CMU Fiscal Year Health Care & Wellness Report 2018

Medical claims and prescription total plan costs

Here’s welcome news: After several years of significant increases, health care costs — medical claims and prescriptions — nearly leveled off in 2017-18:

Medical plan utilization

CMU employees and dependents made good use of the health plan in 2017-18 compared with other Blue Cross Blue Shield clients, according to BCBSM health care analyst Keith Hart. Here’s a look at utilization:

Cancer screenings compared

  • Dropping off the list of top 10 expenses were ischemic heart disease (No. 10 last year) and obesity health conditions (No. 6 last year). Heart disease costs fell by nearly $200,000 from the previous year.
  • Back degeneration costs fell from No. 3 to No. 8 on the top 10 expenses list, as care shifted from expensive inpatient services to less costly outpatient and professional services.
  • Joint disease costs fell by nearly $800,000.
  • Costs fell by 35 percent for chronic conditions such as osteoarthritis, mental health and depression, spinal and back disorders, hypertension, coronary artery disease, asthma, COPD, congestive heart failure, overweight and obesity, and hypertension.
  • Diabetes costs increased by $70,000. Six percent of employees and dependents covered at CMU were treated for diabetes. According to the U.S. Centers for Disease Control and Prevention, 9.4 percent of the U.S. population has diabetes.
  • Emergency room visits decreased by 5 percent, from 1,085 to 1,027.
  • New data provided by BCBSM showed 2.6 percent of those covered utilized overweight and obesity services.

Prescription plan utilization

  • Specialty drug costs increased significantly: The gross cost of specialty drugs increased 63 percent to $2.2 million. That’s 42.2 percent of total gross plan costs of $5.3 million.
  • Use of generics remains steady: The utilization rate for generics was unchanged at 86.6 percent. That continues to be comparable to CVS Caremark’s overall book of business (86.4 percent) and CVS Caremark’s colleges and universities peer group (85.1 percent).

Tips: Save on prescriptions

  • Ask your doctor for samples.
  • Request generic or lower-cost versions when available.
  • Investigate discount plans at major retailers.
  • Check for coupons for the prescriptions on the drug manufacturer’s website.
  • Shop around, and use online pharmacy tools.

Virgin Pulse enrollment and engagement

CMU’s total enrollment of employees plus eligible spouses and other eligible individuals in the Virgin Pulse wellness rewards program is well above the overall participation rate of Virgin Pulse clients:

Total annual steps

  • CMU Virgin Pulse enrollees logged 3.4 billion total annual steps, equivalent to about 1.6 million miles, or more than three round trips to the Moon.
  • The 8,683 average daily steps per person is equivalent to about 4.1 miles, or nearly two trips across campus and back on Central Avenue, the main north-south walking path.

Tips: Be a wise consumer to save dollars

You don’t have to sacrifice the quality of care to keep your costs down. Here are a few tips for being a wise health care consumer:
  • See your doctor regularly for checkups to help prevent problems later on. Checkups and other preventive care are free with every CMU plan.
  • Stay in-network to always receive the benefit and credit toward your annual deductible and out-of-pocket maximum.
  • Be prepared and informed before emergencies:
    • Investigate the most cost-effective options near you for emergencies or care needed outside of regular doctor’s office hours.
    • Some clinics offer extended and weekend hours with no or minimal extra cost.
    • Urgent Care facilities usually are significantly less expensive than emergency rooms, but do your homework to find the best one at a reasonable price.
  • Negotiate when you can. Most doctors will negotiate payment terms especially for more expensive procedures such as surgery, MRIs or braces.
  • Maximize your tax benefits. Consider enrolling in a flexible spending account (FSA) or health savings account (HSA) to lower your tax bill by paying for health care costs with tax-free dollars.

Check up on CMU’s health care costs

Learn about the performance of the Central Care Plan, CMU’s self-funded health plans and wellness program, throughout the plan year with the easy-to-understand Central Care Checkup.

Find wellness opportunities

From online health surveys and health monitoring stations, to estate planning and ID theft protection, to work-life resources and wellness coaching, learn about the benefits available to CMU employees and dependents.