LACERS BOARD UPDATE: LACERS Reviews Health Management Averages


Michael Wilkinson, LACERS/Legal Representative

By Michael R. Wilkinson
LACERS/Legal Representative

LACERS Benefits Administration Committee (which I chair) recently reviewed a report on our Health Management Dashboards as part of our plan to improve the health of our members and keep our health costs low. The reports reviewed were presented by our health consultant, Keenan and Associates, and cover the period through Dec. 31, 2018.

Starting in 2015, staff and Keenan contacted Kaiser and Anthem to identify the health problems that were most serious for our members based on the premium costs for each diagnostic category. These two plans were selected since they can provide the greatest amount of data based on serving 90 percent of our members.

The top cost categories were: circulatory (cardiovascular disease), musculoskeletal (such as osteoarthritis), neoplasms (cancer), obesity and diabetes. The claims costs for our members are closely tracked to see how we may make changes to improve our members’ lives through the LACERS Well program and working with the health providers.

There is not enough space here to go over the whole report, but I am happy to share a few glimpses of the process to show how the system works. For instance, Kaiser reports that LACERS Medicare patients are keeping up with other groups for preventive care except for cervical cancer screening, where it is lower than the benchmark. Here are the numbers to show the Kaiser member Medicare participation rate by category:

  • Clinical visit, 94.0 percent;
  • Flu shot, 75.1 percent;
  • Blood pressure checked, 92.5 percent;
  • Blood glucose checked, 91.5 percent;
  • Body Mass Index (BMI) checked, 83.9 percent;
  • Exercise level checked, 89.8 percent;
  • Cholesterol level checked, 89.8 percent;
  • Cervical cancer screening, 72.2 percent;
  • Breast cancer screening, 89.6 percent; and
  • Colorectal cancer screening, 90.2 percent.

Here is a quick look at some of the Anthem data. Note that some information cannot be directly compared between Anthem and Kaiser since Kaiser reports on the Medicare members separately and Anthem does not. Anthem reports a slight decrease in the prevalence percentage of lifestyle related chronic conditions, from 81.6 percent to 81.0 percent, and a reduction in high blood pressure from 34.4 percent to 32.0 percent from 2016 to 2018. Diabetes increased slightly from 18.4 percent to 19.3 percent over the same period.

I know that’s a lot of numbers, but what does it mean to each of us? We all should be getting regular doctor checkups and following up on our recommended treatments, eating right and getting that fun daily exercise on the bike, in the gym, or just walking your dog around the neighborhood. It need not be complicated, and a lot of help can be found on the LACERS Well Webpage or Facebook page.