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Small wellness initiatives, big savings for North Carolina State Health Plan

Simple steps reduce member premiums, prompt cost-cutting care coordination plans

Even the simplest of wellness initiatives can reap big savings for payers, representatives of the North Carolina State Health Plan said at the Health Information and Management System Society's annual conference in Chicago.

The plan covers approximately 680,000 teachers and state employees in a diverse geography spanning "from the mountains to the sea," said State Treasurer Janet Cowell, who runs the health plan among her other duties. Cowell spoke along with Charles Saunders, M.D., CEO of Healthagen, the population health management technology arm of Aetna.

A 2011 reorganization put the health plan under the leadership of a 10-member board of directors, which subsequently developed a strategic plan focused on population health management.

The plan included three wellness initiatives that members could finish in order to reduce their premiums: Name a primary care physician, complete a health risk assessment and complete a smoking cessation program. The latter initiative represented a big step--"We are the Tobacco State," Cowell said, adding that smoking wasn't banned from the floor of the state legislature until the 2000s.

Through these three initiatives, health plan members should save about $23 million on their premiums in 2015, she said.

What's more, data gathered from the risk assessments--filled out by more than 230,000 members as of November 2014--helped the health plan develop care management plans for members with catastrophic illnesses and care coordination plans for those with chronic conditions, Saunders said. Collectively, these members represent 52 percent of the health plan's total enrollment but 88 percent of its overall costs.

The plan estimates that population health management improvements stemming from these wellness initiatives, as well as additional initiatives such as case management and disease management programs, generated $450 million in cost savings from 2011 to 2013, Saunders said. The plan's cash balance is now close to $1 billion, Cowell added.

(Editor's note: This post has been updated to reflect the factors that contribute to the North Carolina State Health Plan's savings from 2011 to 2013.)

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