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Small Business
      &
 Health Care
   For Businesses Where
  Your People are the Key


         ZeNeurobics LLC
Already rapidly increasing health
             insurance premiums set to jump
                       dramatically
      Thanks to mandates that take effect in 2014, premiums in individual
            markets will shoot up. Some may double (WSJ OPED)

*New ACA taxes and fees                            *Guaranteed Issuance and
on insurers and the self-                          more coverage mandates
insured
*Affordable Care Act reduces                   *More and more doctors joining
spread between older and                       health systems reducing insurer’s
younger insured premiums from                  negotiated rate leverage
5x to 3x
           *Modified rating rules                *Pent up demand and higher use
                                                 of health resources as the
*Lack of consumerism in health                   uninsured get insurance under
care – no price transparency                     ACA
and no price shopping                       *Current system shields people
                                            from the financial impact of poor life
    *Wellness not embedded in our culture   style choices that lead to chronic
                                            diseases
Average Annual Premiums for Single and Family
                                   Coverage, 1999-2012
                           Plus 2014 and 2015 potential premiums

     1999                $2,196
                                                 $5,791                                              Single Coverage
     2000                   $2,471*
                                                      $6,438*
                              $2,689*                                                                Family Coverage
     2001                                                 $7,061*

     2002                      $3,083*
                                                                $8,003*
                                  $3,383*
     2003                                                            $9,068*
                                   $3,695*
     2004                                                                 $9,950*

     2005                             $4,024*
                                                                               $10,880*

     2006                               $4,242*
                                                                                    $11,480*
                                         $4,479*
     2007                                                                              $12,106*
                                            $4,704*
     2008                                                                                 $12,680*
                                             $4,824
     2009                                                                                      $13,375*
                                                $5,049*
     2010                                                                                         $13,770*
                                                $5,429*
     2011                                                                                                 $15,073*

     2012                                        $5,615
                                                                                                              $15,745*

            $0     $2,000      $4,000        $6,000       $8,000    $10,000    $12,000     $14,000        $16,000    $18,000

                                                                    $7,468                                                     33%?
     2014                                                                                                                             $20,941

                                                                                         $9,321                                                 $26,137
     2015

* Estimate is statistically different from estimate for the previous year shown (p<.05).                                       66%?
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2012.
Comparison of Debt Held by the Public - January 2010 and Fall 2010 GAO
 Simulations




Taking ACA
Into account
What does it Mean
•Per Capita spend on health care continues to grow faster than per capita
 GDP
•Technology accounts for 50% of health care spending rise
•R&D works – life expectancy increases as does lifetime cost
•Spending increase in unsustainable over time (pick your GAO simulation
 assumptions)
•Across the board changes in healthcare in practice, cost, and insurance
 will have the biggest impact on businesses since the Internet impacted
 operations


Employers have an opportunity to affect this trend
The Employee’s Complex View of Health
                Care

     Records –
     EHR & PHR              Facilities




                            Doctors
      Insurance             & Staff


                  Banking
                  FSA/HSA
Business can take the lead
Where?
 There need to be financial consequences to poor lifestyle. Reward good behavior
  and penalize bad behavior
 We need to become healthcare consumers. Usually we want the product that best
  meets our needs at the best price, but not in healthcare today.
 We need a culture of wellness. A good part of our health is in our own hands.
How?
We are already seeing premium penalties both from employer plans and in ACA –
most often for smokers and morbidly obese people
We need price transparency, and outcome statistics along with advocates to help
employees navigate the very complex eco system of healthcare
Employers need to offer wellness programs that provide intervention that can help
employees and their families move to healthy life style habits.
Lifestyle Choices can Improve Health
    and Prevent Chronic Diseases
Obesity is related to:      Cognitive decline from:
  Heart disease               Alzheimer’s disease
  Type 2 diabetes             Vascular dementia
  Obstructive sleep apnea     Mild Traumatic Brain Injury
  Some types of cancer        Mild Cognitive Impairment
  Osteoarthritis

             US




                            Chart of lifestyle effects & current medications on AD
Top Down Cognitive Wellness

    Good Heart Health
    Good Nutrition and Diet
    Mental Exercise
    Physical exercise
    Smoking Cessation

   Your brain is your most important organ – protect it

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The Affordable Care Act and Businesses Where People are the Key

  • 1. Small Business & Health Care For Businesses Where Your People are the Key ZeNeurobics LLC
  • 2. Already rapidly increasing health insurance premiums set to jump dramatically Thanks to mandates that take effect in 2014, premiums in individual markets will shoot up. Some may double (WSJ OPED) *New ACA taxes and fees *Guaranteed Issuance and on insurers and the self- more coverage mandates insured *Affordable Care Act reduces *More and more doctors joining spread between older and health systems reducing insurer’s younger insured premiums from negotiated rate leverage 5x to 3x *Modified rating rules *Pent up demand and higher use of health resources as the *Lack of consumerism in health uninsured get insurance under care – no price transparency ACA and no price shopping *Current system shields people from the financial impact of poor life *Wellness not embedded in our culture style choices that lead to chronic diseases
  • 3. Average Annual Premiums for Single and Family Coverage, 1999-2012 Plus 2014 and 2015 potential premiums 1999 $2,196 $5,791 Single Coverage 2000 $2,471* $6,438* $2,689* Family Coverage 2001 $7,061* 2002 $3,083* $8,003* $3,383* 2003 $9,068* $3,695* 2004 $9,950* 2005 $4,024* $10,880* 2006 $4,242* $11,480* $4,479* 2007 $12,106* $4,704* 2008 $12,680* $4,824 2009 $13,375* $5,049* 2010 $13,770* $5,429* 2011 $15,073* 2012 $5,615 $15,745* $0 $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 $18,000 $7,468 33%? 2014 $20,941 $9,321 $26,137 2015 * Estimate is statistically different from estimate for the previous year shown (p<.05). 66%? Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2012.
  • 4. Comparison of Debt Held by the Public - January 2010 and Fall 2010 GAO Simulations Taking ACA Into account
  • 5. What does it Mean •Per Capita spend on health care continues to grow faster than per capita GDP •Technology accounts for 50% of health care spending rise •R&D works – life expectancy increases as does lifetime cost •Spending increase in unsustainable over time (pick your GAO simulation assumptions) •Across the board changes in healthcare in practice, cost, and insurance will have the biggest impact on businesses since the Internet impacted operations Employers have an opportunity to affect this trend
  • 6. The Employee’s Complex View of Health Care Records – EHR & PHR Facilities Doctors Insurance & Staff Banking FSA/HSA
  • 7. Business can take the lead Where?  There need to be financial consequences to poor lifestyle. Reward good behavior and penalize bad behavior  We need to become healthcare consumers. Usually we want the product that best meets our needs at the best price, but not in healthcare today.  We need a culture of wellness. A good part of our health is in our own hands. How? We are already seeing premium penalties both from employer plans and in ACA – most often for smokers and morbidly obese people We need price transparency, and outcome statistics along with advocates to help employees navigate the very complex eco system of healthcare Employers need to offer wellness programs that provide intervention that can help employees and their families move to healthy life style habits.
  • 8. Lifestyle Choices can Improve Health and Prevent Chronic Diseases Obesity is related to: Cognitive decline from: Heart disease Alzheimer’s disease Type 2 diabetes Vascular dementia Obstructive sleep apnea Mild Traumatic Brain Injury Some types of cancer Mild Cognitive Impairment Osteoarthritis US Chart of lifestyle effects & current medications on AD
  • 9. Top Down Cognitive Wellness Good Heart Health Good Nutrition and Diet Mental Exercise Physical exercise Smoking Cessation Your brain is your most important organ – protect it