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Transcript of NDPERS Executive Summary EXECUTIVE SUMMARY | 2 CONTENTS 3 Summary 6 ... Poli;cal Subs Med. Re;rees...
Quarter 1 | 2017 Presented August 2017
NDPERS Executive Summary
NDPERS EXECUTIVE SUMMARY | 2
CONTENTS 3Summary
6 Claims Analysis
8Membership & Utilization
12High Dollar Cases
15Prescription Drugs
18Dakota Wellness Program
22Performance Standards & Guarantees
3 | NDPERS EXECUTIVE SUMMARY
SummaryANNUAL MEMBERSHIP SUMMARY
MEMBERSHIP TREND
*Incurred between January 1, 2016 and March 31, 2017 and paid through May 31, 2017. Includes IBNR for January 2016 through March 2017, as of May 31, 2017. **Historically, 98% of claims will be accounted for within 90 days of the effective date.*Medicare Retirees PMPM excludes prescription drug coverage (Medicare Part D).
PMPM SUMMARY
MEMBERSHIP COMPARISON PERCENT CHANGE
Q3 2015 Q4 2015 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Q1 2017 Q1 17/Q1 16
Actives 56,782 56,923 57,474 57,424 57,087 56,778 56,913 -1.0%
Early Retirees 1,211 1,152 1,121 1,124 1,071 1,060 1,071 -4.5%
Medicare Retirees 8,648 8,635 8,524 8,530 8,605 8,676 8,686 1.9%
56,782 56,923 57,474 57,424 57,087 56,778 56,913
8,648 8,635 8,524 8,530 8,605 8,676 8,686
1,211 1,152 1,121 1,124 1,071 1,060 1,071-
10,000
20,000
30,000
40,000
50,000
60,000
70,000
Q32015
Q42015
Q12016
Q22016
Q32016
Q42016
Q12017
QuarterlyChangesinMembershipTrend
Ac1ves MedicareRe1rees EarlyRe1rees
402 387 391357
1,169
168 178
489 424440 382
996
150 152
425445
440397
1,165
137
137
481 458 464434
1,113
136134
416 419 418
334
840
181169
366 356 359
940
168
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
Poli2calSubs StateEmployees Ac2ves SHPCommercial EarlyRe2rees MedicareRe2rees SHPMedicare
PerMemberPerMonthQuarterlyAverageJan2016-March2017
Q12016 Q22016 Q32016 Q42016 Q12017 Expected
NDPERS EXECUTIVE SUMMARY | 4
Summary FITNESS CENTER REIMBURSEMENT
*Activity decline is the result of the wellness program suspension effective January 1 through May 31, 2017.
0.24% 0.33% 0.36% 0.01%
1.03% 1.43% 1.63%
0.09%
2.09% 2.74% 3.17%
0.26%
9.4%
12.2%14.3%
0.5%
0%
5%
10%
15%
20%
Q2-2016 Q3-2016 Q4-2016 Q1-2017
%ofEligibleMembersComple1ngaHealthAssessment
EarlyRe6rees MedicareRe6rees Poli6calSubs StateEmployees
HEALTH ASSESSMENT
*Activity decline is the result of the wellness program suspension effective January 1 through May 31, 2017. *Gym reimbursements in Q1 reflect unpaid 2016 gym activity. Gyms had until February 8, 2017 to submit 2016 gym activity.
228 189 190 56
1,418 1,219 1,323
362
768494 547
142
4,201
2,6973,154
751
0
600
1,200
1,800
2,400
3,000
3,600
4,200
4,800
Q22016 Q32016 Q42016 Q12017
#ofReimbu
rsem
ents
TotalNumberofFitnessCenterReimbursements
EarlyRe5rees MedicareRe5rees Poli5calSubs StateEmployees
5 | NDPERS EXECUTIVE SUMMARY
Summary
Q22016 Q32016 Q42016 Q12017EarlyRe1rees 125 69 42 35
MedicareRe1rees 519 274 163 128
Poli1calSubs 1,067 739 649 351
StateEmployees 4,828 3,367 3026 1049
4,828
3,367 3026
1049
1,067
739649
351
519
274
163
128
125
69
42
35
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
#ofM
embe
rs
#ofMembersComple8ngOnlineWellnessAc8vi8es
*Activity decline is the result of the wellness program suspension effective January 1 through May 31, 2017.
*This data was prepared by Express Scripts Inc. (ESI)
ONLINE WELLNESS ACTIVITIES
Sanford Health Plan – NDPERS EGWPDescription 1H16 1H17 Change
Avg Members per Month 8,526 8,696 2.0%
Number of Unique Patients 8,069 8,278 2.6%
Pct Members Utilizing Benefit 94.6% 95.2% 0.6
Total Days 6,098,596 6,384,389 4.7%
Total Adjusted Rxs 223,255 233,940 4.8%
Average Member Age 74.8 75.0 0.3%
Nbr Adjusted Rxs PMPM 4.36 4.48 2.7%
Generic Fill Rate 89.6% 91.3% 1.7
Home Delivery Utilization 1.0% 1.2% 0.2
Member Cost % 23.3% 21.3% -1.9
Specialty Percent of Plan Cost 26.5% 31.2% 4.8
Formulary Compliance Rate 98.8% 99.0% 0.2
NDPERS EXECUTIVE SUMMARY | 6
ClaimsAnalysis
PAID CLAIMS PER CONTRACT PER MONTH
*Incurred between July 1, 2015 and March 31, 2017 and paid through May 31, 2017. Includes IBNR for July 2015 through March 2017 as of May 31, 2017.
*Historically, 98% of claims will be accounted for within 90 days of the effective date.
*NDPERS Active contracts have approximately 2.62 members per contract.
$1,137 $1,167
$1,019$1,148 $1,150 $1,212
$1,098
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
Q320
15
Q420
15
Q120
16
Q220
16
Q320
16
Q420
16
Q120
17
AVERAGEQUARTERLYINCURREDCLAIMSPERCONTRACTAcAves
Expected
*Incurred between July 1, 2015 and March 31, 2017 and paid through May 31, 2017. Includes IBNR for
July 2015 through March 2017 as of May 31, 2017.
*Historically, 98% of claims will be accounted for within 90 days of the effective date.
*NDPERS Early Retirees contracts have approximately 1.22 members per contract.
$1,071
$1,294$1,419
$1,210
$1,415 $1,357
$1,016Expected
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
Q320
15
Q420
15
Q120
16
Q220
16
Q320
16
Q420
16
Q120
17
AVERAGEQUARTERLYINCURREDCLAIMSPERCONTRACTEarlyReDrees
7 | NDPERS EXECUTIVE SUMMARY
ClaimsAnalysis
$172 $172
$224$200
$183 $183
$243
$0
$50
$100
$150
$200
$250
$300
Q32015
Q42015
Q12016
Q22016
Q32016
Q42016
Q12017
AVERAGEQUARTERLYINCURREDCLAIMSPERCONTRACTMedicareReBrees
Expected
PAID CLAIMS PER CONTRACT PER MONTH
*Incurred between July 1, 2015 and March 31, 2017 and paid through May 31, 2017. Includes IBNR forJuly 2015 through March 2017 as of May 31, 2017.
*Historically, 98% of claims will be accounted for within 90 days of the effective date.
*NDPERS Medicare Retirees contracts have approximately 1.34 members per contract.
NDPERS EXECUTIVE SUMMARY | 8
Membership& Utilization
MEMBERSHIP PERCENTAGE
*Incurred between January 1, 2016 and March 31, 2017 and paid through May 31, 2017. Includes IBNR for January 2016 through March 2017 as of May 31, 2017.
43,916 43,810 43,619 43,288 43,292
13,557 13,614 13,468 13,490 13,621
8,524 8,530 8,605 8,676 8,686
1,121 1,124 1,071 1,060 1,0710
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
Q12016 Q22016 Q32016 Q42016 Q12017
QuarterlyMembershipTrend
StateEmployees
Poli;calSubs
Med.Re;rees
EarlyRe;rees
85%
2%
13%
MembershipbyPercentage
Ac*ves EarlyRe*rees MedicareRe*rees
91%
4% 5%
PercentageofTotalIncurredClaims
Ac)ves EarlyRe)rees Med.Re)rees
387
424
445458 419
402
489
425
481
416391
440440
464
418
$300
$350
$400
$450
$500
$550
Q12016 Q22016 Q32016 Q42016 Q12017
PaidPMPMTrendbyQuarter
StateEmployees Poli;calSubs TotalAc;ves
PAID PMPM TREND BY QUARTER
9 | NDPERS EXECUTIVE SUMMARY
Membership& Utilization
PMPM BY CLAIM TYPE
*Incurred between April 1, 2016 and March 31, 2017 and paid through May 31, 2017. Includes IBNR for April 2016 through March 2017 as of May 31, 2017.
206
2
01
213
203
180
1
91
209
162
422
577
48
239
3
95
8
9
90
110
108
9
4
91
107
156
1
63
174
145
125
1
29
143
102
371
415
447
277
54
4
7
46
71
44
4
2
42
62
77
7
6
76
70
77
7
7
81
70
203
172
18
3
171
440
4
40
464
4
18
382
3
97
434
334
996
1,1
65
1,1
13
840
150
1
37
136
1
81
152
1
37
134
1
69
-
200
400
600
800
1,0
00
1,2
00
1,4
00
Q2
2016
Q
320
16
Q4
2016
Q
120
17
Q2
2016
Q
320
16
Q4
2016
Q
120
17
Q2
2016
Q
320
16
Q4
2016
Q
120
17
Q2
2016
Q
320
16
Q4
2016
Q
120
17
Q2
2016
Q
320
16
Q4
2016
Q
120
17
Incurred
PMPM
byClaimType
Rx
Pro
fess
iona
l
Ins<
tu<o
nal
Ac<v
es
SHP
Com
mer
cial
Ea
rlyR
e<re
es
Med
icar
eRe
<ree
sSH
PM
edic
are
NDPERS EXECUTIVE SUMMARY | 10
Membership& Utilization
PAID CLAIMS BY STATE
*Paid Claims by State charts include both active and retiree membership.
76% 80% 80% 78% 79% 78% 79%
24% 20% 20% 22% 21% 22% 21%
0%
20%
40%
60%
80%
100%
120%
Q32015 Q42015 Q12016 Q22016 Q32016 Q42016 Q12017
%ofTotalClaimsPaid-NDvs.Out-of-State
NorthDakota Out-ofState
$5.4M
$4.5M $4.3M
$5.1M $4.9M$5.1M
$4.4M
$0
$1
$2
$3
$4
$5
$6
Q32015 Q42015 Q12016 Q22016 Q32016 Q42016 Q12017
Millions
Avg.QuarterlyMedicalSpendbyStateforOutofStateServices
Minnesota SouthDakota Montana Others
11 | NDPERS EXECUTIVE SUMMARY
Membership& Utilization
MEMBER RISK PROFILE & UTILIZATION
*Incurred between April 1, 2016 and March 31, 2017 and paid through May 31, 2017.
*All data was normalized using Verisk’s methodologies and algorithms.
*NDPERS includes Political Subdivisions, Early (Pre-Medicare) Retirees and State Employees.
NDPERS SHP BoBAverage Age 35.11 33.65 % Male (Current) 49.17 44.74Average Risk Score 1.25 1.11 Average Care Gap Index 1.31 1.04 Inpatient Days Per 1000 287 274 Total Admissions Per 1000 64 71 ER Visits Per 1000 219 165Total Office Visits Per 1000 4,295 4,014 Pharmacy Scripts Per 1000 8,532 9,280
NDPERS EXECUTIVE SUMMARY | 12
High DollarCases
ACTIVES
Avg. Paid/Case $202,303% of Total Payments 26.9%
$69.8
$49.2
$0
$10
$20
$30
$40
$50
$60
$70
$80$M
illions
TotalPaidforHighDollarClaimants(over$100,000/member)-AcAves
302Members
July15-June167
302Members
July16-Mar17
243Members
26.9%
73.1%
HighClaimantAc6vesas%ofTotalPaymentsJuly2016-Mar2017
HighDollarPay AllOtherMembers
13 | NDPERS EXECUTIVE SUMMARY
High DollarCases
EARLY RETIREES
$0
$1
$2
$3
$4
$5
$6
$Millions
TotalPaidforHighDollarClaimants(over$100,000/member)-EarlyReBrees
15Members$3.7M
20Members
July15-June16July16-Mar17
$4.8M
Avg. Paid/Case $183,999
% of Total Payments 44.9%
44.9%55.1%
HighClaimantEarlyRe7reesas
%ofTotalPaymentsJuly2016-Mar2017
HighDollarPay AllOtherMembers
NDPERS EXECUTIVE SUMMARY | 14
High DollarCases
PRIMARY DIAGNOSIS
36%
16%15%
12%
7%
5%4%
3%
2%
HighestPaidDiagnosisGroupApr2016-Mar2017
Cancer(36%) OtherDiagnosis(16%)
GI/GU(15%) Heart/Circulatory(12%)
Musculoskeletal/Back/Joints(7%)
&BehavioralHealth/SubstanceAbuse(5%)
NewbornCare(4%)
Respiratory/COPD(3%)
Neuro/Spine(2%)
$29
$13 $12$10 $5
$4 $3 $3 $20
40
80
120
160
0
10
20
30
40
# of
Mem
bers
$ M
illio
ns
Highest Paid Diagnosis Group w/ Member CountApr 2016 - Mar 2017
Sum of Total Paid Count of Individuals
*High dollar cases consist of claims with a total over $100,000.
36%
16%15%
12%
7%
5%4%
3%
2%
HighestPaidDiagnosisGroupApr2016-Mar2017
Cancer(36%) OtherDiagnosis(16%)
GI/GU(15%) Heart/Circulatory(12%)
Musculoskeletal/Back/Joints(7%)
&BehavioralHealth/SubstanceAbuse(5%)
NewbornCare(4%)
Respiratory/COPD(3%)
Neuro/Spine(2%)
36%
16%15%
12%
7%
5%4%
3%
2%
HighestPaidDiagnosisGroupApr2016-Mar2017
Cancer(36%) OtherDiagnosis(16%)
GI/GU(15%) Heart/Circulatory(12%)
Musculoskeletal/Back/Joints(7%)
&BehavioralHealth/SubstanceAbuse(5%)
NewbornCare(4%)
Respiratory/COPD(3%)
Neuro/Spine(2%)
2%
36%
16%15%
12%
7%
5%4%
3%
2%
HighestPaidDiagnosisGroupApr2016-Mar2017
Cancer(36%) OtherDiagnosis(16%)
GI/GU(15%) Heart/Circulatory(12%)
Musculoskeletal/Back/Joints(7%)
&BehavioralHealth/SubstanceAbuse(5%)
NewbornCare(4%)
Respiratory/COPD(3%)
Neuro/Spine(2%)
15 | NDPERS EXECUTIVE SUMMARY
PrescriptionDrugs
GENERIC UTILIZATION
$17$187
$2,973
AveragePaid/RxAc7ves&EarlyRe7rees
Apr2016-Mar2017
Generic Brand Specialty
86.6%87.0% 87.1% 88.4%
85.1%85.6% 86.0% 86.5%
84.1%
85.9% 86.4% 87.0%
80%
85%
90%
Q22016
Q32016
Q42016
Q12017
GenericU)liza)onRate#ofRxClaims
SHPCommercial Ac<ves EarlyRe<rees
21.5% 21.7%22.6% 22.4%
20.9% 21.5%
22.7% 23.8%
16.5%20.5% 21.2%
20.1%
15%
20%
25%
30%
Q22016
Q32016
Q42016
Q12017
GenericU)liza)onRate$ofRxClaims
SHPCommercial Ac<ves EarlyRe<rees
*Incurred between April 1, 2016 and March 31, 2017 and paid through May 31, 2017.
NDPERS EXECUTIVE SUMMARY | 16
PrescriptionDrugs
SPECIALTY PHARMACY
*Incurred between April 1, 2016 and March 31, 2017 and paid through May 31, 2017.
0.93%0.90% 0.87%
0.81%
0.99% 0.93%0.85%
1.08% 0.95%0.94%
0.82%
0.6%0.7%0.8%0.9%1.0%1.1%1.2%
Q22016
Q32016
Q42016
Q12017
SpecialtyU5liza5onRate#ofRxClaims
SHPCommercial Ac<ves EarlyRe<rees
39.3%38.1% 36.8% 36.6%
43.8%41.0% 37.8% 40.0%
49.6%43.4% 42.4%
50.2%
25%30%35%40%45%50%55%
Q22016
Q32016
Q42016
Q12017
SpecialtyU,liza,onRate$ofRxClaims
SHPCommercial Ac<ves EarlyRe<rees
17 | NDPERS EXECUTIVE SUMMARY
PrescriptionDrugs
PHARMACY
*Incurred between April 1, 2016 and March 31, 2017 and paid through May 31, 2017.
$2.9 $2.9 $3.1 $3.0
$4.9 $5.1 $5.3 $4.5
$6.1 $5.6 $5.2$5.0
$0
$2
$4
$6
$8
$10
$12
$14
$16
Q22016
Q32016
Q42016
Q12017
Millions
QuarterlyDrugSpendingbyDrugCategory
Generic Brand Specialty
NDPERS EXECUTIVE SUMMARY | 18
DakotaWellnessProgram
MONTHLY WELLNESS THEMESMonthly themes keep the wellness program fresh throughout the year and keepsmembers engaged in their individual wellness pursuit. Newsletters, e-blasts andworksite posters are used to introduce themes.
SVHP-1960 2/17
Dakota Wellness Program
ESTABLISH HEALTHY EATING IN KIDS Research shows that children build food acceptance through repeated tastings and sensory experiences. Try these tips to make trying new foods a positive experience.
Schedule Set a specific schedule for meals and snacks. This gives structure to the day and your child will know what to expect. If your child declines to eat, explain that they will be able to eat again in “x” amount of time.
Proportion Focus meals on proportion, variety and moderation. Help your child judge their fullness by asking them, “Are you hungry, or are you full?”
Adventure Let your child play detective and analyze new food. Have a conversation by using prompt questions that ask about the size, shape, color, texture and look of the food.
SVHP-1912 12/16
Dakota Wellness Program
TAKE STOCK IN YOU THIS NEW YEAR If your New Year’s goals are usually tossed aside by January 31, you deserve a better approach. What need does meeting your goal help fulfill? Know your needs, enjoy the change process and 2017 can be your year to shine!
Ask yourself:
• Which two needs drive much of what I do every day?
• How will the process of working toward my goal help meet my top two needs?
Wellness Activities
Monthly Book Club: The Three Marriages: Reimagining Work, Self and Relationship by David Whyte
Certainty The perception of safety & security
VarietyNew and exciting experiences
Significance A sense of importanceand meaning
GrowthStretching our limitstoward improvement
Love & ConnectionPart of an accepting group
ContributionServing, protecting and giving to a cause larger than ourselves
SVHP-1936 1/17
Dakota Wellness Program
HOW IS YOUR HEALTH? LOOK INSIDE YOUR MOUTH According to the Academy of General Dentistry, new research shows that the health of your mouth mirrors the condition of your body as a whole. Without proper oral hygiene, bacteria can reach levels that may lead to oral infections that can lead to intestinal failure, irritable bowel syndrome and other digestive disorders.
The American Dental Association provides these recommendations to help reduce your risk of oral complications:
Brush twice a day for at least two minutes, using fluoridated toothpaste.
Floss daily to remove plaque from places your toothbrush can’t reach.
Eat a healthy diet to provide the nutrients necessary (vitamins A and C, in particular) to prevent gum disease.
Avoid cigarettes and smokeless tobacco, which are known to contribute to gum disease and oral cancer.
Visit the dentist regularly for cleanings and exams. This is one of the most effective ways to detect the early signs of gum disease.
19 | NDPERS EXECUTIVE SUMMARY
DakotaWellnessProgram
TOP 10 ONLINE WELLNESS ACTIVITIESThese are the top 10 online Novu activities that were selected and completedby NDPERS members.
NUTRITION
CARDIO
BALANCE &MOBILITY
SLEEP HEALTH
HEALTHY WEIGHT
STRENGTH
STRESS
YOGA & RELAXATION
PURPOSE
DAILY HYDRATION CHALLENGE
#1 #6
#2 #7
#3 #8
#4 #9
#5 #10
NDPERS EXECUTIVE SUMMARY | 20
DakotaWellnessProgram
GR
AN
D FO
RK
S
BIS
MA
RCK
MIN
OT
CAR
RIN
GTO
N
DE
VILS
LA
KE
FAR
GO
MAY
VILL
E
MA
ND
AN
WA
HP
ETO
N
BO
WB
ELLS
FESS
END
EN
GR
AFT
ON
Wal
sh C
ount
y H
ealt
h D
istr
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HIL
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OR
O Trai
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ist
Hea
lth
Uni
t
LISB
ON
Ran
som
Cou
nty
VALL
EY
CITY
Bar
nes
Cou
nty
LIN
TON
Emm
ons
Coun
ty
Pub
lic H
ealt
h
RO
LLA
Rol
ette
Cou
nty
Min
ot S
tate
Uni
vers
ityW
ard
Coun
ty C
hild
Sup
port
Gar
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iver
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Con
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ist
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nce
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Dea
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Sta
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Wel
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ount
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ist
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anda
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ahpe
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Bur
ke C
ount
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ate
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the
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rand
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ksG
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rand
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ks
Se
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zen
Ass
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lind
UN
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For
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ousi
ng
Au
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FOR
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NSa
rgen
t Cou
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Cour
thou
seSa
rgen
t Cou
nty
Hea
lth
Uni
t
EVENT ATTENDANCE BY AGENCYThe Sanford Health Plan NDPERS wellness team engages members both offline
and online. Wellness educators travel across the state to support agency wellness
coordinators and provide worksite education and activities. This map shows where
they’ve been over the last quarter.
TOTA
L M
EMB
ER
ATTE
ND
AN
CE
THIS
QU
AR
TER
:
626
TOTA
L N
UM
BER
OF
AG
ENC
IES
VISI
TED
(U
ND
UP
LIC
ATED
)
34P
aint
You
r P
late
Stic
k to
You
r R
esol
utio
nsM
indf
ul E
atin
gSi
ttin
g D
isea
se
PR
ESE
NTA
TIO
NS/
EVE
NTS
:O
rgan
ize
My
Life
NO
VUM
ake
It H
appe
nN
o G
ym N
o P
robl
emO
verc
omin
g St
ress
Hea
lth
Fair
Wel
lnes
s C
oord
inat
or
1:1
Mee
tings
Yoga
Cla
ssB
igge
st L
oser
C
hall
enge
Lead
ing
for
Wel
lnes
s
21 | NDPERS EXECUTIVE SUMMARY
DakotaWellnessProgram
LEADING FOR WELLNESSIn the first quarter of 2017, the Dakota Wellness Program focused on agency leader wellness training and offered two-hour Leading for Wellness sessions in Bismarck, Minot, Fargo and Grand Forks with over 100 agency leaders attending.
Leading for Wellness recognizes organizational culture can serve as an accelerator or barrier to employee well-being. This leadership development training reveals how supervisors, managers, directors and executives can use employee engagement to drive wellness. The following survey responses were collected after the training sessions.
1. As a result of the Leading for Wellness presentation, I am more knowledgeable about the connection between employee engagement and employee well-being, with career well-being as the primary driver of overall well-being. 97% of Participants Agreed or Strongly Agreed
2. As a leader, I am now more aware of how I can change organizational culture by influencing the six dimensions of well-being with my employees. 92% of Participants Agreed or Strongly Agreed
3. I will apply the leadership competencies I learned in the presentation to increase the well-being of my employees. 90% of Participants Agreed or Strongly Agreed
4. Which technique(s) resonated the most with you, and which ones do you plan to focus on first? (responses unduplicated)• Physical, social, emotional and career well-being• Finding out what creates stress for our employees and addressing it• Improved sleep• Career well-being: strengths, autonomy, positive feedback• Stress in the workplace• Community well-being• Acknowledging achievements and good work of employees• Employee engagement• Getting more department heads on board with the dimensions
of well-being
5. Additional Comments: (responses unduplicated)• Loved this training! Very insightful. Related a lot to the speaker’s examples
and discussion.• Excellent two hours spent. Well done!• Great session! A lot of new information, enjoyed the presentation and
examples.• Thanks! Worth my time!• Really liked the piece on positive reinforcement.• Great ideas. I’m anxious to implement them. Thank you!• I am not the administrator of our department. Our management sees the
need, but does not realize how important wellness is and is “too busy” to assist in any program we try to complete.
• We will try to restart the in-office concession stand with healthy options.• I will apply to the extent my CEO permits.
NDPERS EXECUTIVE SUMMARY | 22
MEASURE GOAL OUTCOME REPORTING DATES OUTCOME
COST MANAGEMENT:
Health Risk Assessment 10% Dec. 31, 2015 17.9%
HEALTH OUTCOMES:
Medical Home Enrollment 30% July 1, 2016 36.5%
Breast Cancer Screening Rates 80% June 30, 2017 –
Cervical Cancer Screening Rates 85% June 30, 2017 –
Colorectal Cancer Screening Rates 60% June 30, 2017 –
PROVIDER NETWORK/CONTRACTING:
NDPERS PPO network - in-state hospitals, MDs and DOs that participate in the Company’s Par Network.
Hospital = 85%MDs & DOs = 85% Dec. 31, 2015
Hospital = 94%
MDs & DOs = 87%
Minimum provider discount from in-network providers
30% for Non-Medicare
contracts June 30, 2017 –
Claims Financial Accuracy 99% June 30, 2017 –
Claims Payment Incidence Accuracy 97% June 30, 2017 –
Claim Timeliness 99% June 30, 2017 –
Average Speed of Answer 45 seconds June 30, 2017 –
Call Abandoned Rate 7% or less June 30, 2017 –
ANCILLARY ITEMS:
The interest rate utilized currently is based on the US Treasury Notes quoted by the Wall Street Journal
verification June 30, 2017 –
Rx rebates passed-through to NDPERS 100% June 30, 2017 –
HRA WELLNESS SCORE:
HRA Wellness Score 5% point increase Dec. 31, 2016 N/A
bWell Participation 10% Dec. 31, 2015 10.8%
Health Club Credit Goal = 1,950 July 1, 2016 1,879
PerformanceStandards &Guarantees
23 | NDPERS EXECUTIVE SUMMARY
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SVHP-2059 7/17