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【正文】 hospitals offering the best results 33 Mercer Human Resource Consulting Lobbying ? Some employers making presence felt on Capitol Hill ? Many have been active for years and are recognized as important voices ? Some large associations have similar goals and represent large voting populations 34 Mercer Human Resource Consulting Preventive Care and Disease Management Across the Health Care Continuum Programs should be tailored to the needs – Prevention – Screenings – Health Risk Assessment – Targeted Risk Reduction Programs – Risk Modeling – Nurse Advice Line – Web Tools – Consumer Directed Health Plan – Disease Management – Incentive Design – Self Management Training – Case Management – Decision Support – Predictive Modeling Well No Disease At Risk Obesity High Cholesterol Acute Illness/ Discretionary Care Doctor Visits Emergency Visits Chronic Illness Diabetes Coronary Heart Disease Catastrophic Head Injury Cancer 85% members = 15% cost 15% members = 85% cost 35 Mercer Human Resource Consulting Employers Being More Involved Summary ? Typically the larger employers ? “Fighting” to change the way health care delivered to own employees – Goal is to produce better outes…… – And lower cost 36 Mercer Human Resource Consulting Employers Being Less Involved (Camp 2) ? Employers desire to “know their cost” ? Dollarbased plans (often accountbased) ? Reimbursement plans ? Access Only plans ? “Capped Plans”…typically retiree medical ? What these approaches share is an eye toward reducing employer cost at the expense of employees/retirees 37 Mercer Human Resource Consulting AccountBased Approaches ? Defines employer’s mitment as a defined dollar contribution instead of a defined medical benefit ? Commitment can be monthly, annual, aggregate ? Commitment can be based on retireeonly or recognize dependents ? Amounts available for health care only。 three major national PBMs remain CPI API CPN RxNet Value Rx Diagnostek Perform HCS HPI Diagnostek Value Rx RxNet Columbia Value Rx Express Scripts Express Scripts NPA DPS Express Scripts PAID MEDCO Advanced Paradigm Advance Medco Integrated Prescription Solutions (IPS) PCS Foundation MerckMedco MerckMedco Proadvantage Systemed Paradigm MerckMedco Medco Advance PCS Major Insurers Major Insurers MPS PCS Clinical Pharmacy Advantage 14 Mercer Human Resource Consulting Population Trends Aging baby boomers will increase the elderly and near elderly populations Data Source: . Census Bureau State Population Projections Baby Boomers Year of Birth 1946 to 1964 Source: . Census Bureau as of January 2023 3 , 0 0 08 , 0 0 01 3 , 0 0 01 8 , 0 0 02 3 , 0 0 02 8 , 0 0 020 2425 2930 3435 3940 4445 4950 5455 5960 6465 6970 7475 7980 8485+A g e G r o u pNumber (000s)2 0 0 0 U S P o p u l a t i o nB a b y B o o m e r s. Population, 2023 Projected Population 010203040506070802 0 0 0 2 0 1 0 2023 2030A g e s 5 5 t o 6 4A g e s 6 5 o r O l d e rMillions 15 Mercer Human Resource Consulting Negative Tidal Wave of Available Talent Pool of “prime workers” will be decreasing Source: DRI, World at Work Journal, fourth quarter 2023 Percent Change in Population by Age Group, 202310 20% 10% 0% 10% 20% 30% 40% 50% 60% 59 1014 1519 2024 2529 3034 3539 4044 4549 5054 5559 6064 6569 7074 7579 The “Echo boom” ages 1529 Shrinking Pool of “Prime workers” ages 3044 Aging “Baby boomers” ages 4569 16 Mercer Human Resource Consulting Impact of Demographics on Health Care Cost Cost increases with age 2024 2529 3034 3539 4044 4549 5054 5559 6064 65+ Age Relative Cost by Age Male Female Average employer cost = Relative Costs By Age and Gender 17 Mercer Human Resource Consulting Health Deterioration A cause and a consequence 1 3 . 0 %1 5 . 0 %2 3 . 0 %3 1 . 0 %1 4 . 5 %3 2 . 0 %3 2 . 5 % 3 2 . 0 %3 3 . 5 %3 3 . 0 %0 . 0 %1 0 . 0 %2 0 . 0 %3 0 . 0 %4 0 . 0 %5 0 . 0 %6 0 . 0 %7 0 . 0 %1 9 6 0 1 9 6 2 1 9 7 1 1 9 7 4 1 9 7 6 1 9 8 0 1 9 8 8 1 9 9 4 1 9 9 9 2 0 0 0% o f a d u l t s a g e s 2 0 7 4w h o a r e o v e r w e i g h t o ro b e s e * h a s c l i m b e d o v e rt h e y e a r s% w h o a r e o b e s e a l s o h a si n c r e a s e d? We eat too much % of adults overweight ? Population with diabetes increased over 50% in last decade *Overweight is roughly 10 to 30 pounds over an ideal weight. Obesity is roughly 30 pounds over an ideal weight Source: National Health and Nutrition Examination Survey % % % % % 18 Mercer Human Resource Consulting Issues Facing Businesses The perfect storm ? Low ambient inflation。來(lái)自 中國(guó)最大的資料庫(kù)下載 Rich Bailey FSA, MAAA, FCA Richmond, VA Is it Time for Employers to Move Away From the Traditional Ways of Providing Employee Benefits? November 3, 2023 Mercer Human Resource Consulting Agenda ? The Environment ? The Catch22 ? Paths Away from Traditional Delivery: Two Camps ? Opportunities Along Path 2 ? The Answer ? Additional Topics 1 Mercer Human Resource Consulting Agenda ? The Environment – Medical Trends – Legislation – Marketplace Changes – Population Demographics – Employer Outlook ? The Catch22 ? Paths Away from Traditional Delivery: Two Camps ? Opportunities Along Path 2 ? The Ans
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