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Healthy Merits Offers Cure for Escalating Healthcare Costs

Contact:
Kerry O'Neill
410.902.5035
koneill@mghus.com  

Chris McMurry
410.902.5036
cmcmurry@mghus.com  

New Healthy Merits program developed in response to statistic stating nearly 90 percent of diagnosed illnesses are preventable

AMHERST, N.Y. (May 1, 2007) - An effective solution to rapidly escalating healthcare costs has been elusive, even as many in the healthcare industry continue to play the blame game and point fingers at malpractice and tort reform, the cost of prescription drugs, and aging baby boomers, to name a few. With the knowledge that 74 percent of diagnosed illnesses are preventable¹, Meritain Health, the country's largest independent provider of services for self-funded health plans, has created a comprehensive total population management program built entirely on a simple, yet innovative idea - preventing illness is the most effective strategy to reduce healthcare costs.

Today, Meritain Health introduces Healthy Merits, a ground-breaking program that empowers employers to reduce healthcare costs, maximize productivity and enhance profitability. It provides the tools and resources to motivate employees to change their behaviors and achieve their healthcare goals. Since Meritain Health is a full-service health benefits and wellness provider, it allows the company to be intimately acquainted with each of its clients and to create customized wellness solutions based on each client's specific needs.

Healthy Merits is a trio of complementary services that provide wellness management, disease management and comprehensive educational tools and resources to members. Meritain Health's wellness consultants work with employers to build a customized wellness program specific to the needs of its employees. The wellness consultant will review the employer's demographics, make program design recommendations and develop and facilitate training programs and seminars.

On average, employers can expect to show an annual return of $600 for every $100 invested in employee wellness programs². The success of shifting an employee from a high health-risk category to a low health-risk category can save an employer more than $3,000 per year³.

"The most effective way to prevent rising healthcare costs is to institute a solid method of prevention," said Dr. Larry Luter, Chief Medical Officer for Meritain Health. "The Healthy Merits program will address a variety of health conditions, including depression, weight gain and smoking, reducing the number of people diagnosed with preventable illnesses in the future."

Member Wellness

Healthy Merits Wellness Management is composed of four programs: Managed Metrics, Health Aware, Physically Fit and Nicotine Free.

Managed Metrics
Managed Metrics involves onsite member health screenings that include a health risk assessment, blood pressure screening and a blood chemistry profile that includes over 35 tests to detect conditions such as diabetes, and heart, kidney and liver disease. It also takes an in-depth look at participants' medical histories and makes analyses based on past and possible future medical conditions. Based on their screening results, members are then encouraged to join the health coaching program.

Health Aware
Health Aware rewards members who complete an online health risk assessment and receive comprehensive annual preventive care exams.

Physically Fit
Recent studies estimate medical care due to overweight and obesity constitutes nearly $93 billion in healthcare costs⁴. In 1960, only 13 percent of adults were considered obese. According to the American Obesity Association, more than 30 percent now fall into that category.

Should the current rate continue, every child and adult in the U.S. will be obese by the year 2058⁵. The Healthy Merits Physically Fit program encourages members to get and stay in shape, with reimbursements and rewards for members taking part in a managed weight-loss program or attending fitness centers regularly.

Nicotine Free
Nicotine Free helps members stop smoking or chewing tobacco, practices that have health-related costs exceeding $75 billion nationally each year. According to the Centers for Disease Control and Prevention, cigarette smoking is the leading preventable cause of illness and premature death in the U.S. The Nicotine Free program provides resources and incentives such as expert tips, FAQs, individualized smoking-cessation plans and discounts for cessation products. The program also features an online group that members can join to connect them with other individuals who are striving to become nicotine free for life.

Disease Management

Chronic diseases contribute to 70 percent of all deaths in the U.S., and those costs account for 75 percent of the nation's $1.4 trillion spent on healthcare⁶. In response to this alarming trend, the second portion of the Healthy Merits program is Disease Management, which focuses on members' chronic health conditions.

The program begins by screening a member's health claims and prescription data and entering the information into sophisticated predictive modeling software. Based on the results, healthcare needs are carefully coordinated with the participant's healthcare providers to offer continuous intervention against pre-existing or potential illnesses.

Most disease management programs focus on five limited conditions: asthma, coronary artery disease, coronary heart failure, chronic obstructive pulmonary disease and diabetes. The Healthy Merits program targets these five afflictions and many others, including arthritis, cancer, depression, obesity and multiple sclerosis.

Educational Tools and Resources

While offering comprehensive programs to manage diseases and focus on preventive wellness measures, Healthy Merits provides participants with a wealth of educational resources and tools that allow them to receive information and advice any time they need it. A 24/7 telephone nurse line offers live and immediate answers to participants? health questions. In addition to the nurse line, Healthy Merits offers a Web site that provides online health coaching, healthy menu planning, and an encyclopedia of health information. Both resources allow members to keep their health a top priority as they make decisions on care.

¹ Purdue University study, 2006.
² “Employee wellness programs can help trim medical costs,” Chamber Report, May 3, 2006.
³ “Small steps through a wellness program can lead to big benefits,” Faist, Allyson, Houston Business Journal, July 7, 2006.
⁴ Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: How much, and who's paying? Health Affairs Web Exclusive. 2003; W3:219-226 
⁵ University of Missouri-Columbia
⁶ www.cdc.gov

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About Meritain Health
Meritain Health is the nation's largest independent provider of services for self-funded health plans. Meritain Health serves over 1,400 self-funded clients and over a million members nationally. The company provides plan administration, innovative wellness, medical management, disease management, network management, and cost management services. Meritain Health is also a pioneer and now the leading independent provider of Consumer Directed Health Plans. Meritain Health employs over 1,350 people, with headquarters in Amherst, N.Y., and regional offices in 28 cities across the country.

For more information, visit http://www.meritain.com.