global culture of health a johnson & johnson model for worksite health & wellness new york...
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Global Culture of Health
A Johnson & Johnson Model for Worksite Health & Wellness
New York Business Group on HealthApril 7, 2010
Jennifer BrunoExecutive Director, Strategic Accounts
of diabetes and cardiovascular disease could be avoided if people:
Ate a healthy diet Exercised more Quit smoking
employees have behavioral health risks (e.g. stress, depression, sleep issues), leading to significantly greater productivity loss and healthcare costs
of costs in the healthcare system could have been prevented through lifestyle behavior modification
Sources: U.S. data, World Health Organization 2005, “Preventing Chronic Disease: A Vital Investment”;
CDC Report, “Chronic Disease: At a Glance 2009”; Kaiser Foundation
Almanac of Chronic Disease 2008 Edition – Partnership to Fight Chronic Disease; Presenteeism defined as lost productivity that occurs when employees come to work but perform below par due to any kind of illness
We all play an important role in preventing the healthcare crisis
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ANNUAL COST OF PRODUCTIVITY LOSS DUE TO CHRONIC DISEASES: ~$1 TRILLION
80%
70%
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Out of
Health and Productivity as a Business Strategy
High effectivenesscompanies (%)
Low effectivenesscompanies (%)
Average market premium
+11.7 - 15.8
Turnover rates 14.8 21
Companies that approach health and productivity as a business strategy experience superior human capital and achieve significantly better financial outcomes.
Watson Wyatt, 2009
Companies that approach health and productivity as a business strategy – by creating a balanced set of programs and practice and by monitoring the effectiveness of their approach- experience superior human capital and achieve significantly better financial outcomes.
High effectiveness: Health & Productivity focused companies showed an +11.7% average market premium vs. industry average; low effectiveness organizations were -15.8%
Turnover rates among the high effectiveness companies were 14.8% while low effectiveness companies reported total turnover of nearly 21%
Leading-edge employers are shifting their senior management discussions from the cost of benefits to how to create value through the investment in employee health and effectiveness.
Employers Seek Multiple Benefits in Health & Wellness
Decreased Healthcare Costs
Enhanced Productivity and Performance
Improved Employee Health
Increased Employee Engagement
OUR STORYCulture of Health
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The world’s largest & most comprehensive health care company
2009 sales of $61.9 billion More than 250 operating companies selling products throughout the world
Three worldwide business segments Consumer Medical Devices/Diagnostics Pharmaceutical
Managed by a unique form of decentralized management 115,500 employees worldwide.
New Wellness & Prevention growth platform established in 2008: Established to deliver workplace health and wellness programs and services –
HealthMedia® and Human Performance® Institute
Background
Business Value
“The health of the employee is inseparable from the health of the Corporation.”
“An important part of our Credo responsibility to our employees is providing them with resources to lead healthier lives. Good health is important to all of us. Good health is also good business.”
William C. Weldon CEO Johnson & Johnson
A Long-term Commitment to a Culture of Health
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Culture of Health Evolution
LIVE FOR LIFE®: Partnership between Benefits, Safety, Medical, Wellness and EAP
James E. Burke, J&J Chairman and CEO, set two major program goals:
Encourage employees to become “healthiest in the world”
Reduce health care costs through on-site programs and services
Established Health & Wellness Shared Service, integrating:
Employee Assistance Occupational Health Wellness & Health
Promotion Disability
Management
Global expansion of integrated services to provide:
Leadership Consultation Guidance Support
Health & Wellness key policies harmonized as part of Global HR Transformation (GHRT)
Global Health Risk Assessment Pilot
Wellness & Prevention identified as key New Business strategy
Acquisition of HealthMedia, Inc. and Human Performance Institute, Inc.
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Global Health Strategies to Drive Results
• Foster a culture of health• Integrate service delivery with a focus on prevention,
behavior modification and linkage to benefit design• Use appropriate incentives• Integrate data to support goals and metrics• Commit long term
Our Strategic Approach
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Keep well—mind and body
Keep safe
Identify and manage health and injury risks
Identify and manage/mitigate disease impact
Identify and focus medical and disease management resources
Address spectrum of needs
Use proven programs/methods
Measure outcomes/manage program investments
Setting Global Enterprise Health Goals
CRITICAL ELEMENTSCulture of Health
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5 Key Culture of Health Components
1. Leadership and Commitment
2. Enterprise Programs
3. Policies and Procedures
4. Promotion and Communication
5. Measurement and Results
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Leadership & Commitment
Public advocacy for healthy, innovative workplaces
Internal management emphasis (talking the talk and walking the walk)
Communications inside and outside
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Mental Health & Wellbeing
Mental Health & Wellbeing
Healthy LifestylePrograms
Healthy LifestylePrograms
• Access to Employee Assistance Professionals
• 24/7 Telephonic Counseling• Online Mental Health Screening • HealthMedia Digital Coaching Programs• Resiliency/Stress Management Training• Yoga and Meditation
Occupational Health & Disease Mgmt.
Occupational Health & Disease Mgmt.
Health Education & Awareness Program
Health Education & Awareness Program
• Health Profile & Biometrics• Health Profile Counseling• Digital Coaching Programs• Pedometers and Million Step Challenges• Weight Watchers and Nutritional Counseling• Tobacco Cessation Programs (PIQ)
• Onsite Occupational Health Clinics• Employee Health Centers• Medical Surveillance Compliance• Medical Case Management• Value Added Services (Phlebotomy, Pharmacy
and Physical Therapy)• CareConnect & Health Advocate
• My eHealth (Tip of the Day, Family Health Guides, Personal Trackers)
• Healthy People News• Healthy People Bulletin Boards• Global Health Observances (ie Move For
Health, World Diabetes Day, Breast Cancer Awareness, World AIDS Day)
Johnson & Johnson
Employees and Families
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Enterprise Programs
Addressing Lifestyle Factors
• Healthy People Initiative• Annual Health Profile• $500 Medical Benefit Discount• Tracking and Enterprise-Wide
Reporting• Operating Company-Level
Reporting/Accountability
• Started in U.S. in 1995 with global expansion currently underway.
• US Participation Rates 2009: 83%* *N=33,000 participating employees
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Incentives and Employee Engagement
• Employees receive $500 discount on medical plan contributions Increased Health Profile participation from 26% to 93%
• To maintain $500 discount Employees take the Health Profile annually; invited to Health Advising if they show health risk Health Advisors review results and refer employees to resources (e.g., HealthMedia® Digital
Coaching, Million Step Challenge, Disease Management)
• Financial Incentives for the HealthyPeople Medical Plan– $250 incentive for participation in Case/Disease Management– $500 incentive for participation in Maternity Program ($250 for enrollment plus $250 for
postpartum screening)– $250 Preventive Colonoscopy Incentive (2010)– $150 HealthyWeight Incentive (2010)
• Healthier consumers
• Fewer ER Visits
• Decreased inpatient
hospital stays
• Higher productivity
• Lower absenteeism
• Better controlled
health care costs
• Improved bottom lines
• Healthier consumers
• Fewer ER Visits
• Decreased inpatient
hospital stays
• Higher productivity
• Lower absenteeism
• Better controlled
health care costs
• Improved bottom lines
HealthMedia, Inc.Digital Health Coaching
• Health Risk Assessment
• Weight Management
• Smoking Cessation
• Stress Management
• Nutrition Counseling
• Insomnia
• Back Pain Prevention
• Adolescent Health
• Physical Activity
• Health Risk Assessment
• Weight Management
• Smoking Cessation
• Stress Management
• Nutrition Counseling
• Insomnia
• Back Pain Prevention
• Adolescent Health
• Physical Activity
•Chronic Illness Management Hypertension, Hyperlipidemia, etc.
•Doctor-Patient -Pharmacist Relationships
•Management of secondary symptoms: stress, fatigue, etc.
•Diabetes
•Pain Management
•Back Pain Mgmt
•Chronic Illness Management Hypertension, Hyperlipidemia, etc.
•Doctor-Patient -Pharmacist Relationships
•Management of secondary symptoms: stress, fatigue, etc.
•Diabetes
•Pain Management
•Back Pain Mgmt
• Insomnia
• Depression
• Binge Eating Disorder
• Obesity
• Alcohol and Addiction
• Insomnia
• Depression
• Binge Eating Disorder
• Obesity
• Alcohol and Addiction
DiseaseManagement
DiseaseManagement
Digital Health Coaching ProgramsDigital Health Coaching Programs
Health &WellnessHealth &Wellness
MedicationAdherenceMedicationAdherence
BehavioralHealth
BehavioralHealth
Proven science-based behavior change modelsProven science-based behavior change models
19Treats the Individual, Not the Condition
Policies & Procedures
Global harmonized policies Tobacco FreeWellness, Occupational Health, EAP HIV-AIDS And Others….
Standardized Procedures (“toolkits”) that allow for program/implementation worldwide
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Promotion & Communication
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Measurement & Results Global Health Assessment Tool
• Accessible via J&J Intranet• Reporting by all operating companies
annually (413 reported in 2009)• Reports can be queried by several
variables with the option to export to excel
• Answering “yes” to having a GCH program at the site requires more in-depth validation of program elements
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Culture of HealthMeasuring our Progress
Global Health Assessment Tool Captures metrics that support our global G&O2009: 413 locations WW reportingImmediate feedback provided to the site after tool completion (Culture of Health Scorecard)GH Leaders review results 1:1 with Franchise Leaders for follow-up/next steps
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Integrated data drives planning, enables evaluation to achieve total economic value from benefit investments
J&J Payroll & EligibilityJ&J Payroll & Eligibility
MedicalMedical
DrugDrug
Care ManagementCare Management
STD and LTDSTD and LTD
Worker’s CompensationWorker’s Compensation
Dental & VisionDental & Vision
Financial AccountingFinancial Accounting
Health & WellnessHealth & Wellness
IntegratedData
Warehouseand
Analytics
IntegratedData
Warehouseand
Analytics
Financial ManagementFinancial Management
Vendor Performance & Quality Management
Vendor Performance & Quality Management
Benefit Planning & DesignBenefit Planning & Design
Regulatory ComplianceRegulatory Compliance
Program EvaluationProgram Evaluation
Health & Productivity Management
Health & Productivity Management
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Data Integration
Improving Health Risks via Tailored Health & Wellness Offerings and an Engaged Culture of Health
High Risk (5+)
Medium Risk (3-4)
Low Risk (0-2)
OVERALL INCREASE IN LOW-RISK CATEGORY OVER TIME.
OVERALL DECREASE IN MEDIUM/HIGH-RISK CATEGORY OVER TIME.
POPULATION HEALTH RISK REDUCTION (2006 TO 2009)
2008
1.1%
13.9%
85%
1.6%
20.6%
2007
77.8%
78.1%
1.4%
2006
20.5%
2009
0.9%
12.0%
87.1%
High Risk Factor(in descending order by High Risk
Prevalence)Johnson & Johnson CDC US Data*
Unhealthy Eating(<5 Servings / Day)
60.0% 75.6%(2007)
Obesity (BMI 30.0+)
20.4% 34.1%(2003-2006)
Inactivity(<150 Moderate Minute
Equivalents)20.4% 30.5%
(2005-2006)
Hypertension(Blood Pressure 140+/90+ mmhg)
6.3% 17.9%(2003-2006)
Cholesterol(Total Cholesterol 240+ mg/dl)
5.3% 16.3%(2003-2006)
Tobacco Use(Current User of Any Tobacco)
3.9% 29.6%(2006)
Glucose(126+ Fasting)
2.5% 10.2%**(2003-2006)
Stress (Heavily or Excessively Stressed)
1.6% 3.0%***(2006)
*Based on “Health, United States, 2008” a publication by the Centers for Disease Control and Prevention and National Center for Health Statistics, except for “Unhealthy Eating” which is based off of the Behavioral Risk Factor Surveillance System (BRFSS) data from 2007.
**CDC’s definition of high glucose / diabetes = “Physician Diagnosed and Undiagnosed Diabetes”***CDC’s definition of stress = “Serious Psychological Distress”n=30,595
• Population health risks trending superior to other industries
• Per capita health care costs consistently 1%-2% below benchmarks for past 10+ years
• J&J medical plan ranked in “top quartile” of peer group benchmark
• Projected ROI from 2002 to 2008 estimated at $4 :$1 (medical expenditure and productivity.
Proven Multi-dimensional Approach Yields Sustainable Results
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In Summary
Johnson & Johnson has established a comprehensive and integrated approach to employee health management Many of these programs are scalable to small business
Success springs from a culture of health, which is built into the fabric of our business Commitment is key from the top leadership as well as strategic alignment with
the business “Carrots” can work Employee buy in is important
A culture of health is not created overnight Small, consistent steps can make a meaningful difference, and ultimately drive
lower health care costs, and while enhancing employee health, productivity, and performance
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To significantly improve the health, performance, and productivity of organizationsand their employees
Wellness & Prevention, Inc.
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PARTICIPATION & ENGAGEMENT
EFFECTIVE BEHAVIOR CHANGE
SCALABILITY
CREATE A CULTURE OF HEALTH
OUTCOMES/ MEASUREMENT
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Factors for implementing a successful program
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Healthy Enterprise ToolAssessing a Culture of Health
Customizing the solution to meet employer challenges
Large global food manufacturer
Key needs:
• Desire to create a culture of health
• Little participation and engagement in existing health and wellness programs
• Dissatisfied with disjointed approach to health &and wellness programs and looking for holistic approach
• Business performance improvement
Solution:• Comprehensive and collaborative
approach that leverages existing assets and integrates innovative technologies
• Build culture of health with focus on driving participation
Large global advertising agency
Key needs: • Protect greatest asset (their people)
through improved health and productivity• Drive higher level of energy and
performance, while preserving highly creative and fast-paced culture
• Address issues with chronic stress, burn-out, overall health
Solution:• Holistic, yet focused solutions to drive
engagement and productivity• Personalize for flexible work settings
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Unique behavioral change technologies key to holistic solution
Science-based training to manageand expand their energy for greaterhealth and performance
Benefits:• Increased engagement at
individual and organizational levels
• Cross-disciplinary scientific approach (performance psychology, exercise physiology and nutrition)
Effective and scalable digital coaching interventions that spanWellness, Behavioral Health andDisease Management
Benefits:•Increased participation & engagement through unique tailoring technology
• Highly scalable and cost-effective
• Clinical outcomes
DIGITAL COACHING ENERGY MANAGEMENT TRAINING
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Digital CoachingEngaging. Scalable. Effective.
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Thank you!
Jennifer Bruno
Executive Director, Strategic AccountsJohnson & Johnson Wellness & Prevention
Kathleen A. Devlin
Director, Employer Markets - NortheastJohnson & Johnson Health Care Systems Inc.
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