The Value of Workplace Health Promotion Nashville Area Chamber and - - PowerPoint PPT Presentation

The Value of Workplace Health Promotion

Nashville Area Chamber and P2020 Annual Meeting -- September 30, 2016

Ron Z. Goetzel, Ph.D. Johns Hopkins University and Truven Health Analytics, an IBM Company

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Agenda

• Business Case for Health & Wellbeing in the Workplace
• ROI vs. VOI
• Wall Street Studies
• Dissemination of Best/Promising Practices
• Q&A

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The Controversy: Do Health Promotion Programs Work?

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The Confusion

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What Do We Mean When We Say: A Wellness Program Works?

• “Make workers aware of their health and how it improves quality
• f life.”
• “High participation and engagement.”
• “Lose weight, stop smoking, exercise more.”
• “Medical claims costs should go down.”
• “Less absenteeism, fewer safety incidents.”
• “Attract the best talent.”
• “Happier workers with more energy.”
• “Create a culture of health.”

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What Do We Mean When We Say: A Wellness Program Works? (Con’t)

“Produce a positive return on investment (ROI)?”

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Q: What problem are we trying to solve? A: Spending a lot of money on sick care!

• The United States will spend $3.351 trillion

in healthcare in 2016, or $10,346 for every man, woman and child.

• Spending by sector
• Private health insurance - $1.093

trillion

• Medicare - $681.3 billion
• Medicaid - $577.7 billion
• Out of pocket -- $350.1 billion
• Health expenditures as percent of GDP:
• 7.2 % in 1970
• 18.1% in 2016 (projected)
• 20.1% in 2025 (projected)

Source: Keehan et al., Health Affairs, 35:8, August 2016

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Employer Per Capita Spending on Healthcare

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Convince me… Why should I invest in the health and well-being of my workers?

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What Is the Evidence Base?

• A large proportion of diseases and disorders is preventable. Modifiable health risk factors are

precursors to a large number of diseases and disorders and to premature death (Healthy People 2000, 2010, Amler & Dull, 1987, Breslow, 1993, McGinnis & Foege, 1993, Mokdad et al., 2004)

• Many modifiable health risks are associated with increased health care costs within a relatively

short time window (Milliman & Robinson, 1987, Yen et al., 1992, Goetzel, et al., 1998, Anderson et al., 2000, Bertera, 1991, Pronk, 1999, Goetzel 2012)

• Modifiable health risks can be improved through workplace sponsored health promotion and

disease prevention programs (Wilson et al., 1996, Heaney & Goetzel, 1997, Pelletier, 1991-2011, Soler et al. 2010)

• Improvements in the health risk profile of a population can lead to reductions in health costs

(Edington et al., 2001, Goetzel et al., 1999, Carls et al., 2011)

• Worksite health promotion and disease prevention programs save companies money in health

care expenditures and produce a positive ROI (Citibank 1999-2000, Procter and Gamble 1998, Highmark, 2008, Johnson & Johnson, 2011, Dell 2015, Duke University 2015)

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Diseases Caused (at Least Partially) by Lifestyle

• Obesity: Cholesystitis/Cholelithiasis, Coronary Artery Disease, Diabetes, Hypertension, Lipid

Metabolism Disorders, Osteoarthritis, Sleep Apnea, Venous Embolism/Thrombosis, Cancers (Breast, Cervix, Colorectal, Gallbladder, Biliary Tract, Ovary, Prostate)

• Tobacco Use: Cerebrovascular Disease, Coronary Artery Disease, Osteoporosis, Peripheral

Vascular Disease, Asthma, Acute Bronchitis, COPD, Pneumonia, Cancers (Bladder, Kidney, Urinary, Larynx, Lip, Oral Cavity, Pharynx, Pancreas, Trachea, Bronchus, Lung)

• Lack of Exercise: Coronary Artery Disease, Diabetes, Hypertension, Obesity, Osteoporosis
• Poor Nutrition: Cerebrovascular Disease, Coronary Artery Disease, Diabetes, Diverticular Disease,

Hypertension, Oral Disease, Osteoporosis, Cancers (Breast, Colorectal, Prostate)

• Alcohol Use: Liver Damage, Alcohol Psychosis, Pancreatitis, Hypertension, Cerebrovascular

Disease, Cancers (Breast, Esophagus, Larynx, Liver)

• Stress, Anxiety, Depression: Coronary Artery Disease, Hypertension
• Uncontrolled Hypertension: Coronary Artery Disease, Cerebrovascular Disease, Peripheral

Vascular Disease

• Uncontrolled Lipids: Coronary Artery Disease, Lipid Metabolism Disorders, Pancreatitis, Peripheral

Vascular Disease

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Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

1994

CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

1995

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

1996

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

1997

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

1998

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

1999

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2000

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2001

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2002

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2003

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2004

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2005

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2006

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2007

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2008

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2009

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CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at http://www.cdc.gov/diabetes/statistics

Age-Adjusted Prevalence of Obesity and Diagnosed Diabetes Among US Adults

Obesity (BMI≥30 Kg/m2 ) Diabetes

<4.5% Missing data 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% ≥9.0% 18.0%–21.9% <14.0% Missing Data 14.0%–17.9% 22.0%–25.9% ≥26.0%

2010

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LEADING CAUSES OF DEATH IN THE U.S.

Cause of Death # of Deaths Percentage Heart Disease 710,760 30% Malignant Neoplasm 553,091 23% Cerebrovascular Disease 167,661 7% Chronic Lower Respiratory Tract Disease 122,009 5% Unintentional Injuries 97,900 4% Diabetes 69,301 3% Influenza / Pneumonia 65,313 3% Alzheimer's 49,558 2% Nephritis 37,251 2% Septicemia 31,224 1% Other 499,283 21% Total 2,403,351 100%

*Source: Year 2000, Mokdad et al., JAMA,291:10, March, 2004

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ACTUAL CAUSES OF DEATH IN THE U.S. (2000)

50 100 150 200 250 300 350 400 450 Tobacco Use Diet & Inactivity Alcohol Misuse Microbial Agents Toxic Agents Motor Vehicles Firearms Sexual Behavior Illicit Drug use

Source: Mokdad, et al

in thousands

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BOTTOM LINE: THE VAST MAJORITY OF CHRONIC DISEASE CAN BE PREVENTED OR BETTER MANAGED The Centers for Disease Control and Prevention (CDC) estimates…

• 80% of heart disease and stroke
• 80% of type 2 diabetes
• 40% of cancer

…could be prevented if only Americans were to do three things:

• Stop smoking
• Start eating healthy
• Get in shape

FTI CONSULTING ON NASHVILLE HEALTH

35 LINK: http://www.nashvillechamber.com/docs/default- source/pdfs/060315_fti_assessmentofnashville_final.pdf

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Good News – Worksite Health Promotion Works! Caveat: If you do it right…

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CDC Community Guide to Preventive Services Review – AJPM, February 2010 86 Studies Reviewed

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Summary Results and Team Consensus

Outcome Body of Evidence Consistent Results Magnitude of Effect Finding Alcohol Use 9 Yes Variable Sufficient Fruits & Vegetables % Fat Intake 9 13 No Yes 0.09 serving

• 5.4%

Insufficient Strong % Change in Those Physically Active 18 Yes +15.3 pct pt Sufficient Tobacco Use Strong Prevalence 23 Yes –2.3 pct pt Cessation 11 Yes +3.8 pct pt Seat Belt Non-Use 10 Yes –27.6 pct pt Sufficient

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Summary Results and Team Consensus

Outcome Body of Evidence Consistent Results Magnitude of Effect Finding Diastolic blood pressure Systolic blood pressure Risk prevalence 17 Yes Yes Yes Diastolic:–1.8 mm Hq Systolic:–2.6 mm Hg –4.5 pct pt Strong 19 12 BMI Weight % body fat Risk prevalence 6 12 5 5 Yes No Yes No –0.5 pt BMI –0.56 pounds –2.2% body fat –2.2% at risk Insufficient Total Cholesterol HDL Cholesterol Risk prevalence 19 8 11 Yes No Yes –4.8 mg/dL (total) +.94 mg/dL –6.6 pct pt Strong Fitness 5 Yes Small Insufficient

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Summary Results and Team Consensus

Outcome Body of Evidence Consistent Results Magnitude of Effect Finding Estimated Risk 15 Yes Moderate Sufficient Healthcare Use 6 Yes Moderate Sufficient Worker Productivity 10 Yes Moderate Strong

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Reduced Utilization Risk Reduction Behavior Change Improved Attitudes Increased Knowledge Participation Awareness Financial ROI

What About ROI? Critical Steps to Success

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Health Affairs ROI Literature Review

Baicker K, Cutler D, Song Z. Workplace Wellness Programs Can Generate Savings. Health Aff (Millwood). 2010; 29(2). Published online 14 January 2010.+

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Results - Medical Care Cost Savings

Description N Average ROI Studies reporting costs and savings 15 $3.37 Studies reporting savings only 7 Not Available Studies with randomized or matched control group 9 $3.36 Studies with non-randomized or matched control group 6 $2.38 All studies examining medical care savings 22 $3.27

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Results – Absenteeism Savings

Description N Average ROI Studies reporting costs and savings 12 $3.27 All studies examining absenteeism savings 22 $2.73

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Goetzel’s Rule: an ROI of 1:1 Is Good Enough…

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…if You Can Demonstrate Health Improvement!

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Poor Health Costs Money

Drill Down…

• Medical
• Absence/work loss
• Safety
• Presenteeism

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Top 10 Most Costly Physical Health Conditions

Medical, Drug, Absence, STD Expenditures (1999 annual $ per eligible), by Component

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The Big Picture: Overall Burden of Illness

Using Average Impairment and Prevalence Rates for Presenteeism ($23.15/hour wage estimate)

$- $50 $100 $150 $200 $250 $300 $350 $400 $450 Allergy* Arthritis Asthma Any Cancer Depression/Sadness/Mental Illness Diabetes Heart Disease Hypertension Migraine/Headache Respiratory Infections Annual Costs Presenteeism STD Absence RX ER Outpatient Inpatient

Source: Goetzel, Long, Ozminkowski, et al. JOEM 46:4, April, 2004)

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HERO II Study

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Cost Per Capita of Risk Factors

• 100
• 50

50 100 150 200 250 300 350

347 178.6 128.2 106.2 104.1 80.8 38.3

• 6.4
• 14
• 75.4

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Research on Risk-Cost Relationships - Novartis

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Risk Factors and Presenteeism (N = 5,875)

Risk factors predicted .80 – 1.67 additional presenteeism days/year

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Risk-Cost Relationships at PepsiCo

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BMI Breakdown by Category

25% 44% 22% 7% 3%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Normal BMI < 25 Overweight BMI 25-30 Class I BMI 30-35 Class II BMI 35-40 Class III BMI 40+ Percentage Sample In Each BMI Category

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PepsiCo – Overweight / Obese Analysis (N=11,217)

Difference between combined overweight/obese categories and normal weight is displayed Source: Henke RM, Carls GS, Short ME, Pei X, Wang S, Moley S, Sullivan M, Goetzel RZ. The Relationship between Health Risks and Health and Productivity Costs among Employees at Pepsi Bottling Group. J Occup Environ Med. 52, 5, May 2010.

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NHLBI Multi-Center Study: Estimated Annual Costs of Healthcare Utilization, Absenteeism, and Presenteeism by BMI Category

$1,416 $1,180 $2,034 $229 $1,402 $918 $1,544 $155 $182 $1,200 $872 $1,535 $149 $178 $219 $0 $500 $1,000 $1,500 $2,000 $2,500

Presenteeism Absenteeism Days Hospital Admissions Emergency Room Visits Doctor Visits

Normal Overweight Obese

* * * * * Source: Goetzel RZ, Gibson TB, Short ME, Chu BC, Waddell J, Bowen J, Lemon SC, Fernandez ID, Ozminkowski RJ, Wilson MG, DeJoy

• DM. A multi-worksite analysis of the relationships among body mass index, medical utilization, and worker productivity. J Occup Environ Med.

2010 Jan;52 Suppl 1:S52-8.

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J&J Study – Health Affairs, March 2011

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Health Risks – Biometric Measures -- Adjusted

Results adjusted for age, sex, region * p<0.05 ** p<0.01

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Health Risks – Health Behaviors -- Adjusted

Results adjusted for age, sex, region * p<0.05 ** p<0.01

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Health Risks – Psychosocial -- Adjusted

Results adjusted for age, sex, region * p<0.05 ** p<0.01

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Adjusted Medical and Drug Costs vs. Expected Costs from Comparison Group

Average Savings 2002-2008 = $565/employee/year Estimated ROI: $1.88 - $3.92 to $1.00

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VANDERBILT UNIVERSITY

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SEVEN YEAR AGGREGATE AND COHORT ANALYSIS

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PHYSICAL ACTIVITY

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OBESITY

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SMOKING

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Vanderbilt – 8-Year Study

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Obesity and Diabetes

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• DR. KOOP WITH 2008 WINNER – VANDERBILT UNIVERSITY

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http://www.thehealthproject.com

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But…what about the Value-on-Investment (VOI)?

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Wall Street Studies

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Ray Fabius’ 2013 study

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American College of Occupational and Environmental Medicine (AECOM) Corporate Health Achievement Award (CHAA) Winners – 1996 - 2013

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ACOEM Winners vs. S&P 500

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HERO Study: Connecting Corporate Health and Wellness Best Practices to Superior Market Performance

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Grossmeier et al., HERO S&P Study

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HERO Study Results

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Koop Award Winners and S&P 500 Index

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Koop S&P Study

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Koop Winners: 1999-2014

BP America BP 2014 Eastman Chemical EMN 2011 Prudential Financial PRU 2011 Pfizer, Inc. PFE 2010 The Volvo Group VOLVF 2010 Alliance Data Systems Corp ADS 2009 Dow Chemical Company DOW 2008 International Business Machines IBM 2008 Pepsi Bottling Group PBG 2007 WE Energies WEC 2007 Union Pacific Railroad UNP 2005 UAW-GM GM 2004 Johnson & Johnson Services, Inc JNJ 2003 FedEx Corp. FDX 2002 Motorola Solutions Inc. MSI 2002 Citibank C 2001 Union Pacific Railroad UNP 2001 Northeast Utilities NU 2001 Caterpillar Inc. CAT 2000 Cigna Corp. CI 2000 DaimlerChrysler Corporation DDAIF 2000 Fannie Mae FNMA 2000 Aetna AET 1999 Pfizer, Inc. PFE 1999 Glaxo Wellcome GSK 1999 UNUM/ Provident UNM 1999

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HERO Scorecard Study

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Average Change in Medical Expenditures

Average Percent Change in Medical Expenditures Over Three Years for the Study Sample (Adjusted to 2012 Dollars – Not Adjusted for Confounders)

20 40 60 80 100 120 140 160 180 200

• 10.0%
• 8.0%
• 6.0%
• 4.0%
• 2.0%

0.0% 2.0% 4.0% 6.0% 8.0%

Total Hero Scorecard Score Average Percent Change in Medical Expenditures from 2009 - 2011

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Comparison of Expenditures by HERO Score, Adjusted for Confounders

Predicted Average Annual Per Member Healthcare Expenditures (Adjusted to 2012 dollars) for Organizations with High and Low HERO Scores

2009 2010 (% Change from 2009) 2011 (% Change from 2010) LOW $3,048 $3,050 $3,051 HIGH $2,948 $2,901 $2,855 $2,800 $2,850 $2,900 $2,950 $3,000 $3,050 $3,100

Adjusted Annual Cost HERO Score

(0.05%) (0.05%) (-1.6%) (-1.6%)

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Getting the Word Out on Best and Promising Practices in Workplace Health Promotion

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Case Studies – Companies That Do It “Right”

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Kent et al., JOEM Study

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Transamerica Employer Guide

https://www.transamericacenterforhealthstudies.org/health-wellness

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Harvard Business Review Translation

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Employer Playbook

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The Secret Sauce

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• 1. Culture of Health
• More than just a wellness program –

It’s a way of life

• Ingrained in every part of the
• rganization

– Business Mission – Built Environment – Performance Metrics – Programs, Policies, Health Benefits

98

• 2. Leadership Commitment
• CEO Driven
• Lead by Example
• Middle Management Support
• Budget/business plan
• Empowered workers/unions

99

• 3. Specific Goals and Expectations
• Think big, start small, act fast -- one step at a time
• Set short and long term objectives
• Be realistic about what can be achieved in 1, 3, 5, 10+ years
• Accountability – leaders and employees are accountable for doing

their part to support a culture of health

100

• 4. Strategic Communications

Relentless Surround Sound

• Messages need to be:

– Consistent – Constant – Engaging – Targeted

• Two-way dialogue using a

variety of channels

• Wellness champions

101

• 5. Employee Engagement in Program

Design/Implementation

• Wellness Committees
• Employee Feedback Surveys
• Participatory Based Program

Design

• Focus Groups

102

• 6. Best Practice Interventions
• Convenience, removing

barriers

• Many choices
• Making the healthy choice

the easy choice

• Applying behavior change

theory/practice

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• 7. Effective Screening and Triage
• Health Risk Assessments

with Follow-up -- PLUS

• Biometric Screenings

(USPSTF Guidelines)

• On-site Clinics and

Counselors

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• 8. Smart Incentives
• Tailoring, and providing alternative

paths to motivate, reward, and help employees achieve their goals

• Tiered Incentive Programs
• Non-Monetary Incentives
• Carrots, Not Sticks
• Voluntary – reasonable dollar

amounts

• Long-term view - retirement

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• 9. Effective Implementation
• Tailored to the company’s

culture

• Integrated solutions
• Flexibility
• Fresh ideas
• Fun

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• 10. Measurement and Evaluation

Modified Worksite Health Promotion (Assessment of Health Risk with Follow-Up) Logic Model adopted by the CDC Community Guide Task Force

STRUCTURE PROCESS OUTCOMES Workplace Health and Wellbeing

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This Is Hard!

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Workplace Health and Wellbeing Works – If You Do it Right!

Financial Outcomes Health Outcomes

QOL and Productivity Outcomes

Cost savings, return on investment (ROI) and net present value (NPV). Where to find savings:

• Medical costs
• Absenteeism
• Short term disability

(STD)

• Safety/Workers’ Comp
• Presenteeism
• Adherence to evidence

based medicine.

• Behavior change, risk

reduction, health improvement.

• Improved “functioning” and

productivity

• Attraction/retention –

employer of choice

• Employee engagement
• Corporate social

responsibility (CSR)

• Balanced scorecard

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Another Benefit: Engaged Workers Who Love Their Job!

Where We Need to Go…..

Old Paradigm

• Bad behavior (poor diet)…leads to
• High risk condition (obesity)…leads to
• Disease (diabetes)…leads to
• Death

New Paradigm

• Good health (physical, mental,

emotional, social, financial, spiritual)… leads to

• Well-being (energy)…leads to
• Purposeful life

AND HIGH VALUE

Learn More at….

http://www.jhsph.edu/promoting-healthy-workplaces

Thank You!

Ron Z. Goetzel, Ph.D. Senior Scientist at the Johns Hopkins Bloomberg School of Public Health Vice President at Truven Health Analytics, an IBM Company ron.goetzel@truvenhealth.com Learn about Promoting Healthy Workplaces project at: http://goo.gl/ui1rBQ Follow us on Twitter @JHU_IHPS Connect with us on LinkedIN