Speech, Ron Sims, Health care reform- King County

An Integrated Approach to Support Health, Healthy Employees and a Healthy Bottom Line

This presentation is part of the plenary session conference track:
Managing Medical Costs, Medical System Improvement & Quality

Health & Human Capital Management Congress 2006
Ritz Carlton Hotel
Washington, DC
Wednesday, Jan. 25, 2006
9:30 a.m.-10:30 a.m.
King County Executive Ron Sims

Good morning. I am Ron Sims, King County Executive.

To give you an idea of where King County , Washington is and what it is like, King County includes Seattle , Redmond and Bellevue and is home to 1.8 million people. We alone account for more than 40 percent of the state's jobs and are home to worldwide leaders in aviation, technology and coffee.

I am also the Chairman of the Puget Sound Health Alliance, a groundbreaking nonprofit organization striving to improve the quality of health care delivered and slow the rate of growth in health care costs.

With me is Annette King, director of benefits worldwide for Starbucks - a company that started with a small shop in the Pike Place Market.

Ms. King helped create the Alliance and is currently an Alliance Board member, chair of the Alliance 's Communication Committee, as well as a member of the Integration Committee.

Annette and I will talk to you about how we are reducing the increase in health care costs by controlling the supply and demand sides of the market equation – the demand side through innovations in the benefit plans we offer to our own employees and the supply side through Puget Sound Health Alliance – the only coalition of its kind in the country.

I don't need to tell any of you about the unsustainable health care crisis facing our nation. Employers around the nation, both public and private, have seen their health care costs skyrocket, far outstripping the rate of inflation. Frankly, it is frightening.

Research points to a disconnect between cost and quality as a major cause of skyrocketing health costs. According to a 2004 RAND study 41% of the health care that employers and patients purchase and receive in the Seattle area does not contribute to better health outcomes. Shockingly, Seattle ranked the highest among the 12 large metropolitan cities in the study. Nationally, patients receive only about 55% of recommended care across various conditions and treatments. These figures of 41% and 55% are inexcusable. They represent countless millions of dollars of inefficiency and waste in our medical system. Reforms that reduce this figure by even a small amount results in both tremendous savings and vastly improved quality of care.

That's what the Alliance 's is trying to achieve: create a system that uses evidence-based guidelines and standard measures to deliver quality care at the right time in the right setting.

This is not a simple goal nor is it easy to implement. Success requires a major effort to overhaul, on a regional level, the way we provide health care. Success also requires organizations that provide health care to rethink their health care benefit strategies to encourage more responsible behaviors of their employees.

Puget Sound Health Alliance was founded in December 2004 as an independent, non-profit, non-partisan organization. It is a regional effort operating in 5 counties in Western Washington . The Alliance is predicated on the understanding that improving the quality of care and reducing the cost of care is a regional problem that requires a regional solution. Research shows that medical care varies tremendously from region to region.

The Alliance is built on a foundation of collaboration. It is unique in that it is the first such effort to bring together at the same table:

private and public employers,
and the full spectrum of healthcare providers, including:
hospitals,
health plans,
unions, and
patients.

Each stakeholder's voice and expertise are vital to changing quality of health care received.

We were able to get all of these stakeholders to the table because of what we offered each: purchasers get lower health care costs; insurers get to participate in a reform effort that could drastically affect the insurance business; hospitals get one standard of care, eliminating often conflicting demands and information from insurance companies; providers get to set realistic standards; patients benefit from improved quality of care.

I want to point out what the Alliance is NOT – It is NOT a purchasing pool. Participating organizations will maintain their own individual insurance plans.

The collaborative nature of the Alliance benefits from the weaving together of all of the motivations I described above. The force of change comes from a cooperative, integrated and determined team of highly motivated and interested stakeholders.

The Alliance and its members operate from the proven fact that higher quality health care reduces costs. As an employer who provides health care to nearly 40,000 persons, I have learned that higher quality care improves efficiency while, at the same time, lowering costs.

The Alliance also believes that sharing, comparing and applying data is essential. Right now consumers cannot compare Provider A and Provider B because the contracting health plan uses their own guidelines and standards for care provided by physicians and hospitals. With each health plan setting its own requirements, providers are swamped with frustratingly large amounts of paperwork that is duplicative at best and often includes inconsistent and conflicting expectations.

The Alliance solidly believes in evidence-based medicine. The research is clear - evidence-based medicine practices produce high quality health care.

If the Alliance can generate a common set of practice guidelines, shared among all of the area health plans, the administrative savings for the providers can be substantial. And consumers will have more accurate information to make educated choices about the care they seek. The bottom line is -- high quality data is needed for performance improvement.

And, as I mentioned, the Alliance is unique. This combination of stakeholders has never sat down at the table together to seek a solution at the regional level.

So how did all of this get started?

In 2003, King County 's health care costs were projected to double by 2012, amounting to $300M without any interventions. I needed to find a way of providing health care to the employees of King County without making drastic tradeoffs that could result in cuts to essential public services. I called on national and international experts who also happened to live and work in King County . I asked them to analyze the problem of mushrooming health care costs.

They looked at how each health care dollar is spent, and they developed some fascinating insights. They pointed to the landmark 2004 Rand Study and earlier quality chasm reports and how waste results from inadequate quality of care.

Second, they pointed out that traditional cost-cutting approaches of premium sharing or cutting benefits will not help solve the problem in the long term, because neither actually addresses the underlying cause of the problem – quality of care.

The real problem is: normal market forces do not operate in health care.

It's basic economics. Employees choose whatever care they need or want, providers deliver whatever care they deem necessary, and the bill gets paid by a disengaged third party, which is of course the county. It is a deeply flawed system.

For one thing, the employee is not well informed of costs, quality or options because cost and quality information does not exist;
Also, the provider is rewarded for providing more treatment and is not rewarded at all for disease prevention or disease management; and
And finally, the employer has no control over the quality, appropriateness or efficiency of the services for which it pays.
A transparent system that rewards efficiency and quality and incentives to provide high-quality health care is currently missing from the health care delivery system.

The Task Force told me the solution lies in a regional approach. As one region we can leverage and drive change in the health care system in a way that one purchaser, one provider, or one health plan cannot.

But in order for market reform to happen:

Each stakeholder in the health care system – public and private employers, providers, health plans, and patients – must play a significant role in the process. All stakeholders must change to create market forces that work.
Standardization of evidence-based measures is essential. All providers need to employ the same guidelines and approach in treating certain diseases, based on a comprehensive assessment of the efficacy of treatment protocols. They need to practice "evidence-based" medicine so that the right care is provided at the right time. Evidence-based medicine will reduce overused, underused, and misused care – which will save billions in the long-run.
Health care professionals providing high-quality health care, as well as those that prioritize prevention and disease management, should be rewarded. As a corollary, those providers delivering low quality care should receive the proper tools and support to help them improve care delivered.
Change also needs to happen on the demand side –the consumer--in the health care market.

To tackle these challenges, I formed the Puget Sound Health Alliance.

The Alliance 's goals are:

Improve the quality of health care services
Improve health outcomes
Slow the rate of increase in health care cost
Strengthen the partnership between patients and providers to manage personal health
Increase evidence-based decision making
Ensure collaboration, not duplication.

Our action plan for meeting these goals includes:

Creating a uniform approach to measuring quality, based on evidence of what works

Collecting, analyzing and publicly reporting the quality of Puget Sound providers compared to others

Distributing health information and tools patients can use to manage personal health better

Providing the public with reliable and understandable information to help in health care decision-making

Providing information for use by employers and payers

Creating model health benefit strategies that align incentives

Enabling the provider to pay for performance strategies

Developing strategies to slow the increase in health care costs

How are we doing this?

The Alliance 's mantra is collaborate, communicate, coordinate. We cannot transform the system unless we work together, listen to each other and build off our collective knowledge and expertise.

We must also focus on patient-centered care, because health care is extremely personal. Every day we are bombarded by different messages – do this, don't eat this, exercise more. But until you personalize the message to the point where people can relate to an experience or an illness, behavior change will not be achieved.

Last, the Alliance is also working with and adopting best practices of other quality efforts around the nation including Leapfrog, and the National Quality Forum. The Alliance does not want to waste time by reinventing the wheel when other groups have done the research and know which strategies are effective and which are not.

The Alliance has made tremendous progress and achieved substantial growth as an organization since its incorporation in December 2004. Currently, the Alliance includes over 80 public and private employers, hospitals, health plans, provider practices, unions and consumers, representing more than 700,000 persons with health insurance. With more than two-thirds of a million lives covered, we expect that the strategies the Alliance implements will soon become standard practice throughout the central Puget Sound region.

An Alliance staff of six professionals led by Executive Director Margaret Stanley supports the Alliance work. Many of you might know of Ms. Stanley from her distinguished career in health care both in the private sector, where she was Senior VP at Regence BlueShield in Seattle , and in the public sector, where she held high-level positions in CALPERS and the Washington State Health Care Authority. In June 2005, Ms. Stanley came out of retirement to lead the Alliance .

In addition to the Alliance staff, nearly 100 people actively volunteer time and expertise to the various Alliance committees including:

Employers and other business people
Physicians
Hospital and clinic leaders
Nurses, dentists, pharmacists, others
Health plans
Patients, employees, consumers

The Alliance is organized by many different committees and groups. The Quality Improvement Committee is responsible for creating quality strategies and making recommendations to the Board along with the Communication Committee and Health Information & Technology Committee. The Quality Improvement Committee also oversees the work of the Alliance 's 5 initial priority areas. The five areas are diabetes, heart disease, low back pain, depression and pharmacy issues.

The Alliance last month adopted the newly published Institute of Medicine standards and measures as a foundation for our work.

We have a lot of work ahead of us, but I believe the positive outcomes will undoubtedly outweigh the costs and risks of implementing these initiatives.

In 2006 the Alliance intends to:

Implement a subset of the Institute of Medicine 's clinical guidelines and quality measures

Publicly report on provider quality and efficiency, based on performance measures

Share useful information with patients, employers, health practitioners and others to improve their decision-making

Increase public awareness and momentum for behavior changes that will improve quality health care and slow cost growth

The entire community will receive higher quality health care as a result of the Alliance labors.

The Alliance will work hard to:

Ensure employees and their families receive consistently high quality care, based on what works to improve health

Obtain more value for each health care dollar. This means cutting waste created by misuse, overuse and underuse of health care. It also means cutting waste created by inefficient processes with inconsistent or conflicting incentives.

Slow the rate of health care cost increase for all organizations and consumers.

Anyone can join the Alliance . However, all participants of the Alliance are expected to adhere to the Alliance 's overall goals and to carry out the strategy of their respective stakeholder group.

Physicians, hospitals and others are expected to provide care consistent with evidence based best-practices that works.

Patients, employees and family members are expected to use provider quality report cards and evidence-based medical information to make better health decisions. They are expected to ask for care that works and make healthy choices.

Health plans are expected to give physicians, hospitals and others incentives to provide quality care with better outcomes, and to pay for care that works.

Employers are expected to use reporting to support benefit designs and networks based on quality and value, and encourage employees to become better health decision-makers. Employers are expected to design benefits that cover and reward health care that works.

To reiterate, the Alliance 's strategies going forward will be built on the following strategies:

We will be patient-centered

We will collaborate, communicate and coordinate

We will learn from other quality efforts

To complement the Alliance work and strategy, King County has created its own internal employee benefit and wellness initiative for the nearly 40,000 employees and family members we insure, called Healthy Incentives.

King County 's Healthy Incentives program targets the "demand" side of the problem by teaching employees to be smarter health care consumers and encouraging them to adopt healthier lifestyles.

Healthy Incentives began in 2005, in partnership with labor, when King County began to stem the ever rising employee health care costs. Wellness, disease management, case management and member education are key elements of our strategy.

Our innovative program, designed to combat cost increases and improve health and health care, gives the employees the tools they need to get healthy, manage chronic health conditions and actively participate with their providers in their health care.

Most importantly, we have incentives for active participation in the program. Employees who take a wellness assessment and agree to work with a personal health coach over a 90 day period get the lowest possible deductible and out of pocket payments. Our goal is that 60 percent of our employees will choose to take the health assessment and participate in the program. January is the month for taking the assessment and we are already well on our way to accomplishing a 60 percent participation rate.

We believe that the higher the participation in the Healthy Incentives program, the more likely employees and family members will adopt healthy behaviors. We're not asking people to jump up and run a marathon – we're asking people to take reasonable actions towards better health. We think of it as working the risk upstream, because these healthier behaviors prevent lower risk problems from becoming catastrophic. These behaviors, as well as the disease and case management programs we've put in place, help people with existing chronic conditions better manage those conditions.

We have set ambitious goals for our health initiative: To cut the rate of growth in the county's costs by 1/3 ($40 million) during the three year period, 2007 - 2009.

While our goal for Healthy Incentives and the Alliance is quite ambitious, it is also achievable. Initial analyses from 2005 health care claims data show that our initial efforts, which include a major outreach effort to our employees and unions regarding cost containment, are already having a noticeable and quantifiable impact. Our rate of growth has already slowed dramatically and we haven't fully implemented the program.

Starbucks' has also developed its own inventive internal benefit strategy. Ms. King will now present Starbuck's internal benefit strategy. Following Ms. King's presentation, we would be happy to answer any questions you may have.

King County Executive, Ron Sims County news Executive initiatives Speeches Excellence in Government Executive offices Biography Contact information King County Executive Office Ron Sims, King County Executive 701 Fifth Ave. Suite 3210 Seattle, WA 98104 Phone: 206-296-4040 Fax: 206-296-0194 TTY Relay: 711	KING COUNTY HOME \| NEWS \| SERVICES \| DIRECTORY \| CONTACT King County Executive, Ron Sims An Integrated Approach to Support Health, Healthy Employees and a You're in: King County Executive, Ron Sims » Speeches print An Integrated Approach to Support Health, Healthy Employees and a Healthy Bottom Line This presentation is part of the plenary session conference track: Managing Medical Costs, Medical System Improvement & Quality Health & Human Capital Management Congress 2006 Ritz Carlton Hotel Washington, DC Wednesday, Jan. 25, 2006 9:30 a.m.-10:30 a.m. King County Executive Ron Sims Good morning. I am Ron Sims, King County Executive. To give you an idea of where King County , Washington is and what it is like, King County includes Seattle , Redmond and Bellevue and is home to 1.8 million people. We alone account for more than 40 percent of the state's jobs and are home to worldwide leaders in aviation, technology and coffee. I am also the Chairman of the Puget Sound Health Alliance, a groundbreaking nonprofit organization striving to improve the quality of health care delivered and slow the rate of growth in health care costs. With me is Annette King, director of benefits worldwide for Starbucks - a company that started with a small shop in the Pike Place Market. Ms. King helped create the Alliance and is currently an Alliance Board member, chair of the Alliance 's Communication Committee, as well as a member of the Integration Committee. Annette and I will talk to you about how we are reducing the increase in health care costs by controlling the supply and demand sides of the market equation – the demand side through innovations in the benefit plans we offer to our own employees and the supply side through Puget Sound Health Alliance – the only coalition of its kind in the country. I don't need to tell any of you about the unsustainable health care crisis facing our nation. Employers around the nation, both public and private, have seen their health care costs skyrocket, far outstripping the rate of inflation. Frankly, it is frightening. Research points to a disconnect between cost and quality as a major cause of skyrocketing health costs. According to a 2004 RAND study 41% of the health care that employers and patients purchase and receive in the Seattle area does not contribute to better health outcomes. Shockingly, Seattle ranked the highest among the 12 large metropolitan cities in the study. Nationally, patients receive only about 55% of recommended care across various conditions and treatments. These figures of 41% and 55% are inexcusable. They represent countless millions of dollars of inefficiency and waste in our medical system. Reforms that reduce this figure by even a small amount results in both tremendous savings and vastly improved quality of care. That's what the Alliance 's is trying to achieve: create a system that uses evidence-based guidelines and standard measures to deliver quality care at the right time in the right setting. This is not a simple goal nor is it easy to implement. Success requires a major effort to overhaul, on a regional level, the way we provide health care. Success also requires organizations that provide health care to rethink their health care benefit strategies to encourage more responsible behaviors of their employees. Puget Sound Health Alliance was founded in December 2004 as an independent, non-profit, non-partisan organization. It is a regional effort operating in 5 counties in Western Washington . The Alliance is predicated on the understanding that improving the quality of care and reducing the cost of care is a regional problem that requires a regional solution. Research shows that medical care varies tremendously from region to region. The Alliance is built on a foundation of collaboration. It is unique in that it is the first such effort to bring together at the same table: private and public employers, and the full spectrum of healthcare providers, including: hospitals, health plans, unions, and patients. Each stakeholder's voice and expertise are vital to changing quality of health care received. We were able to get all of these stakeholders to the table because of what we offered each: purchasers get lower health care costs; insurers get to participate in a reform effort that could drastically affect the insurance business; hospitals get one standard of care, eliminating often conflicting demands and information from insurance companies; providers get to set realistic standards; patients benefit from improved quality of care. I want to point out what the Alliance is NOT – It is NOT a purchasing pool. Participating organizations will maintain their own individual insurance plans. The collaborative nature of the Alliance benefits from the weaving together of all of the motivations I described above. The force of change comes from a cooperative, integrated and determined team of highly motivated and interested stakeholders. The Alliance and its members operate from the proven fact that higher quality health care reduces costs. As an employer who provides health care to nearly 40,000 persons, I have learned that higher quality care improves efficiency while, at the same time, lowering costs. The Alliance also believes that sharing, comparing and applying data is essential. Right now consumers cannot compare Provider A and Provider B because the contracting health plan uses their own guidelines and standards for care provided by physicians and hospitals. With each health plan setting its own requirements, providers are swamped with frustratingly large amounts of paperwork that is duplicative at best and often includes inconsistent and conflicting expectations. The Alliance solidly believes in evidence-based medicine. The research is clear - evidence-based medicine practices produce high quality health care. If the Alliance can generate a common set of practice guidelines, shared among all of the area health plans, the administrative savings for the providers can be substantial. And consumers will have more accurate information to make educated choices about the care they seek. The bottom line is -- high quality data is needed for performance improvement. And, as I mentioned, the Alliance is unique. This combination of stakeholders has never sat down at the table together to seek a solution at the regional level. So how did all of this get started? In 2003, King County 's health care costs were projected to double by 2012, amounting to $300M without any interventions. I needed to find a way of providing health care to the employees of King County without making drastic tradeoffs that could result in cuts to essential public services. I called on national and international experts who also happened to live and work in King County . I asked them to analyze the problem of mushrooming health care costs. They looked at how each health care dollar is spent, and they developed some fascinating insights. They pointed to the landmark 2004 Rand Study and earlier quality chasm reports and how waste results from inadequate quality of care. Second, they pointed out that traditional cost-cutting approaches of premium sharing or cutting benefits will not help solve the problem in the long term, because neither actually addresses the underlying cause of the problem – quality of care. The real problem is: normal market forces do not operate in health care. It's basic economics. Employees choose whatever care they need or want, providers deliver whatever care they deem necessary, and the bill gets paid by a disengaged third party, which is of course the county. It is a deeply flawed system. For one thing, the employee is not well informed of costs, quality or options because cost and quality information does not exist; Also, the provider is rewarded for providing more treatment and is not rewarded at all for disease prevention or disease management; and And finally, the employer has no control over the quality, appropriateness or efficiency of the services for which it pays. A transparent system that rewards efficiency and quality and incentives to provide high-quality health care is currently missing from the health care delivery system. The Task Force told me the solution lies in a regional approach. As one region we can leverage and drive change in the health care system in a way that one purchaser, one provider, or one health plan cannot. But in order for market reform to happen: Each stakeholder in the health care system – public and private employers, providers, health plans, and patients – must play a significant role in the process. All stakeholders must change to create market forces that work. Standardization of evidence-based measures is essential. All providers need to employ the same guidelines and approach in treating certain diseases, based on a comprehensive assessment of the efficacy of treatment protocols. They need to practice "evidence-based" medicine so that the right care is provided at the right time. Evidence-based medicine will reduce overused, underused, and misused care – which will save billions in the long-run. Health care professionals providing high-quality health care, as well as those that prioritize prevention and disease management, should be rewarded. As a corollary, those providers delivering low quality care should receive the proper tools and support to help them improve care delivered. Change also needs to happen on the demand side –the consumer--in the health care market. To tackle these challenges, I formed the Puget Sound Health Alliance. The Alliance 's goals are: Improve the quality of health care services Improve health outcomes Slow the rate of increase in health care cost Strengthen the partnership between patients and providers to manage personal health Increase evidence-based decision making Ensure collaboration, not duplication. Our action plan for meeting these goals includes: Creating a uniform approach to measuring quality, based on evidence of what works Collecting, analyzing and publicly reporting the quality of Puget Sound providers compared to others Distributing health information and tools patients can use to manage personal health better Providing the public with reliable and understandable information to help in health care decision-making Providing information for use by employers and payers Creating model health benefit strategies that align incentives Enabling the provider to pay for performance strategies Developing strategies to slow the increase in health care costs How are we doing this? The Alliance 's mantra is collaborate, communicate, coordinate. We cannot transform the system unless we work together, listen to each other and build off our collective knowledge and expertise. We must also focus on patient-centered care, because health care is extremely personal. Every day we are bombarded by different messages – do this, don't eat this, exercise more. But until you personalize the message to the point where people can relate to an experience or an illness, behavior change will not be achieved. Last, the Alliance is also working with and adopting best practices of other quality efforts around the nation including Leapfrog, and the National Quality Forum. The Alliance does not want to waste time by reinventing the wheel when other groups have done the research and know which strategies are effective and which are not. The Alliance has made tremendous progress and achieved substantial growth as an organization since its incorporation in December 2004. Currently, the Alliance includes over 80 public and private employers, hospitals, health plans, provider practices, unions and consumers, representing more than 700,000 persons with health insurance. With more than two-thirds of a million lives covered, we expect that the strategies the Alliance implements will soon become standard practice throughout the central Puget Sound region. An Alliance staff of six professionals led by Executive Director Margaret Stanley supports the Alliance work. Many of you might know of Ms. Stanley from her distinguished career in health care both in the private sector, where she was Senior VP at Regence BlueShield in Seattle , and in the public sector, where she held high-level positions in CALPERS and the Washington State Health Care Authority. In June 2005, Ms. Stanley came out of retirement to lead the Alliance . In addition to the Alliance staff, nearly 100 people actively volunteer time and expertise to the various Alliance committees including: Employers and other business people Physicians Hospital and clinic leaders Nurses, dentists, pharmacists, others Health plans Patients, employees, consumers The Alliance is organized by many different committees and groups. The Quality Improvement Committee is responsible for creating quality strategies and making recommendations to the Board along with the Communication Committee and Health Information & Technology Committee. The Quality Improvement Committee also oversees the work of the Alliance 's 5 initial priority areas. The five areas are diabetes, heart disease, low back pain, depression and pharmacy issues. The Alliance last month adopted the newly published Institute of Medicine standards and measures as a foundation for our work. We have a lot of work ahead of us, but I believe the positive outcomes will undoubtedly outweigh the costs and risks of implementing these initiatives. In 2006 the Alliance intends to: Implement a subset of the Institute of Medicine 's clinical guidelines and quality measures Publicly report on provider quality and efficiency, based on performance measures Share useful information with patients, employers, health practitioners and others to improve their decision-making Increase public awareness and momentum for behavior changes that will improve quality health care and slow cost growth The entire community will receive higher quality health care as a result of the Alliance labors. The Alliance will work hard to: Ensure employees and their families receive consistently high quality care, based on what works to improve health Obtain more value for each health care dollar. This means cutting waste created by misuse, overuse and underuse of health care. It also means cutting waste created by inefficient processes with inconsistent or conflicting incentives. Slow the rate of health care cost increase for all organizations and consumers. Anyone can join the Alliance . However, all participants of the Alliance are expected to adhere to the Alliance 's overall goals and to carry out the strategy of their respective stakeholder group. Physicians, hospitals and others are expected to provide care consistent with evidence based best-practices that works. Patients, employees and family members are expected to use provider quality report cards and evidence-based medical information to make better health decisions. They are expected to ask for care that works and make healthy choices. Health plans are expected to give physicians, hospitals and others incentives to provide quality care with better outcomes, and to pay for care that works. Employers are expected to use reporting to support benefit designs and networks based on quality and value, and encourage employees to become better health decision-makers. Employers are expected to design benefits that cover and reward health care that works. To reiterate, the Alliance 's strategies going forward will be built on the following strategies: We will be patient-centered We will collaborate, communicate and coordinate We will learn from other quality efforts To complement the Alliance work and strategy, King County has created its own internal employee benefit and wellness initiative for the nearly 40,000 employees and family members we insure, called Healthy Incentives. King County 's Healthy Incentives program targets the "demand" side of the problem by teaching employees to be smarter health care consumers and encouraging them to adopt healthier lifestyles. Healthy Incentives began in 2005, in partnership with labor, when King County began to stem the ever rising employee health care costs. Wellness, disease management, case management and member education are key elements of our strategy. Our innovative program, designed to combat cost increases and improve health and health care, gives the employees the tools they need to get healthy, manage chronic health conditions and actively participate with their providers in their health care. Most importantly, we have incentives for active participation in the program. Employees who take a wellness assessment and agree to work with a personal health coach over a 90 day period get the lowest possible deductible and out of pocket payments. Our goal is that 60 percent of our employees will choose to take the health assessment and participate in the program. January is the month for taking the assessment and we are already well on our way to accomplishing a 60 percent participation rate. We believe that the higher the participation in the Healthy Incentives program, the more likely employees and family members will adopt healthy behaviors. We're not asking people to jump up and run a marathon – we're asking people to take reasonable actions towards better health. We think of it as working the risk upstream, because these healthier behaviors prevent lower risk problems from becoming catastrophic. These behaviors, as well as the disease and case management programs we've put in place, help people with existing chronic conditions better manage those conditions. We have set ambitious goals for our health initiative: To cut the rate of growth in the county's costs by 1/3 ($40 million) during the three year period, 2007 - 2009. While our goal for Healthy Incentives and the Alliance is quite ambitious, it is also achievable. Initial analyses from 2005 health care claims data show that our initial efforts, which include a major outreach effort to our employees and unions regarding cost containment, are already having a noticeable and quantifiable impact. Our rate of growth has already slowed dramatically and we haven't fully implemented the program. Starbucks' has also developed its own inventive internal benefit strategy. Ms. King will now present Starbuck's internal benefit strategy. Following Ms. King's presentation, we would be happy to answer any questions you may have. Additional information News release Puget Sound Health Alliance Listen to the entire speech (MP3, 5.6MG, 25 mins.)
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	Updated: Jan. 25, 2006

An Integrated Approach to Support Health, Healthy Employees and a Healthy Bottom Line

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