If you missed our most recent webcast, Healthcare Benefits Trends to Watch in 2014 featuring insights and analysis from leaders at Microsoft U.S. Health and Kaiser Permanente, you're in luck. Healthcare Trends Institute (HTI), a leading research organization compiling the top news and analysis regarding both Healthcare Reform and Defined Contribution, has released the slideshow covering the discussion from this webcast. Part of HTI's quarterly HealthChange web series, this webcast featured analysis from leaders in the healthcare field. Featured in this webcast were the following: -Shajmil Smith, Executive Director of Product Program Services, National Product Management, Kaiser Permanente -Sam Robinson, Health Plan National Director, Microsoft Health and Life Sciences. -Members from our own advisory board To listen to the full report and insight, follow the link (http://www.evolution1.com/healthcare-trends-institute/healthcare-benefits-trends-webcast-presentation-now-available-for-download/) and download the full review.

1. © 2014. Healthcare Trends Institute. All Rights Reserved. 1
2/4/14
Healthcare Benefits Trends
to Watch in 2014 Webcast

2. © 2014. Healthcare Trends Institute. All Rights Reserved. 2
Today’s Agenda
ü Healthcare Benefits Trends to Watch in 2014 is part of the
Healthcare Trends Institute’s quarterly HealthChange™ Web
Series
ü We will cover several healthcare benefits topics including
CDHP, exchanges, wellness plans, health IT, and more
ü Overview of trends from the 2013 Healthcare Benefits Trends
Benchmark Study from Tiffany Wirth, Executive Director, HTI
ü Expert panel includes Healthcare Trends Institute Editorial
Advisory Board members :
ü Shajmil Smith, Executive Director of Product Program
Services and Solutions, National Product Management,
Kaiser Permanente
ü Sam Robinson, National Director, U.S. Health Plan
Industry, Microsoft Health and Life Sciences

3. © 2014. Healthcare Trends Institute. All Rights Reserved. 3
2013 Healthcare Benefits Trends
Benchmark Study
ü Polled over 300 HR executives, benefit managers,
and other benefit decision-makers across the US
ü Conducted Fall of 2013 (September-October)
ü Company size ranged from less than 50 full-time
employees, to more than 2,500
ü Variety of of industries represented including
manufacturing, government, technology, and
finance & insurance
ü Surveyed topics included employee and health
benefits, defined contribution, public and private
health insurance exchanges, and wellness
programs

4. © 2014. Healthcare Trends Institute. All Rights Reserved. 4
Study Highlights
ü The majority of respondents (59.4%) indicated they were somewhat to very familiar with
Defined Contribution Plans (DCPs) as they relate to health benefits
ü Of those respondents (36.1%)who indicated they were interested in DCPs for the future,
55.8% reported they were considering for 2015 followed by 26.9% in 2016, and 17.3%
indicated considering DCPs before the end of 2014
ü 62.1% somewhat to very familiar with public exchanges and 55.5% somewhat to very
familiar with Private exchanges
ü Of the respondents indicating they were somewhat to very familiar with exchanges, over
half (51.3%) indicated they believed exchanges will help employees make more cost-
conscious benefit decisions as well as offer a wider array of options for benefit plans.
ü 43.9% of companies surveyed are already using some kind of healthy lifestyle incentive/
program, while 22.6% are considering for the future.
ü To promote positive health outcomes, 61% of companies offer at least one wellness
program and 43% offer employees the opportunity for health risk assessment.

5. © 2014. Healthcare Trends Institute. All Rights Reserved. 5
Study Key Trends
ü Ongoing cost concerns among employers of all sizes will continue to spur change both
in the form of defined contribution plans and the use of health insurance exchanges.
ü Most employers are interested in learning more about DCPs for the future supporting
the shift away from a traditional defined benefit model to manage employee healthcare
benefits and control costs.
ü Overall, employers are more familiar with public exchanges than private exchanges.
This may be due to the October 1 launch of the Federal Insurance Marketplace, which
coincided with survey data collection. As most employers surveyed provide group
coverage, the awareness of public exchanges may not be as important to these
respondents.
ü Because DCPs are starting to gain ground among employer groups, awareness of
private exchanges is expected to grow in correlation with DCP use in companies.
ü We can expect an increase in the number of companies offering at least one wellness
program or health initiative as ACA wellness incentives go into effect in 2014.

6. Emerging Benefit Trends for a Post-Reform Healthcare Market
Shajmil Smith, Executive Director in National Product Management
Kaiser Permanente
February 4, 2014

7. Contents
Market Context
Emerging Trends
Conclusion
7

8. Market Context:
Impacts from the Affordable Care Act and the continued pressure to control costs are
driving changes across every sector of the healthcare marketplace
Source: Strategic Health Perspectives, 2013
8
Response to
changing
healthcare market
(more costs, risk,
and change)
Shift to retail
healthcare
marketplace
New employee
benefit
strategies
Continued focus
on ACA
implications
Focus on
consumer
engagement
and wellness
 Overarching slowdown in revenue
growth across entire industry
 Confidence in public and private
exchanges increasing and defined
contribution taking shape
 Employers continue movement to
narrow Networks, CDHPs, and
strategies that reduce coverage for
certain populations
 Continued focus on rewarding
healthy behavior and increasing
consumer engagement

9. Emerging Trends:
Consumer Directed Health Plans are expected to continue to grow
9
 Enrollment in CDHP’s continue to increase, with an additional focus on CDHC as a Total Replacement Strategy
 While only 10% of employers have moved to a total replacement strategy for CDHC, another 44% are expected
to move in in this direction over the next 3 – 5 years
 Additionally, where only 5% of employers require employees to contribute to their own HSA as prerequisite to
earning a match contribution, more employers
Source: Mercer’s National Survey of Employer-Sponsored Health Plans
Aon Hewett 2013 Health Care Survey

10. Emerging Trends:
Companies are using a variety of strategies to contain insurance costs
10
§ Continuing to increase co-pays/deductibles.
Movement to CDHPs
§ Using narrow networks/ACOs to lower rate
without or in addition to cutting benefits
§ Employers offering Medicare Group
coverage are cutting retiree coverage or
moving to a Connector
§ Dependents, early retirees, and part time
employees to be increasingly squeezed out
of coverage
§ A growing number of employers are shifting
to defined contribution models and the use of
private exchanges to deliver health
insurance
26%
45%
59%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2011 2012 2013
“My Company is Actively Exploring Ways to Get Out of
Providing Health Insurance to our Employees”
(% Strongly Agree or Somewhat Agree)
Source: 2013 Strategic Health Perspectives Report

11. Emerging Trends:
Companies are changing the way they approach providing healthcare
Source: Strategic Health Perspectives, 2013
11
Base: All Employer Health Benefit Decision Makers (N=313)
Q910: Do you provide health insurance benefits or some type of financial contribution towards health costs to any of your employees?
Q911: Which health benefit do you currently offer to your employees?
Q1401: Assuming the ACA remains intact, what is your future plan for health insurance benefits for your employees? Please estimate what your company will be doing in 2015 and in 2020.

12. Emerging Trends:
Alternative approaches to delivering care provide opportunities to engage
consumers in a cost-efficient way
12
• According to the 2013 Kaiser Family Foundation Report, 35% of firms offering health benefits
stated that wellness programs would be very effective at containing health insurance costs, more
than any other strategy
• Among firms offering health benefits, over half (56%) cover care received at retail clinics in the
plans with the largest enrollment. Of those, 17% offer a financial incentive

13. Conclusion
§ Existing strategies such as movement toward CDHP’s, focus on
wellness and healthy behavior, and narrowing healthcare coverage,
will continue to provide opportunities to manage costs
§ A shift towards a more retail-oriented healthcare marketplace is also
emerging as a strategy that provides consumer choice and cost-
efficiency opportunities
§ Post Reform, employers will need to execute strategies that respond
to the impending ACA implications, manage costs, and increase
consumer engagement
13

14.
Emerging Technology Trends
SAM ROBINSON
NATIONAL DIRECTOR, U.S. HEALTH AND LIFE SCIENCES
SAMROB@MICROSOFT.COM

15. Megatrends that will dominate the next
decade
of CIOs see
mobile as most
disruptive
technology over
next decade
70%
of all new
application
development
target a mobile
form factor
>1/3
Today
57%of
enterprises
will be
invested in
enterprise
social by
2014
Social networking will
follow not just people
but also appliances,
devices and products
>70%of CIOs will
embrace a cloud-first
strategy by 2016
of organizations
planned to
increase public
cloud spending in
2013
54%
Spending
on Big Data:
Percent
of digital
universe
tagged:
3%
(2020)
33%
(today
)
$10 billon 2013 >
$20 billion 2016
zettabytes
in 2013
4
50%
From
2012
Total
digital
content
will
grow =

16. Consumer Engagement
Engage
Ac3vate
Having
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mo#va#on,
knowledge,
confidence,
and
capabili#es
to
take
a
role
in
managing
your
health
Ac#ons
that
people
take
for
their
health
and
to
benefit
from
care.

18. really

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21. © 2014. Healthcare Trends Institute. All Rights Reserved. 21
About the Institute
Institute Programs include:
ü HealthChange™ Educational Web Series
ü HealthDifference™ Awards (Launching March 15, 2014)
ü Institute membership
ü Healthcare Trends E-newsletter
ü Defined Contribution Today E-newsletter
The mission of the Healthcare Trends Institute is to provide the latest information,
news, education, resources and insights into the rapidly changing healthcare
environment. This site will cover a range of topics including healthcare and employee
benefits, health exchanges, insurance, and related areas of interest.
Tiffany Wirth, Executive Director
Tiffany Wirth is Executive Director of the
Healthcare Trends Institute. She also serves as
Director of Marketing at Evolution1™.
Healthcare Trends Institute 4324 20th Avenue,
SW, Ste.
200, Fargo, ND 58103
P: 701.499.7215
E: info@HealthcareTrendsInstitute.org

22. © 2014. Healthcare Trends Institute. All Rights Reserved. 22