Agenda Item   

AGENDA STAFF REPORT

 

                                                                                                                        ASR Control  25-000158

 

MEETING DATE:

03/11/25

legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

County Executive Office   (Approved)

Department contact person(s):

Kim Derrick (714) 834-2564 

 

 

Lauren Pierson (714) 834-5376

 

 

Subject:  Renewal of Contract for Administration of Health Management Program with WebMD

 

      ceo CONCUR

County Counsel Review

Clerk of the Board

          Concur

Approved Agreement to Form

Discussion

 

 

3 Votes Board Majority

 

 

 

    Budgeted: Yes

Current Year Cost:   $366,767

Annual Cost: FY 2025-26: $1,945,726
FY 2026-27: $1,649,305

 

 

 

    Staffing Impact:

No

# of Positions:            

Sole Source:   No

    Current Fiscal Year Revenue: N/A

   Funding Source:     Fund 29W 100%

County Audit in last 3 years: No

   Levine Act Review Completed: Yes

 

    Prior Board Action:         12/14/2021 #38

 

RECOMMENDED ACTION(S):

 

Authorize the Chief Human Resources Officer or designee to execute Amendment Number One to the Contract with WebMD Health Services Group, Inc. for the administration of the Health Management Program for the County of Orange employees, effective May 1, 2025, through April 30, 2027, for an estimated total of $3,961,798, for a revised cumulative estimated contract amount of $8,285,898.

 

 

 

 

SUMMARY:

 

Approval of Amendment Number One will allow the County to continue to provide administration of the Health Management Program for the County of Orange employees, as required under the various Memorandums of Understanding.

 

 

 

 

BACKGROUND INFORMATION:

 

In 2014, as agreed through labor negotiations, the County implemented a five percent reduction on health premiums for eligible employees that participated in the County’s Wellness Program. The program, Your Pathway to Wellness, is designed to help employees become aware of their risk factors and key information that impact their health, as well as provide cost-effective health management interventions to assist employees in maintaining or improving their health.

 

Over the years, the program has seen participation rates greater than 80 percent and has evolved to promote year-round engagement and offer employees greater flexibility to choose the areas of wellness they want to focus on. The program now consists of a menu of healthy actions that focus on physical, emotional, financial, and social wellbeing.

 

The program has been a contributing factor in controlling the cost of the health plan premiums. The continued engagement and decrease in risk prevalence among the population can be attributed to the evolution of the wellness program.  The modifiable risk prevalence continues to improve among the employees who have completed the health assessment.  The largest improvement among the 2023 to 2024 cohort report of participants was seen in the risk areas of exercise, nutrition, and sleep.  Over a three-year period of 2022 to 2024, participants saw the largest improvement in nutrition with a 14.69 percent risk prevalence improvement, followed by sleep with a 10.4 percent improvement over the same period.

 

WebMD Health Services Group, Inc. (WebMD) is the leading provider of health information and services to consumers, physicians, health care professionals, employers, and health plans through public and private online platforms. WebMD supports 100 direct clients and 2,000 clients across their business groups. Additionally, WebMD currently services 13 government clients and supports over 63 million lives. 

 

The current contract with WebMD expires on April 30, 2025.  Over the last nine years, WebMD has been the County’s administrator of the Health Management Program for the County of Orange employees. WebMD will continue to administer the Wellness Credit Program and provide online health trackers, telephonic coaching, online emotional and financial wellness programs, and wellness challenges. WebMD will subcontract with Quest and Total Health to complete the Biometric Screening services. 

 

WebMD offers a holistic approach to wellbeing that supports the whole person. 83 percent of County employees have registered for the WebMD portal and averaged six site visits in 2024. On the portal, employees have access to a wide variety of health management resources, including health trackers for employees to track their activity, sleep, hydration, and more. Employees have access to the Beyond Well podcasts that are hosted by a team of medical doctors, psychologists, and therapists to provide current and evidence-based content focused on mental health.

 

In 2024, employees downloaded 533 podcasts from Beyond Well, available on the WebMD portal, on identifying and understanding mental illness, and another 109 podcasts on self-care and work life balance.

 

Their online stress and resilience solution, meQuilibrium, offers participants help with increasing their resilience and emotional wellbeing by combining the care of a personal coach with the convenience of an online solution. Over the initial three-year term of the contract, the enrollment in meQuilibrium has increased from 36 users in 2022 to 6,325 users in 2024.

 

The financial wellness platform, Enrich, also available on the WebMD portal, offers engaging, effective, online financial programs that are customized to each participant, offering a personalized approach to help individuals meet their financial goals. In 2024, 4,098 employees utilized the Enrich program to focus on savings goals and to manage debt.

 

In addition, the contract offers a variety of coaching programs. One such program is Daily Habits which offers a self-driven coaching program, designed to turn small, attainable goals into long-term behavior change. Topics range from lifestyle programs like increasing exercise to clinical programs such as diabetes management.  Throughout 2024, County employees started 4,041 goals in Daily Habits with the most popular topics being Balance Your Diet, Enjoy Exercise, and Improve Back Health.

 

WebMD’s telephonic health coaching program is focused on creating sustainable lifestyle behavior changes through one-on-one coaching sessions.  Participants are provided with health advice, resources, and referrals to other County resources that best fit their current wellbeing needs.  By using methodology such as Motivational Interviewing and SMART goal setting, coaches can reduce barriers to success for those that participate. For employees that qualify, WebMD has a more specialized health coaching program focused on weight management, called Positively Me.  This is a 12-month program that follows a diabetes prevention inspired curriculum to guide participants through the necessary behavior changes to see healthy and sustainable weight loss. Participants learn skills to break negative thought patterns, overcome time constraints, improve their nutrition and physical activity. In 2024 we increased our efforts around promoting these programs through email communications and quarterly newsletter articles. Both programs’ utilization is trending positively compared to last year. We take a passive approach to coaching and allow employees to opt-in to the programs rather than auto-enrolling them based on their health assessment results and having WebMD make outbound calls to eligible employees. 

 

The WebMD Contract also includes three dedicated onsite Wellbeing Coordinators.  The onsite Wellbeing team's mission is to provide expert guidance that inspires people to take charge of their health.  They do this by helping the County's employees understand their health risks, make smart health care decisions, and take active steps toward living and maintaining healthier lives. The key responsibilities for these positions include:

 

- Increasing awareness and engagement in County-wide, wellbeing offerings.

- Educating employees about cardiovascular and metabolic health management and chronic condition management.

- Coordinating and assisting with implementation of over 35 biometric screening events across 20 different County locations that screened over 3,700 employees in 2024.

- Processing appeals for the annual Wellness Credit program.

- Instructing over 300 yoga and guided meditation classes for the Employee Wellness Center in 2024 that had over 3,400 participants.

- Administering the Wellness on Wheels Program that extends the programming in the Wellness Center to other locations throughout the County which visited 10 County departments and had over 1,600 participants. 

- Assisting in the delivery and coordination of health improvement, health and wellness programs, and challenges for employees.

- Coordinating the flow of information and materials between WebMD and individual County locations.

- Assisting and facilitating the linkage between County HRS/Employee Benefits, WebMD, the Employee Assistance Program, and other County benefits vendors.

- Working with the WebMD communications team to coordinate the customization of standard communication vehicles and the development of original materials, including the quarterly Your Pathway to Wellness Newsletter for County employees.

- Ongoing program performance review and wellness program strategy support.

 

Modifications to the contract have been made.   Attachment B, Compensation/Payment, has been revised to remove services no longer provided by WebMD and to include new services now offered by WebMD. Additionally, the Performance Standards have been updated and restated in Attachment E of the contract.

 

Human Resource Services is satisfied with WebMD’s performance under the current contract, which has provided valuable programs and resources to support the County employees’ wellbeing. Throughout the three-year term of the current contract, WebMD has achieved 94.7 percent or higher of their Performance Guarantees. WebMD will continue to offer 7.9 percent in fees at risk for core services and seven percent of fees at risk for health coaching services plus additional fees at risk for onsite biometric screening services based on service metrics as it relates to start times, adequate event supplies, staffing, client satisfaction, event cancellations, equipment quality assurance, and reporting.

 

On December 14, 2021, the Board approved the initial contract for the period of May 1, 2022, through April 30, 2025, renewable for two additional one-year periods. HRS asked for the standard three-year term with WebMD, renewable for two additional one-year periods, due to the fact it was the first year under the WebMD service contract after acquiring Staywell, the previous administrator of the Health Management Program. HRS is requesting to combine the two one-year renewal periods into one and renew the contract with WebMD for two years. This is the result of being satisfied with their performance, along with WebMD offering the same fee structure, keeping the pricing the same over the next two years, and they will continue to offer the County credits totaling an annual maximum amount of $75,000 that may be used towards programs, new products, communications, challenges and/or data files.

 

HRS has verified there are no concerns that must be addressed with respect to Contractor’s ownership/name, litigation status or conflicts with County interests. As such, HRS requests approval of the contract before your Board today to continue the administration of the Health Management Program for the County of Orange employees.

 

CONTRACT AND PRIOR BOARD ACTIONS:

 

On December 14, 2021, the Board approved execution of the Contract with WebMD for the administration of a Health Management Program effective May 1, 2022, through April 30, 2025, renewable for two additional one-year periods per Board policy.

 

 

 

FINANCIAL IMPACT:

 

The total cost for the two-year amendment is estimated at $3,961,798. The actual cost will vary based on employees participating in the Wellness Credit Program and the various other Your Pathway to Wellness programs.

 

Appropriations for this Contract are included in Fund 29W FY 2024-25 Budget and will be included in the budgeting process for future years.

 

The proposed Contract includes provisions that the Contract is contingent upon the availability of funds in the budget approved by the Board for each fiscal year the Contract remains in effect or operation. In the event such funding is terminated or reduced, the County may terminate the Contract, reduce the County’s maximum obligation, or modify the Contract, without penalty.

 

 

 

 

 

STAFFING IMPACT:

 

N/A

 

ATTACHMENT(S):

 

Attachment A – Amendment One to Contract with WebMD
Attachment B - Contract Summary Form
Attachment C - WebMD Performance Guarantee Summary