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3. PASSPORT TO WELLNESS PROGRAM Approve a voluntary program, designed to increase utilization of recommended preventive services based on age and gender, for employees, spouses and their dependent children enrolled in a County-sponsored medical plan, which encourages prevention and early detection of diseases. The Program requires the completion of periodic exams, medical screenings, immunizations and oral health exams which are available at no cost. Each employee and/or spouse who completes the program requirements will receive $100 taxable incentive payment. Each dependent child who completes the program requirements will receive $50 taxable incentive payment. In order for spouses and dependent children to qualify for the incentive payment, the employee must complete his/her program requirements. Timely screening can detect diseases in their early phase and prevent needless deaths. Yet, despite the well-known benefits of these interventions, many employees and their dependents are not taking advantage of preventive services even though these services have been offered at no cost for the past several years. Based on CIGNA data for claims incurred between July 2008 and June 2009 and paid through June 2009, preventive care as a percent of total medical spend decreased from 2.4% to 2.2% and compares to a CIGNA Book of Business norm of 2.0%. The Healthcare Effectiveness Data and Information Set (HEDIS) is collected from over 1,000 different health plans (more than 90% of all managed health care plans and some PPO plans) to measure performance on important dimensions of care and services. Each year, the National Committee for Quality Assurance (NCQA) produces The State of Health Care Quality Report with HEDIS results from their annual health care system survey. HEDIS data for flu shots for adults show in 2005, less than half of the age 50-64 high-risk group (e.g., people with asthma) had a flu shot, and about one quarter of the 18-49 high-risk group had one. Total direct hospitalization costs of an influenza epidemic are estimated to be over $3 billion. The cost of delivering the flu vaccine has been estimated to be around $15 per person. Achieving 90% vaccination coverage would reduce deaths by over 15,000 annually in a year with an average flu season (i.e., not a major epidemic). Vaccination rates for HMO members in commercial plans for 2009 were 51.3%. 6,583 Maricopa County enrollees received flu shots in FY2011 which is a 26% utilization rate. Early detection of breast cancer is associated with better survival rates and more treatment options. The five-year survival rate is 89% and the 10-year survival rate is 81%. The annual cost for breast cancer treatment is approximately $7 billion. Treating breast cancer detected in its earliest, pre-invasive stage costs significantly less than if the cancer is detected at more advanced stages. Breast cancer screening rates for HMO commercial members in 2009 were 71.3%. Maricopa County enrollees have a 69% breast cancer screening rate. The one-year survival rate for cervical cancer is 88%; the five-year survival rate is 71%. Earlier detection is associated with higher survival rates. Death from cervical cancer is rare among women who have regular screening, regardless of race or age. The cost of treating cervical cancer is between $300 and $400 million annually and is concentrated in care of women detected at a late stage. Cervical cancer screening rates for HMO commercial members in 2009 were 77.3%. Maricopa County enrollees have a 69% cervical cancer screening rate. More than two in five adults do not receive the necessary colorectal cancer screening. Colorectal screening of asymptomatic individuals can identify polyps whose removal can prevent more than 90% of colorectal cancers. In the last 15 years, deaths associated with colorectal cancer have decreased, primarily because screening has increased the likelihood of detecting and removing polyps. Colorectal cancer screening rates for HMO commercial members in 2009 were 60.7%. Maricopa County enrollees have a colon cancer screening rate of 38%. (C-39-11-001-M-00)