City of Los Angeles 2019 Annual Review Agenda Executive Summary - - PowerPoint PPT Presentation
JUNE 4, 2020 City of Los Angeles 2019 Annual Review Agenda Executive Summary Utilization Review - Exam Utilization - Network Utilization Working Together Performance Guarantee Review Questions C onfident ial N
2019 Annual Review
JUNE 4, 2020
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Key activities
Vision plan assessment
January 2017 – December 2019
membership is adapt ing t o a st andalone vision program
Summary
Focus on vision healt h result ed in an increase in overall eye exams over prior year. EyeMed saved Cit y of Los Angeles members $5.8 Million ret ail in 2019; t his represent s an 11.5% savings increase over t he prior year. On average members saved 70% ($246) on rout ine vision services and mat erials.
Utilization Review
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City of Los Angeles Contract Period of January 2017 – December 2019
Focus on wellness contributes to increases in exam utilization
utilization has consistently increased.
eye exam s between 2017 and 2019. Calendar Year Mem bers Exam s
(EyeMed + Kaiser)
Utilization 2017 57,239 17,605 30.8% 2018 56,978 18,083 31.7% 2019 57,484 18,580 32.0% 2020* 59,413 18,700 32.2%
* Enrollm ent forecast based on average m embership increase of 3.4% Q1 2020 vs Q1 2019; exam utilization forecast based on 2019 growth rate of 0.9%
Combined eye exam ut ilizat ion grew by 3.9% since January 2017
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EyeMed providers account ed f or over 75% of exam s in 2019; EyeMed 24.6% , Kaiser 7.4%
24.2% 26.2% 26.3% 25.1% 0% 20% 40% 2017 2018 2019 EyeMed* 30.8% 31.7%
32.0%
0% 20% 40% 2017 2018 2019 EyeMed* 28.0%
Utilization Rate
18.2% since 2017
t he increase in EyeMed provider ut ilizat ion
Exams
Based on your 2019 calendar year end data for in and out-of- network claim s * EyeMed book of business data for non-voluntary/ employer paid client accounts
Materials
4.4% of EyeMed members have a high- risk condit ion
markers for High Blood Pressure
Diabet es
Exceeds ut ilizat ion of EyeMed book of business f or em ployer paid groups
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Based on your 2019 calendar year end data * No longer part of EyeMed network, effective February 2020
2% 2% 4% 8% 9% 21% 55%
Sears* JCPenney* OON Other retail Target LensCraft ers I ndependent
EyeMed I nsight Network Choices
Where Your Em ployees are Going Your I n-network Utilization
Ret ail 24% I ndependent 76%
EXAM & MATERIALS UTILIZATION COMPOSITION
Retail is a valuable component of netw ork: 3 8 % of all eye exams performed and 4 4 % of materials w ere purchased in a retail setting
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$209 $175 $167 $142 $152 $143 $121 $180 $0 $50 $100 $150 $200 $250
* Based on your 2019 calendar year end data; fram e only, does not include lenses
Value of integrated system :
their allowance
contracted to m aintain and display a m inim um of 100 fram es which retail for $130 or less
access to over 500 fram es covered in full, on average, across the network
Your average frame price by location*
Maximizing Your Vision Experience
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Results from Your Pop-up Clinics
Figueroa Plaza Central Library Public Works City Hall East
5% of patients received first eye exam 30% of patients were overdue for an eye exam prior to Pop- up Clinic₁
Figueroa Plaza Central Library Public Works City Hall East
1Based on survey results for 2019. Confidential Notice: This docum ent contains privileged inform ation and is for the sole use of the intended recipient( s) . Disclosure or distribution to and review or use by any unauthorized Luxottica EyeMed associate( s) and external parties is prohibited.
Supporting City of Los Angeles Wellness I nitiatives
Service Provider sum m its
Diabetic com m unication
detail, assists with early detection of high-risk conditions
Los Angeles m em bers in 2019
testing once every 6 m onths
Engagement Retinal Imaging Diabetic Benefits
Less than 1 0 % of the EyeMed book of business includes coverage for Retinal I maging 9 % of EyeMed book of business and only one of the City’s peers
Benefits
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100% of I D cards m ailed in 10 days
100% of eligibility files updated in 2 days
100% claim s financial accuracy
100% claim s processing accuracy
100% of claim s paid in 10 days
9 seconds average speed of answer
0.6% call abandonm ent
100% com plaint acknowledgment in writing within 3 business days
100% com plaint resolution within 30 days
97% m em ber satisfaction
C it y of Los Angeles 2019 c alendar y ear end results
Direct im pact on m em ber satisfaction
In Closing …
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