements, improved strategies and better systems, as well as ongoing training of our staff to ensure that our clients receive consistent, quality service. We work closely with our clients to ensure seamless installation of our programs, and have developed a robust, turnkey communications program to help support broad awareness and utilization of our service. Superior Team Qualifications Health Advocate s founders have more than 100 years of combined experience in the healthcare industry, and have recruited extremely talented and experienced individuals to comprise our management and service teams. Our company possesses superior operational, medical, technical and administrative expertise to meet the diverse needs of our clients. Our Team Our staff is continually trained in navigating all aspects of the healthcare system, to provide the best assistance and support to employees and employers. Personal Health Advocates. Typically registered nurses, supported by medical directors and benefits and claims specialists, our Personal Health Advocates have extensive clinical experience; most have worked for hospitals or physicians. The ability of our knowledgeable staff to resolve burdensome issues in a compassionate and dedicated manner is a hallmark of Health Advocate s Core Health Advocacy service. Wellness Coaches. All of our skilled Wellness Coaches have a bachelor s degree in a health-related field and complete a training period with a senior coach. They are also certified in tobacco cessation counseling by the American Lung Association, and hold at least one additional certification in a relevant specialty (e.g., exercise physiology, nutrition, health education). Chronic Care Coaches. Typically registered nurses, our Chronic Care Coaches are supported by medical directors. Most have over 10 years of experience caring for patients with complicated medical problems, including the chronic conditions supported by the Chronic Care Solutions program. Many have been clinical case managers prior to joining Health Advocate, and have added training in coaching individuals with chronic disease. Licensed Professional Counselors and Work/Life Specialists. Our team of Licensed Professional Counselors and Work/Life Specialists deliver our comprehensive EAP+Work/Life program. These trained professionals are experts in a diverse cross-section of specialties including family/parenting issues, stress management, grief and loss, depression and more. 16
Capabilities Onsite Biometric Screening Staff. Our trained screening professionals include registered nurses, EMTs, paramedics and health educators. All of our nurses have a state nursing license and must pass the National Council Licensure Examination. Our EMTs and paramedics must pass the National Registry of Emergency Medical Technicians exam and possess any state-required licensing. The staff is fully trained and in compliance with all HIPAA privacy regulations. Medical Directors. Our Medical Directors have many years of clinical practice experience and support each clinical case, communicating with physicians and other professionals, as needed. Benefits and Claims Specialists. Our experts have extensive experience in employee benefits or claims management for health plans. Infrastructure Support Staff. Our IT team has extensive experience and training, including senior-level experience in applications, data and systems architecture and management, to ensure that our integrated telephone, computer and database technologies fully support our capabilities. The team also ensures that our customized member websites allow easy access to the specific solutions offered by the client for their employees, and that our reporting tools create better efficiencies to fully support their employees. Management Team. Our executive management team includes our five founders, who previously led one of the nation s largest health insurance companies, and our highly experienced senior managers and other key executives. Our team has operational, medical, technical and administrative expertise and is uniquely qualified to manage a complex organization while meeting the diverse needs of our clients. Ongoing Hiring and Training. We continually recruit candidates who have the expert skill set required to meet the growing needs of our clients. Our ongoing training and collaborative information-sharing programs ensure that our team is always up to date on healthcare developments, case outcomes and system upgrades. Innovative Technology To enable our Personal Health Advocates to efficiently access client benefit information, expand on our present services and support our clients needs for data integration, we have made a considerable investment in scalable, innovative, state-of-the-art telephone and computer systems. Health Advocate s comprehensive online Customer Relationship Management (CRM) system provides an integrated environment in which all user benefit information is assimilated and accessible at the time of an employee s call. The system links relevant information including eligibility files, health benefit information, and accompanying program information from dental, prescription, medical and other benefits. Our computerized call switching system can warm transfer calls to other vendors as appropriate. Detailed case tracking protocols enhance knowledge-sharing among our Personal Health Advocates, and ensure timely resolution of cases. Further, our system includes sophisticated call tracking and reporting capabilities, enabling Health Advocate to measure call center performance as part of our ongoing quality assurance program. 17
Capabilities All operations are centralized in our expansive headquarters in suburban Philadelphia, enabling resource sharing, face-to-face collaboration among team members on all levels, and ensuring a coordinated response to the employee s needs. Health Informatics Division Health Advocate s health informatics division, Engage2Health, provides health informatics solutions to support employers and employees in achieving improved health outcomes and reduced healthcare costs. The division s state-of-the-art technology, advanced algorithms and software systems maximize healthcare data to facilitate our proprietary Health Information Dashboard, wellness and engagement programs. The unit is headed by a leading health informatics authority and staffed by skilled programmers, statisticians and researchers with extensive experience performing complex analyses of healthcare data. Implementation Planning Health Advocate works closely with our clients to ensure the smooth installation of our program. Our experience working with organizations, from large national companies to smaller local and regional employers, allows us to customize an Implementation Plan to meet your specific requirements. The following are key elements of our plan: Account Manager support Focused resources Flexibility with launch phase-in Comprehensive communications Ongoing review Turnkey Communications Our ongoing print and electronic communications include a wide range of materials designed to educate employees about our services and to increase utilization. Many of the materials, such as our newsletters, are designed to be easily forwarded to employees in a timely manner while our convenient websites provide easy access to program information. Spanish-language versions are available, and, for an added cost, our team will work with you to develop customized materials to meet your needs. 18
Capabilities Information Reporting Health Advocate s comprehensive Group Information Reports provide critical program utilization and savings information in a user-friendly format. Our reports measure performance and report results on an interaction basis, listing by major category each activity Health Advocate has worked on through the reporting period. We report on the time our staff has expended and on the number of discrete contacts required to resolve an issue. In addition, all activities are assigned an intensity factor that reflects the seriousness, complexity and urgency of the matter. We measure value based on the combination of utilization, urgency, time spent, and number of contacts between our Personal Health Advocates and employees. Further, we report and identify savings that accrue to either plan sponsors or employees. The Chronic Care Solutions program reports a wide variety of program-level and condition-specific metrics to evaluate program engagement and effectiveness. Independent Service Health Advocate is independent of any insurance plan or third party provider, enabling us to provide completely unbiased assistance. Our team is fully compliant with all HIPAA privacy regulations. 19
Section 5 HealthAdvocate Company Overview 20
HealthAdvocate Company Overview About Health Advocate Health Advocate, Inc., a subsidiary of West Corporation, is the nation s leading healthcare advocacy and assistance company. Health Advocate serves more than 10,000 clients offering solutions that save time and lower healthcare costs. Our award-winning solutions include EmpoweredHealth, Health Advocacy, Wellness Coaching, EAP+Work/Life and Chronic Care Solutions, among others. We also leverage the power of data analytics to help our clients and members get more value out of the healthcare system. Our client base includes large and small insured and self-insured employers, government bodies, unions and union health and welfare trusts, affinity groups, nonprofit and charitable organizations, schools, school boards and universities, health plans, third-party administrators and other plan sponsors in virtually every industry. History Health Advocate was founded by five former executives of one of the nation s leading health insurance companies. Equipped with unparalleled, combined experience in the healthcare industry, the founders envisioned a way to help alleviate the frustration and complexity that many people experience when confronting healthcare and insurance-related issues. Under their leadership and building upon this mission, the company has grown to become the largest healthcare advocacy and assistance company in the country. In 2014, Health Advocate became part of West Corporation, a leading provider of technology-driven communications services, serving Fortune 1000 companies and other clients in a variety of industries including healthcare, telecommunications, retail, financial services, public safety and technology. 21
Company Overview Spectrum of Solutions Health Advocate offers a full range of employee and employer solutions that provide personalized help across a continuum of healthcare and insurance-related needs. Our solutions help employees take charge of their health, make smarter medical decisions, quickly connect to the right benefits, balance work and life demands, understand consumer-driven health plans, and lower medical bills. Our employer solutions promote improved health outcomes and reduced medical costs by keeping employees healthier and more productive. They also help ease the burden of administering multiple programs by integrating key services onto one coordinated platform. The company also offers a direct-to-consumer service, Health Proponent, that provides the same expert, personal assistance with healthcare and insurance-related issues to individuals who are not part of groups. Company Culture Maintaining our high standards of performance takes a lot of hard work. It requires ongoing nourishment by a culture which is sustained by a deeply-held and shared set of values. Always at your side is not just a motto; it is what makes our company so special. Our employees are responsible for helping people deal with challenging healthcare and insurance-related issues, which require not just expertise, but empathy and communication. Consequently, we have built our company around empowering our employees with the ability to provide maximum support to our clients. In addition to promoting teamwork, we ensure that employees not only have the resources they need to serve our members properly, but that our work environment can be structured to allow employees to enjoy themselves within the context of their important work. We have created a supportive workplace, offering fun activities, family events, and health and wellness programs throughout the year. Charitable Contributions Health Advocate s commitment to helping people extends to local, regional and national charities. Throughout the year, both employees and the company raise money for and donate time to a variety of charitable organizations, including: the American Heart Association, the Sandy Rollman Ovarian Cancer Foundation, Inc., The Children s Hospital of Philadelphia, Police Athletic League, American Cancer Society, local police departments, local theater, local colleges and universities, local ambulatory services, etc. We also forge strategic partnerships with leading regional and national organizations to promote awareness of important health issues, including breast cancer prevention, heart health and Alzheimer s disease. Customer Satisfaction Our mission is to provide compassionate, resourceful and quality service to clients and employees. Numerous customer surveys report the highest level of satisfaction and praise for the dedication and perseverance shown by our Personal Health Advocates to resolve even the most difficult challenges. If you would like references, we would be happy to share case studies with you. 22
Company Overview Awards/News Media Coverage Health Advocate has received widespread recognition from the following organizations and publications: America s fastest growing private companies Inc. 500 (2007-2013) Fastest growing technology companies in North America Deloitte s Technology Fast 500 (2010-2013) Worldwide Leader in Service Workforce Management magazine Optimas Award PACT Life Sciences Company of the Year Award (Greater Philadelphia Region) Entrepreneur of the Year (Greater Philadelphia Region) Ernst & Young InformationWeek Top Tech Innovations Top 20 Best Places to Work Philadelphia magazine and the Philadelphia Business Journal Mobile Application Awards for SmartHelp and Health Cost Estimator Apps - Web Health Awards SM MOBILE Inc. Hire Power Award for New Job Creation (Pennsylvania) Health Advocate has been featured in hundreds of national, regional and local print articles, radio and TV news stories, including: BusinessWeek, The Wall Street Journal, The New York Times, The Washington Post, The Philadelphia Inquirer, the Los Angeles Times, The Atlanta Journal - Constitution, Crain s New York Business, USA Today, U.S. News & World Report, CBS Evening News, NBC 10 TV, Fox 29 News (Philadelphia) and National Public Radio. Publications Health Advocate has published a number of in-depth white papers on a variety of timely subjects impacting the workplace, including the challenges relating to the rising rate of obesity, stress and caregiving. In addition, two of the company s founders co-authored The Healthcare Survival Guide. This valuable resource has been widely acclaimed and is the winner of the 2010 IBPA Benjamin Franklin Award for Best First Book (Non-Fiction) and the 2010 APEX Grand Award for One-of-a-Kind-Publication. About West Corporation West Corporation is a leading provider of technology-driven communication services, serving Fortune 1000 companies and other clients in a variety of industries, including healthcare, telecommunications, retail, financial services, public safety and technology. Founded in 1986, West has over 32,600 employees worldwide, working from 41 locations. Company highlights: World s largest conferencing provider (InterCall) Nation s leading provider of public safety services 90% of the Fortune 10, 89% of the Fortune 100 and 84% of the Fortune 500 use West Corporation 23
Section 6 HealthAdvocate Spectrum of Solutions 24
HealthAdvocate Spectrum of Solutions Health Advocate offers a spectrum of fully integrated solutions. Our programs help employees improve their health, make smarter medical decisions, balance work and life demands, connect to the right benefits and lower medical bills. All of our solutions promote improved health outcomes and lower costs for both employees and their employers. Our employer solutions ease the burden of administering multiple programs, including internal and external appeals, benefits enrollment and family leave requests. The following is a brief description of our entire suite of solutions, some of which may have been described in this proposal. Encourage Better Health and Well-Being Core Health Advocacy Our Core Health Advocacy program is the cornerstone of what we do, taking a highly personalized approach to helping employees navigate and resolve time-consuming healthcare and insurance-related issues. Delivered by a team of highly trained Personal Health Advocates, typically registered nurses supported by medical directors and benefits and claims specialists, the program helps find in-network providers, obtain second opinions, resolve claims problems and address a wide range of other issues. Wellness Coaching Our Wellness Coaching Program offers a proven approach to engage and support members in modifying unhealthy behaviors to get and stay healthy. A Personal Wellness Coach works with employees by telephone, email or instant message to help them make healthy lifestyle changes and reach their personal health goals. What makes our program distinctive is our coordinated approach. We combine personalized one-on-one coaching, interactive events and health data analysis to improve health outcomes, reduce costs and extend lives. EmpoweredHealth EmpoweredHealth is a powerful, one-stop solution that connects employees to a complete range of personalized and integrated services including advocacy, wellness, employee assistance and chronic care support all through a single, toll-free number. EAP+Work/Life EAP professionals provide short-term assistance and support for personal, family and work/life issues, and assist HR staff with sensitive issues. 25
Spectrum of Solutions Encourage Better Health (cont d) Chronic Care Solutions Chronic Care Solutions is a population-based health program that uses a unique predictive modeling approach to identify and risk stratify members who have (or are at risk for) one or more common chronic conditions. It provides personalized support across the spectrum of risk level, tailored to each individual s specific needs. Promote Healthy Behaviors Onsite Biometric Screenings Provides an accessible, dependable way to get the crucial baseline data needed to tailor wellness programs for the highest impact. Incentive Management Help creating and tracking customized engagement strategies and programs. Tobacco Cessation A 12-week program that features personalized, telephonic, email or instant message-based coaching using evidence-based strategies to help employees become (and stay) tobacco-free. NurseLine Provides 24/7 access to registered nurses for advice about non-urgent medical conditions and answers to general health questions. Improve Health Outcomes Data Analytics Leading-edge analytics drive interventions that improve outcomes and strengthen employee engagement. Benefits Gateway Live benefits experts connect employees to the right benefit through a single toll-free number. Health Information Dashboards Technology analyzes employee benefit, health and wellness information to leverage teachable moments and address gaps in care. Personalized Health Communications Tailored communications remind employees about important preventive care, while advanced information systems identify those with chronic health conditions to help them better manage their disease. Pinpoint Solutions: Dashboards and Analytics Provides access to key performance indicators and risk profiles to easily pinpoint costs and trends. 26
Spectrum of Solutions Drive Cost-Effective Decisions Health Cost Estimator Health Cost Estimator (HCE), our powerful pricing transparency tool, helps reduce medical costs and promotes more informed healthcare decision-making. Leveraging client healthcare data and other, national data sources, the tool provides detailed cost comparisons and hospital quality scores for common medical services and procedures nationwide. Medical Bill Saver Experts negotiate with providers to lower employees non-covered medical and dental bills. MedChoice Support Comparative tool helps employees make more informed decisions about their medical care. Strengthen Organizations Provider Support Program Patient outreach, administrative and clinical assistance, and data analytics helps organizations maximize revenue, enhance customer service and build brand loyalty. Support Streamlined Administration Enrollment Advocate Specialists educate employees about benefits options, including explaining the details of consumer-driven health plans. FMLA Support Independent medical team helps verify employee requests for medical leave, in compliance with the latest regulations and privacy laws. Independent Appeals Administration Experts provide self-funded companies with fiduciary responsibility for the appeals process with impartial appeals analysis, in compliance with all regulations and timelines. External Appeals Administration Helps companies with self-funded plans meet federal requirements for independent reviews within strict timelines. Provider-Centered Analytics Tailored, data-driven analytics measure physician performance to help improve quality of care and reduce costs. Medicare Advantage Stars Program Targeted patient engagement and data sharing helps Medicare Advantage plans earn higher CMS ratings. 27
Section 7 HealthAdvocate Member Communications 28
Health Advocate is a service provided by your employer or plan sponsor, at no cost to you. It can help you and your eligible family members resolve healthcare and insurance-related issues, and balance your work and life. We look forward to serving you! Member Welcome Video Get the right answers Real support when you need it 2010 Health Advocate, Inc. HA-M-1005036 2010 Health Advocate, Inc. HA-M-1005036 2010 Health Advocate, Inc. HA-M-1005036 2010 Health Advocate, Inc. HA-M-1005036 2010 Health Advocate, Inc. HA-M-1005036 HealthAdvocate Member Communications Health Advocate has developed a comprehensive communications program to help support awareness and utilization of our services. Below is an overview of available materials. Train-the-Trainer PowerPoint Our staff offers Train-the-Trainers sessions for managers for an in-depth briefing about Health Advocate prior to launch. They will also provide a PowerPoint as a handy reference. Exclusively for Health Advocate Members Get Started Welcome to Your Health Advocate All-in-1-1 Benefit ng! Featuring! Healthcare Help EAP+Work/Life Your Lifeline for Navigating the Healthcare and Insurance maze Get Started Guide Our guide, available for distribution to employees, provides an easy-to-read overview of Health Advocate and how to use the program. A set of wallet cards is enclosed with each guide. Healthcare Help Video Resources Member Orientation Video. This video reviews how Health Advocate works, and how our service can assist your employees and their eligible family members. Health Advocate in the News. Copies of news stories feature case studies about how Health Advocate helped with healthcare-related issues, and include segments on NBC10 TV, the CBS Evening News and FOX 29 News. These videos can be shown at employee meetings or sent by email. Help is a Phone Call Away Just Call 866.695.8622 Find the right doctors, hospitals Untangle insurance issues Navigate healthcare claims...and d lots more! Your All-in-1 Benefit Just Call 866.799.2728 Your All-in-1 Benefit Your All-in-1 Benefit Just Call 866.695.8622 Just Call 866.799.2728 ur n-1 fit Healthcare Help EAP+Work/Life Just Call 866.79 66.799.2 728 Wellne Healthcare Help Wellness Support althcare Help Wellness Support nefit Healthcare Help Healthcare Help Wellness Support Awareness Posters As part of our awareness campaign, we provide a number of different posters, and we recommend that you display them in prominent areas. English and Spanish versions are available. Additionally, our table tent card displays are available for use on cafeteria tables, workplace counters, etc. EAP+Work/Life 29
We ll also locate the right hospitals, dentists and other leading healthcare providers anywhere in the country. You ll receive estimates of common medical procedures in your area to help you make informed decisions. Our team works on your behalf to obtain appropriate approvals for needed services. Exclusively for Health Advocate Members We help you become informed about test results, treatments and medications prescribed by your physician. Your Health Advocate benefit is paid by your employer or plan sponsor and covers eligible employees, their spouses, dependent children, parents and parents-in-law. 866.695.8622 2012 Health Advocate, Inc. HA-CM-1206036-1FLY We can help expedite the earliest appointments with providers including hard-to-reach specialists and arrange treatments and tests. Independent. Confidential. Convenient. Health Advocate is not affiliated with any insurance or third party provider. Health Advocate does not replace health insurance coverage, provide medical care or recommend treatment. Our experts get to the bottom of your issue to assist with negotiating billing and payment arrangements. HealthAdvocate.com/members High blood pressure is a widespread condition affecting 1 in 3 adults in the U.S. But many people don t know they have it until they find out during a doctor visit. It develops slowly and without any symptoms, and if it s not treated, it can lead to a heart attack, stroke, or other life-threatening conditions. Are you at risk? You could be at risk for developing high blood pressure or already have it and not even know it. Regular blood pressure checks are especially important if High blood pressure runs in your family Your blood pressure is above 120/80 You re over age 55 (men), or over age 65 (women) You re overweight, smoke or have other risk factors 2012 Health Advocate, Inc. HA-CEM-1202035-2FLY Don t Delay! Support We address senior issues such as Medicare and related healthcare issues facing your parents and parents-in-law. We ll also handle the details of transferring X-rays and lab results....and much more Getting checked could save your life! You can have your blood pressure checked in a number of ways. The best way is to have it checked by your doctor or by a trained clinician at a health fair. Walk-in clinics (sometimes called urgent care clinics) are another option clinicians on clinici are on hand for quick, low-cost or free checks. Free Resources Available In partnership with HealthyWomen, the nation s leading nonprofit health information source for women, we encourage you to download a free Heart-to-Heart high blood pressure booklet that offers details about high blood pressure, risk factors, questions to ask your doctor, a tracking sheet and more. http://healthadvocate.com/downloads/heart_to_heart.pdf heart_to_h Member Communications Exclusively for Health Advocate Members Find the right doctors Get cost estimates Schedule appointments Work with insurance companies Help is Only a Phone Call Away Your Lifeline for Healthcare Help Top Reasons to Call Us... 866.695.8622 Help resolve insurance claims Answer questions Assist with eldercare Assist in the transfer of medical records Reminder Materials A series of Health Advocate electronic reminder pieces is available to clients to email to employees throughout the year to reinforce utilization. Print versions of selected pieces are also available. @yourservice Count on Us Your Personal Health Advocate is your Partner in Health get to the right place with Benefits Gateway y Exclusively for Health Advocate Members Exclusively for Health Advocate Members @yourservice e Take Control T ntrol June 2012 Your Complete Wellness Coaching Program for a Healthier Life @yourservice Real-Life Help Assistance and resources for personal, family and work issues m for a Hea ealth lthier Life Member Newsletter Our member newsletter is sent electronically to plan sponsors, which can then be forwarded to employees to help strengthen utilization. Monthly Webinar Tuesday, June 19th HealthAdvocate ate HealthAdvocate ate HealthAdvocate HealthAdvocate ate Manager s Take-One Wallet Card Pads These handy pads with attached wallet cards provide a ready resource to remind employees about Health Advocate. Exclusively for Health Advocate Members 24/7 866.799.2728 High Blood Pressure Stop the Silent Killer! Your Lifeline for Navigating the Healthcare and Insurance maze Custom Materials We will be happy to work with you to customize our standard materials that can feature your organization s logo or other special messages, for an additional fee. your logo here 30
Section 8 HealthAdvocate Getting Started: Next Steps 31
HealthAdvocate Getting Started: Next Steps To initiate the Health Advocate program and ensure a smooth installation, we would be happy to arrange a meeting to discuss the following next steps: Finalize the Group Agreement Select an effective date Finalize the Implementation Plan Train your management team Train our employees about your organization Review communications Distribution of employee materials Getting Started: In order to begin the implementation process, please contact: Cynthia K. Persico, CEAP, MHS Regional Vice President, EAP+Work/Life Solutions HealthAdvocate 904.680.0372 cpersico@healthadvocate.com 32