It’s a bit into the New Year, but I find that these first weeks often are cluttered with tasks from the year before, chaos from holiday celebrations, and a redefining of personal goals.  Eventually, the bright light of early January takes center stage as the days begin to lengthen, and with that brighter light comes renewed energy.

Our November Annual Meeting and Innovation Summit seems far away, yet the success of over 150 people in the room still resonates.  I’m continuing to work with the some of the companies to connect them, define the opportunities to work together, and build showcases of improvement in engagement and accountability for outcomes, the very essence of any value-based design.  I’m waiting for the movies to be clipped to their important messages and the new pages on our website/Facebook/twitter to be created so we can share some of the detail of the summit with all of you.

But standing still is not part of my DNA.  So let’s frame the work of this coming year.

MLK:  A genuine leader is not a searcher for consensus but a molder of consensus.

At the summit, I framed my talk on quotes from Steve Jobs.  Interesting, here, that Jobs and King are in alignment, but perhaps not so surprising, since we were all so influenced by Dr. King.

My role in the Center, as the CEO and one of the founders, has been to assemble leaders, case studies, market evidence, and organizational evidence of improved health outcomes with value-based designs.  But make no mistake:  the accumulation of data points is not my endpoint.  I amass trend data and then create “what if” scenarios that link the art of health promotion to the science of engagement.  I’ve done it my whole life:  I take disparate entities and mold consensus to achieve better outcomes.  Everyday.  In every conversation.

Now there are some who rely on focus groups, surveys, and more.  There is good evidence that these provide information. But my impatience and inability to accept incremental change drives me to rapidly move forward based on the data that is often NOT in the focus group or survey.   In other words, I mold consensus.  I take the vision of “what could be” and compare to the noise of “what is” and ask, “Where is the disconnect that is stalling the improvement?”  Then, I track back to data to see if there is verification of a missed opportunity, I seek evidence and research that show the end-point is valid and achievable, and I prioritize the steps to get there.

Jobs said he didn’t poll the public because he invented what the public didn’t know it wanted—he merged science and creativity into disruptions that changed our lives. King used our emotional ties to our faith to define a disruption that overhauled social systems, forever changing our humanity.  I gain bravery by reading about brave people who carve a different path.  I bring many of those brave people together to solve for improved health.

I don’t equate my efforts with Jobs or King, but I am inspired by them and build my courage from theirs—hence, they are part of my collection of heroes.

This is the ecosystem of the Center for Health Value Innovation as well.  We have created a safe haven for implementing new models for health engagement, an innovation incubator that takes existing and emerging technologies and inserts them into these community models, and an educational resource that informs the general community through our website, summits, webinars and social media.

MLK: Faith is taking the first step even when you don’t see the whole staircase.

It’s imperative that there is a safe haven concept studio such as the Center (CHVI).  People need to know that there are others who have disrupted the status quo and who can share the learnings.  They need to know the first steps to creating the change and avoiding the pitfalls.  They need to know that, once they reset the course, they won’t be left without the map to the next location for supplies—that they can proceed on the course and, when they run into interference, others will help them through.  Vision without action is frustration.  Vision with first steps is the way out of a rut that is holding back progress.  If a company or a person comes to us with vision and faith, we help turn on the lights to the rest of the staircase. Sometimes, we even discover a better way to build the staircase together!

MLK:  All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence.

We are motivated by evidence.  We ask companies who work with us to share their findings and experiences in safe ways, never identifying the company unless the company says it’s ok.  Sometimes companies join our Center to purportedly share learnings, but actually to access leading innovators at big companies.  They quickly find out that they will get little support from us.  The excellence comes because we share with each other.  By creating a data repository of journeys, services that were used, and improvement in outcomes, we quickly can refer or connect organizations.  When the connections are made, the expectation is that a new level of data will come back to the repository.  The excellence in outcomes is sustained by the continual refreshing of the data metrics, which we track over time.

MLK:  Almost always, the creative dedicated minority has made the world better.

We are not a large organization.  Rather, we are a dedicated organization.  We are not solving for better health care—we believe that health care is a tool for better health.  We do not open our doors widely when we are testing a new model, as we’ve learned that others may not revere the confidentiality of a discussion intended to provoke thought.  In order to foster creativity, we respect our differences and leverage them for a better solution.  We understand that all companies are not large brand names and there are no “bad” companies or market segments.  We focus on narrow agendas in order to provide intelligent road maps to the marketplace as a whole.

MLK:  Our lives begin to end the day we become silent about things that matter.

There is no question that is too off-track, too elementary, too argumentative that we won’t ask.  There is no connection of innovation to models that we won’t consider if it’s novel and it’s potential for success has been excellently measured (and has a good chance of succeeding).  The energy in our discussions and presentations is palpable because we believe, en masse, that what we are doing truly matters.   We recognize that some may not move as quickly as we’d hoped, some may even abandon one model for awhile or for another.  But we continue to share among ourselves and with our communities.  We force conversations on their side so we can examine the hidden consequences of our actions.  We are far from silent on the topic that matters and unifies us: health promotion and disease prevention.

That’s who we are at the Center.  Some tell me that we are continually changing our definitions, but we believe we are refining and recommitting to new goals.  Some tell me that we are not growing our membership quickly enough, but we respond that members have to be comfortable with who we are and what we do, and sometimes that takes a bit of learning about us and experiencing our intensity.  Others join our efforts from tweets, posts and seminars in which we present data along with actionable steps for change, a methodology that is rare and based upon some experience and some faith.

Today I find it amazing that one year has passed since I wrote the E Pluribus Unum blog, calling for a commitment to doing better, reaching higher, and securing a stable environment for our children.  You may remember that I was moved by the death of a little girl in Arizona  (Christina) who had gone to meet her Congressional representative and was caught in the shootings that day.  I was overcome with sadness and hoping that others would help me and help them.

It’s amazing what vulnerability can bring.  Today I’m energized with hope and clarity of purpose: I will continue as a change agent for those who truly want to change.  Since last year’s blog, I’ve met new friends at more conferences and private meetings than I ever dreamed possible.  I hear daily from people who are doing nothing less than changing their communities, their companies or their personal lives for the better—and I’m quite sure that’s a commitment that tears at their souls, engages their intelligence, and delivers highs and lows on a daily basis.  I’ve grown more comfortable in admitting that I’m shamelessly working to improve health in America, that I revere the work of Dr. King and Mr. Jobs, that I’m honored to serve with the folks on our Board of Directors in improving the health and economic status of communities.

I’m excited to see who will knock on our door, or phone me on my, well, iPhone, or email me on my (you guessed it) Mac, asking for info or how to join or where we can meet or just chat.

On this day, let us all become disciples of Dr. King, building a better world in whatever way we can.  I hope that we all can stand up and say, “I have a dream…”

I’m here in DC for a series of meetings on impacting the health outcomes of businesses in order to improve the communities in which they and their employees live.  From my dearly-valued leadership colleagues, to the folks on Capitol Hill, to those who persevere in creating quality standards, I have meetings throughout the next few days.

I’ve also engaged the help of some sophisticated social media experts to guide my self-sown experiment.  The hypothesis of this experiment is that I will build a distribution network of transformational concepts that will build bravery, skill, and excitement to change the status quo.  A job for Superman or Superwoman, but goal-setting and goal-achievement is in my DNA, so I’m launching a new methodology based upon the advice I’m receiving.

The first idea, which has “brilliantly” lit up the end of my evening, is that I have to shorten my lists so I can achieve my goal.  I have to stay in touch with those of you who consider my rebel push to improve health to its best impacts–personal, employer-employee, family, community and even US.  So, with this brief blog, I hope to engage more of you and create a conversation that knows few borders, builds on health-wealth-performance improvement for those who participate in the challenge, and results in meaningful, measurable impact to each of us, for each of us.

I hope you’ll contribute to my brief experiment.  Number one rule in behavior change:  set a goal and measure to it.  Number two rule:  set a goal that’s challenging yet achievable in a short timeframe–I like and often lead groups with the timeline of “30 days or you won’t see the impact!”  Visit me on twitter @cyndynayer, or on our CHVI Facebook page .  Tell me about your goals to improve health outcomes and what you achieve in 30 days–and tell me how it affects you and your loved ones.

There’s no doubt that a few committed people can change the world–we know that quote from Margaret Mead.  What happens when a few thousand commit?  A few million?  Let’s go!

I’m inspired by that message, and I have joined forces with other passionate idealists to build the Center for Health Value Innovation.  Simply, we have founded a virtual tent where innovators and disruptive thinkers can come to consider the “what ifs,” test ideas and learn the mistakes of other disrupters ahead of them, and solve for one goal:  how do we improve health? The early member-innovators of this safe haven always knew that our non-profit Center, now known as CHVI, would attract a multi-stakeholder group.  Because people get the letters confused, I made it more memorable:  think of us as the Chevy (sorry, GM) that makes cars affordable and accessible for the masses.  That’s what we do within CHVI (see? Chevy?)—we develop and test and measure new affordable, accessible plan designs so more folks will engage in the management of their health, and more of the delivery system will focus on the improved health of the individual rather than the unit cost of the care. I call that “focusing on the IMPACTS, not the INPUTS.”

Our end goal was never about installing a replica of the Value-Based Benefit Design that my business partner and co-founder Jack Mahoney installed at Pitney Bowes.  As we accumulated a burgeoning stack of innovation and case studies, then surveys and trajectories, our goal was never focused on the benefit design EXCEPT as a tool for health value innovation:  building more health with the dollars that were already in the system.   People who have heard me speak or read my writings know that I tell stories to drive home a point, stories that make the data actionable because the listeners can relate.  The juxtaposition of the shuttle breaking boundaries with our everyday lives showcases these delicate balances in life.  It’s hard work, and lonely work, pushing transformational change up very steep walls.  We build a platform of bravery and courage and innovation that we share among ourselves and with the market. Lately, our innovation summits (invite-only, please) are getting some serious traction and more folks are joining just so that they can be invited to consider new ideas and build themselves into the community of innovators. My passion is the improvement of personal competency in health management.

I have been quite vocal for many years about individual responsibility for our health.  As the former Chair of the Missouri Governor’s Council on Health and Fitness, I tracked the increasing obesity issues in our children and tried in vain to get legislators to hear.  I wrote a book 5 years ago branding the concept of “CEO of MYHealth,” with the poor title of 101 Lifetips for Personal Health Management (you can still get it online, along with the Center’s book Leveraging Health).  I have been very vocal about the need for personal health records and apps for phones that aggregate all the data for me, for you, on our phones, so that WE are the keeper of the health record for each of us.  I’m perfectly capable of pushing a “yes” button so that all of the folks who care for me can download the info into MY record that I will have with me when I visit another care provider who could need to know.  There is no other way that we can build accountability—you can’t be accountable for info you don’t have.

Other brave innovators joined CHVI because they saw the opportunity of sharing the vision and acting in concert for transformational change.  No more incremental baby steps, we would shout our successes as well as our challenges to the communities we serve, calling others with our joined voices to improve health and settling for nothing less.  We were focused on health; health care reform, value-based benefit design, patient-centered care were all a part of the toolbox.  We are a community of all-comers who are primed for disruptive innovation.

We believe it’s really not so hard to engage people in managing their health:  provide the right “cookie” at the right time and people do engage.  We are proud to be launching a tool into the market (Health Value Accelerator^TM) that will cut through the data chaos and show other payers the pathway to better engagement and better health. Value-based benefit design was always the engagement tool that causes accountable behaviors and better outcomes for the consumer, the provider and the payer.  I have managed to reframe our mission into twitter-ese:  we focus on impacts not inputs.

I believe it’s a travesty that $2.7 trillion can be spent in one year and yet our communities are unhealthier and economically distressed.  I believe we are purchasing the wrong item (health care) at the wrong price (widget or unit cost) for the wrong outcome (better health care does not necessarily give better health) and we are asking the wrong question (how much will that care cost?).  We must change the question to “How much new health will that amount of dollars purchase?” (thank you, Peter Hayes).

We have to use our money to invest in the outcomes (that’s why we developed Outcomes-Based Contracting^TM) instead of purchasing on merchandising schemes (preferred products or services are preferred because of their price/rebate/other and not because of their outcomes to the patient and the community).  We must set our goal to achieve more health, not more health care, and the solutions will change and grow as they always do when we ask the right question.

Because it’s really not so hard to get our kids healthier:  reward them for health well-done instead of sitting quietly. Teach them how to choose lifestyles wisely so that they can avoid extraneous health care costs.

Because it’s really not so hard to get the right information to consumers.  I can get my bank balance and withdraw money from any one-eyed steel box on a post anywhere in the world, and I can get directions to all the unhealthy food in any neighborhood that I want—so I don’t tolerate the message that the data fields can’t talk/won’t talk/shouldn’t talk when I can’t get my health data.

Because I learn more in every city, on every plane, when the person in the next seat tells me about the extraordinary health care and outcomes he/she received, and, sometimes, shares the stories of inequities that caused pain.

Because I never want to hear and you never want to hear that others have died because the “system” didn’t work. I want to see one life saved, and then another and another, because I worked so hard and you worked so hard to make the “system” respond to the goal, not for more health care, but for more health—personal health, clinical, financial, emotional, physical, social.

Because I really can’t imagine how we spend $2.7 Trillion yet we are the 37^th industrialized country on the health scale.  We should be the healthiest country, but our safety, access and affordability are awful and we are drowning in health debt.

We are determined star-seekers: we use our disruptive intelligence to change this picture.  We are focused on health.  We build better engagement and adherence, better payment and reimbursement, and we measure milestones to health.  We keep our focus on the impact, the value of the investment in health, and we do it because passionate idealists take on challenges and reach for the stars.  I learned at Boeing years ago that the sky is no limit.  At the Center for Health Value Innovation, we build courage to break barriers to achieve sky-high levels of health.

Five years ago, 5 of us came together to consider the establishment of an organization that would be a community of innovators to share evidence of improved health and performance through investments in appropriate healthcare services.  We each had very different competencies and reasons for our shared vision.  Only Jack and I remain quite visible in the Center; 2 have left to pursue their passions, and one remains on our Council of Advisors.  But Jack and I forged a bond that said our goal was clear and our visions/passions aligned:  innovators needed a “safe haven” in which to test ideas, share journeys, bolster courage, teach others.  We identified innovation in the market, and we frankly rarely spoke about Pitney’s example as we wanted to showcase innovation that was built on the needs and cultures of other companies; not every company would be identical to Pitney–not as large, not led by such an engaged CEO as Mike Critelli, but perhaps more innovative in other ways, led by CEOs who understood the value of their workforce as fundamental to their success.  So we catalogued the journeys of others, built comparative data that we showcased at conferences, hailed and called attention to new ideas and innovation.

Others joined the Center, from large and small companies, from each sector of the health value supply chain (health plans, health systems, physician organizations, non-profits, for-profits, consultants, academics, pharmaceutical and device companies, and more).  In each company, there were groups of new thinkers and, more importantly, do-ers, who were willing to share their stories, their challenges and their data to build a new pathway to improved outcomes.  We don’t all agree about everything, but that’s the beauty of our collective wisdom:  it feeds the curiosity without threatening the development of new ideas.  Together we focus on what we all view as important.  It’s the impact, not the inputs, that we have in our visions, the impact of improved health and economic outcomes, the very essence of health value, which Jack put in our title.

Now, Jack has received recognition for the work he has done for 15 years and more that added to the science of health and productivity management.  From our earliest phone conversation, where Jack and I shared our experiences and visions for engaging populations in the successful management of their health, we have traveled a long and sometimes circuitous route together.  We committed to each other, and a very cold Chicago meeting room, that we would see this Center to its founding purpose, to be the safe haven where new ideas could be shared and measured and communicated to and from the business community.  I’ve been lucky to share this road with Jack, and we have developed a strong bond.

That’s what I wanted to share with you about my business partner and friend, Jack Mahoney.  He wants patients to get the right treatment at the right time, as do all of us in the Center.  He’s not afraid to consider engagement opportunities, particularly for at-risk or vulnerable populations.  That’s what we built in the Center, and we will continue to amplify the successes.  We will focus on the impact, solving to equalize the incentives for all of the engaged, accountable stakeholders in the health value chain.  It will always be about the outcomes.

I’m sharing here an excerpt of the PR that the Pharmacy Benefit Management Institute released about the awardees.  And I’m also linking you to the PR and video that we shared at the conference this past week:  click here and listen to Jack’s acceptance so you, too, can get to know my friend Jack,  the architect of value-based benefit design.

SCOTTSDALE, AZ–(Marketwire – February 17, 2011) – The Pharmacy Benefit Management Institute (PBMI) has awarded four 2011 Rx Benefit Innovation Awards to the Center for Health Value Innovation, Cigna Pharmacy Management, CVS Caremark / Arcelor Mittal, and InformedRx, an SXC company. The awards were announced today at PBMI’s 16^th Annual Drug Benefit Conference in Phoenix.

The recipients of this year’s awards were selected based on the project’s overall originality, strength of reported results, and potential to improve patient outcomes. ”Our 2011 award recipients have demonstrated creative thinking by designing solutions to address numerous challenges in prescription drug programs,” says Tim Watson, PharmD, MBA, Executive Director of PBMI. “Their example will inspire other plan sponsors to implement one or more of these approaches in their own populations.”

Center for Health Value Innovation
The Center for Health Value Innovation is being recognized for their pioneering work in the design, implementation and measurement of Value Based Insurance Designs. The center’s co-founder and Chief Medical Officer, Jack Mahoney led the charge behind Value Based Design with a firm resolve to prove that lowering access barriers to health care services could ultimately engage the most at risk populations, thereby improving care and lowering costs. The center’s work to measure and disseminate outcomes associated with these design strategies continues to provide guidance to others who wish to implement these programs in their population.

SeeChange Health – The New Value-Based Health Insurer Aligns Benefits with Preventive Care and Chronic Condition Management

San Francisco, CA–March 22, 2010 – SeeChange Health today launched the first new value-based health insurance company in California, offering personalized, value-based health plans that provide incentives to encourage individuals to play an active role in their health management and improve their quality of life. As the first value-based health insurance company to launch in the United States, SeeChange Health brings affordable, next-generation insurance designs to the employer group market. The plan will be available initially in Fresno, California, but the company plans to expand their offering to Los Angeles, San Diego, Bakersfield, Monterey, Sacramento and San Francisco in the coming months.

Value-based health care encourages individuals to access preventive care, which will identify looming health problems before they become serious – and expensive. Participants who complete a health questionnaire along with age and gender specific preventive examinations, including cancer screenings and basic lab tests, are rewarded with enhanced benefits such as reduced coinsurance and deductibles along with cash rewards.

Unlike typical health insurance companies, SeeChange Health designed its benefit plans to encourage individuals to see their doctor. SeeChange Health covers preventive examinations, including cancer screenings and associated lab tests, at 100 percent.

“We are thrilled to partner with a health plan that rewards its members for building and maintaining a relationship with their doctor,” said Dr. Daniel Bluestone, Chief Medical Officer of Santé Community Physicians. “SeeChange Health promotes healthy behaviors, which will ultimately reduce chronic illnesses and help people live fuller, healthier lives.”

In addition to providing enhanced benefits for completing preventive examinations and related screenings, SeeChange rewards its members with financial incentives for completing health actions necessary for proactively managing chronic conditions, such as diabetes, asthma and coronary artery disease.

“When SeeChange approached us with its groundbreaking solution, we eagerly embraced the only health plan to completely align its benefits with preventive care and chronic condition management,” said Cyndy Nayer, President of the Center for Health Value Innovation, the nation’s premier information exchange for value-based design.

“The reaction and feedback we are receiving from employers is overwhelmingly positive,” said Chuck Trogdon, CEO of Renberg, Trogdon, & Cavale Insurance Services. “Employers are clamoring for affordable health plans with benefits designed to support individual efforts for staying healthy. This approach drives down health plan costs and promotes a healthier workforce.”

Why the initial focus on California? One out of seven residents are uninsured and the number is growing. In the coming months, SeeChange will expand their health insurance offerings throughout California and into twenty-four states where they are licensed to sell value-based health insurance.

“While the nation debates the merits of a national health care plan, the elephant in the room is who is going to pay for it,” said Martin Watson, CEO of SeeChange Health. “With our new plan, we are effectively showing that you can lower health care costs and improve the quality of care while you’re doing it.”

About SeeChange Health

SeeChange Health provides fully-insured, value-based health insurance to employer groups. The company combines value-based benefit designs, data analytics and an interactive personal health record to consistently improve the health profile of individuals. Preventive health actions are assigned and tracked at an individual level. Individuals with disease states such as pre-diabetes, diabetes, asthma and heart disease receive specific health actions based on their medical condition. SeeChange Health is headquartered in San Francisco and is focused on reducing health care costs through proactive health management and early detection of health conditions.

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PRSeeChangeLaunchMarch22-2010

Read more of the primer by clicking here.

AHP HPP primer 3.2010

The Art of Health Promotion: March/April 2010
Value-Based Design: A New Powerful Perspective for Worksite Health Promotion
John E. Riedel, MBA, MPH; Cyndy Nayer, MA

ST. LOUIS–(BUSINESS WIRE)–A new study confirms that employers believe value-based design (VBD) improves employee health and productivity. The Center for Health Value Innovation, the nation’s premier information exchange for value-based design, today announced the results of a survey, “Value-Based Design 2009,” conducted by Buck Consultants, a global employee benefits and human resources consulting firm.

“Value-Based Design 2009 – Survey Report January 2010”

The survey is the most comprehensive of its kind in the industry, studying 100 employers in 16 major industries, reporting on more than 1 million covered lives, including retirees.

VBD uses benefit design and delivery to align incentives for workers, employers, and providers to improve health and financial outcomes through behavior change. The survey results validate the Center’s efforts to promote VBD as an effective means to improve total health and performance across communities.

“This survey is the first one that examines the experience of companies of all sizes and sectors who had a value-based design in place for two or more years,” says Cyndy Nayer, President and CEO of the Center. “It validates the work of the Center, and expands the knowledge base of change and innovation for the market. In particular, this survey demonstrates increasing focus on employee assistance programs, depression, and financial counseling, which ties in with our goal to expand the definition of VBD and link it to total health and performance.”

Michael Jacobs, principal for Buck Consultants and member of the Center’s Board of Directors, adds, “The survey responses prove that organizations using VBD understand the vital importance of this approach. Despite the recession – when employers more likely to cut expenses by changing their benefits – few of the organizations using VBD changed their benefits structure.”

According to the survey respondents who currently have VBD incorporated into the health program for employees, 79 percent made no changes in 2009. Additionally, more than one half of these companies (56 percent) anticipate no changes in these benefits for 2010.

Other significant survey results include the use of VB levers to improve stakeholder engagement:

• 87 percent use for prevention/wellness
• 60 percent use for chronic care management
• 80 percent use for disease management
• 63 percent waive employee cost sharing for yearly screening exam
• 40 percent provide insurance premium incentive for completion of a Health Risk Assessment (HRA)
• 54 percent cover depression under care management program
• 70 percent reduce/waive co-pay for utilizing the lowest cost appropriate site of care (e.g., urgent care, convenient care, onsite services, medical travel)
• 58 percent provide incentives for the use of EAP programs
• 35 percent provide incentives for financial counseling

“With this survey we can now point to hard numbers that back up everything that we have been communicating regarding the power of VBD to transform health and the administration of health benefits in this country,” says Nayer, noting that there is still work to be done. “We see a growing expansion of value-based design, linking the health and wealth of the individual to the health and wealth of the organization.”

Nayer and Jack Mahoney, M.D., chief medical officer of the Center and former corporate medical director for Pitney Bowes, have spent the last decade showing the evidence for the widespread adoption of VBD programs. Their collective experience and expertise, coupled with co-author Jan Berger, M.D., culminated in the publication of Leveraging Health (2009). The book uses the experience of innovators in many organizations to document “suites” of levers, a metaphor for plan designs and incentives, showing decision makers how to make informed decisions on benefits and services for better corporate performance.

Dr. Mahoney lauds the Buck Consultants survey: “It is very gratifying to see statistics confirm something we have known for years. One common measurement of improved VBD activity is that 74 percent of survey respondents indicate that employees are now getting preventative exams and annual screenings. We see this as a tipping point and envision landmark changes ahead as more employers embrace VBD to drive change by improving the health and productivity of their workforce.”

To see full results from the “Value-Based Design 2009 – Survey Report January 2010” click here

About The Center for Health Value Innovation

Information Exchange for Value-Based Design

The Center for Health Value Innovation has grown into the nation’s premier organization dedicated to sharing the evidence of improved health and economic outcomes through value-based designs for sustainable health and financial improvement.
www.vbhealth.org

About Buck Consultants

Buck Consultants is a leader in human resource and benefits consulting with more than 1,500 professionals worldwide. Founded in 1916 to advise clients in establishing and funding some of the nation’s first public and private retirement programs, Buck is an innovator in the areas of retirement benefits, health and welfare programs, human capital management, compensation, and employee communication. News and other information about Buck Consultants are available at www.buckconsultants.com. Buck is an independent subsidiary of ACS, A Xerox Company.

CHVI-BUCK VBD 2009 FINAL- Report