ORC Western Occupational Safety & Health GroupORC Integrated Employee Wellness Strategies Task Force
Joint Quarterly Meeting – June 15, 2006
Jennifer A. BrunoWorldwide Director Wellness & Health Promotion
Johnson & Johnson
• The World’s most comprehensive and most broadly based Health Care Company 2005 sales of $50.5 billion
• 230 operating companies in 57 countries selling products throughout the world
Three worldwide business segments• Consumer• Medical Devices/Diagnostics• Pharmaceutical
Managed by a unique form of decentralized management 116,000 employees worldwide
OUTCOMES
LowerHealth Care
Costs
ImproveProductivity
Reduce Hazardous Workplace Exposure
ImproveHealth Risk
Factors
DRIVERS
Medical Case Management
Talent and Competencies
Identification ofOccupationalHealth Risks
OrganizationalCulture of
Health
Healthy People
Management ofOccupationalHealth Risks
Healthy People, Healthy Planet, Healthy Business
Healthy Employees Workplace Safety
Health & Safety Vision
We are committed to making
Johnson & Johnson the world
leader in health
and safety by achieving healthy
lifestyles and injury-free workplaces
Global Global Integrated Integrated
HealthHealthAbsenceAbsence
ManagementManagementTravelTravelHealthHealth
Employee Employee AssistanceAssistance
Occupational Occupational HealthHealth
ExecutiveExecutiveHealthHealth
HealthHealthPromotionPromotion
Global Integrated Health Objectives• Leadership, consultation, guidance and support for the
delivery of quality employee health programs and services worldwide:• Absence & Disability Management• Employee Assistance• Wellness & Health Promotion• Occupational Health
• Proactive injury and illness preventive strategies for employees worldwide
• Delivery of consistent global health services
• Uniform health standards with local consideration
• Performance metrics for the global health community
Integrated Health Services- USAbsence & Disability
Management- Management Consultation
- Medical Case Management
- Short Term Disability (STD)
- Disability Appeal Committee
- Vocational Rehabilitation
- Return-to-Work Planning
- Medical Leave Certification
- Workers’ Comp Case Coordination
- Injury/Illness Prevention
- Workplace/Job Accommodation
Wellness & Health Promotion- Healthy People- Health Profiles - Target Risk Interventions- Health Education- Environmental/Cultural Support- Wellness Center Management - Exercise Classes/Personal Training- Fitness Assessments- Job Conditioning - Exercise Reimbursement/Travel Fitness- Integration with Benefits & Disease
Management
Employee Assistance- Management Consultation- Critical Incident Debriefing- 800 Line Crisis Assistance - Short Term Counseling and Referral - Supervisor Training - Coordination of Field Alcohol/Drug
Training- Case Management- Educational Training- Mental Health/Substance Abuse
Screening
Occupational Health- Pre-placement Assessments
- Medical Surveillance
- Emergency Treatments
- Regulatory Compliance
- Ergonomics Program
- Preventive Screening
- Drug Free Workplace
- Global Health Standards Guidelines & Policy
Deployment
- Workers’ Comp Case Management
- Return to Work Evaluation
Work, Family & Personal Life- LifeWorks Consultation Resource & Referral
-Childcare, Parenting, Adoption-Eldercare – Nursing Home Evaluation -Legal, Education, Consumerism
- LifeWorks 800# 24/7- Work/Life Seminars- Educational Materials- LifeWorks Online- NURTURE SPACE - College Coach
200 million days lost/year due to depression resulting in estimated cost of $30-40 billion
Medical cost and lost productivity attributable to obesity amounted to an estimated $99 billion annually
50% of deaths from heart disease & stroke can be avoided by reducing major risk factors: high blood pressure, high cholesterol, obesity, smoking
$92 billion in lost productivity due to smoking related illness & premature death
Severe influenza pandemic may precipitate a global recession with cost exceeding $800 billion
The Link Between Health & Productivity
Why Healthiest Workforce?
• Fulfill Credo Responsibility
• Help Employees Adapt to Rapidly Changing Business Environments
• Improve Employee Productivity
• Control Health Care Costs
Healthiest and Safest Workforce in the Most
Environmentally Responsible Corporation in the World
Achieve the Regional Healthy People Goals
Achieve the Health & Safety Goals
Achieve 80% of the Healthy Planet 2010 Goals
Healthy Employees Healthy Employees Healthy CompanyHealthy Company
Commitment• Leadership
– Public advocacy for healthy workplaces
– Internal management emphasis (talkingthe talk and walking the walk)
• Healthy Lifestyle Support– Physical fitness—fitness centers,
walking trails, pedometer initiative, exercise classes, exercise reimbursement, contests
– Healthy eating—cafeterias, vending, meeting food
• Integration of Healthy People 2005 with Benefit Design
• Global Policies – HIV/AIDS & Tobacco Free Workplaces
Commitment
• Management Communications– Communications inside and
outside the organization
– Health identified as a key element of J&J’s sustainability
– Tracking and reporting of healthand safety metrics by operatingcompany, including:
• Health Profile participation
• Performance against HealthyPeople targets
Effective Approach• Objectives
Address spectrum of needs, and invest in people/programs through strategies that can yield the biggest benefit.
Use proven programs/methods Measure outcomes/manage program investments
accordingly
High Risk/High Cost Claimants*
Chronic DiseaseDisease and Injury
RiskWell/Low Risk
• 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
Effective Approach
J&J Payroll & Eligibility
Medical
Drug
Care Management
STD and LTD
Worker’s Compensation
Dental & Vision
Financial Accounting
Health & Wellness
IntegratedData
Warehouseand
Analytics
Financial Management
Vendor Performance & Quality Management
Benefit Planning & Design
Regulatory Compliance
Program Evaluation
Health & Productivity Management
• Integrated data drives planning, enables evaluation to achieve total economic value from benefit investments
Motivation
• Alignment of Incentives• Healthy People Health Plan
• Healthy People Initiative• Clear Focus (Smoking, BP, Cholesterol, Activity)• Tracking and Enterprise-Wide Reporting• Operating Company-Level Reporting/Accountability
MotivationMarketing & Communications—Healthy People Branding
Newsletter
Biometrics Wallet Card
Web Resource Promotion
Lifestyle Program Promotion
Personal Profile Reminder
• J&J’s Better Health – Better Future tag line addresses both the personal and business motives around health improvement
Healthy People 2010
20%40%
17%21%
16%28%
12%24%
TargetBaseline
US Dept. of Health & Human Services
Healthy People 2010
Inactivity30 min of activity < 3 days/wk
CholesterolAbove 240
Blood PressureAbove 140/90
SmokingTobacco Use
Indicator
• Designed to promote health and disease prevention for all Americans by 2010.
• The program has two overarching goals:
• To increase the quality and years of healthy life
and
• To eliminate health disparities nationwide
Healthy People Strategy
20022002 20052005
Inspire & AlignInspire & Align
• Prepared Business Case
• Identified key executive as Healthy People Champion
• Created Healthy
People Task Force
• Enrolled Key Business Partners
PlanPlan
• Established Health Indicator Targets
• Developed Data Collection and Tracking System
• Launched Communications
• Standardized
Menu of Services
• Started Deployment
ExecuteExecute
• Implemented Best Practices Behavioral Interventions
• Redesigned J&J Health Benefits Plan
• Integrated HRA and Disease Management Counseling
Monitor & ImproveMonitor & Improve
• Implementing Programs to Address Inactivity
• Piloting Healthy Eating Plan
• Preparing Worldwide Next Generation Goals
• Incorporating Healthy Culture Measures in Business Processes
Health Profile• Personalized assessment of health status and lifestyle practices
• Employees invited via email to complete 15-minute online assessment every two years
• Employees consent to sharing results of their Health Profile (with HCP) in order to meet participation requirements for benefit incentive
• Immediate feedback and lifestyle resources provided
• Everyone receives Online Action Planning Guides• Higher risk employees referred for lifestyle counseling
A personalized and effective Smoking
Cessation plan
A personalized & comprehensive
Weight Management program
A personalized Stress
Management plan
A personalized Nutrition planmade simple
Lifestyle CounselingOnline, telephonic tailored programs to the needs of the individual in areas that align
with our Healthy People program focus
Healthy EatingOne billion overweight adults – 300 million of them obese
Results = increased sales, decreased subsidy and high customer satisfaction
Eat Complete
• Support employees’ efforts to reduce their risk
primarily for hypertension, high cholesterol, cancer
and obesity
• Opportunities for employees to access and enjoy
Nutritionally Dense Whole Foods at every cafeteria,
food station, vending machine, catered event, and
whenever food is served at company functions
• Piloted at 6 companies in the US
• Expansion of program by request in 2006
Physical Activity
Continue to build momentum toward a global culture that encourages and supports healthy lifestyles.
Physical Activity ProgramsKnowledge Building & Behavior Change
Pedometers – 30,000 participants globally
Million Step Challenge – 10,000 participants
Exercise Reimbursement Program – 4,600 participants
Online & Nurse Counseling – 5,000 participants
Environmental & Cultural Support
Fitness Centers/Fitness Rooms
Walking Trails
Stairwell Campaigns
Fitness Center Design & Activity Guidelines
At least 60% of global population fails to achieve 30 minutes moderate intensity physical activity daily (WHO)
Mental Health & Depression
Employee Assistance Services (EAP)
Worldwide 50% of employees have access to services 6,000 employees have received resilience training
Productivity Outcomes Study - U.S. Absence decreased in 96% of EAP clients Mental health status improved in 78% of EAP clients $4,000 savings per EAP user
Mental Health Screening Confidential self-assessment to identify individual vulnerability Referral to mental health resource if indicated by screen results Accessed by 13,000 employees
By year end 2005, 50% of employees & household members worldwide had access to Employee Assistance services. This number will increase to 70% by year end 2006.
Depression is the leading cause of disability globally, and the 4th leading health burden affecting humanity. (WHO)
Cancer Prevention
• Applies to all operating company locations, (property, buildings, leased buildings, company vehicles and company-sponsored meetings)
• Flexible guideline to comply with local, state, regional laws or collective bargaining agreements
• Operating companies manage transition to “tobacco-free” by no later than January 2007
• Partnership with Global Human Resources and Worldwide Benefits & Health
• Support materials and toolkit from Worldwide Health & Safety
80% of Operating Companies have implementation plans in place; 30% are already “Tobacco Free”
Single largest preventable cause of disease and premature death in the world
Avian Influenza The world is now closer to another influenza pandemic than at any time
since 1968, when the last of the previous centuries three pandemics began. (WHO)
Pandemic PreparednessDistributed “Guidance on Preparedness for Human Influenza Pandemic” to management
Business Continuity Planning
Developed detailed site specific BCP procedure that is pandemic phase dependent
Communication Plan
Education & Awareness Campaign
Human Resource Guidelines
BCP – Supply Chain management
Assist contacts with access to antiviral prophylaxis and treatment
Partnerships and Resources
CDC, WHO, Local Health and Government Agencies
International SOS, Business Group on Health
Continuing To Evaluate And Anticipate Needs
CareConnect
• Telephonic counseling program designed for individuals with complex or chronic medical conditions
• Individuals are matched to a registered nurse with specific expertise in their condition
Complex Medical Conditions• Cancer
• High-Risk Pregnancies
• Spinal Injuries
• Organ Transplants
Chronic Medical Conditions• Diabetes
• Asthma
• Heart Disease
• Hypertension
Healthy People Medical Plan
• Employees receive annual $500 discount on medical plan contributions
• To maintain the $500 discount, employees must:
– Complete a Health Profile every two years
– Participate in Health Profile Counseling, if identified by health risk criteria
– Participate in CareConnect, if identified by chronic or complex condition criteria
• If employee chooses not to participate in any one of the requirements, they forfeit the annual discount
Healthy Employees – U.S.Johnson & Johnson
Healthy People 2005 Progress
United States
Healthy People 2010
Indicator
Baseline
’95-’99
Target
2005
Results
2003
Results
2004
Results
2005 Baseline Target
SmokingTobacco Use
12% 9% 6% 6% 5% 24% 12%
Blood PressureAbove 140/90
14% 10% 10% 9% 10% 28% 16%
CholesterolAbove 240
19% 15% 9% 9% 8% 21% 7%
Inactivity30 min of activity < 3 days/wk 39% 20% 41% 38% 38% 40% 20%
• Healthy People Indicators provide US enterprise-wide focus and performance targets• Performance meets or exceeds all targets, except physical activity/inactivity
Healthy People U.S.Impact on Health Outcomes & Excess Cost
Health Risk Factor Risk ImprovementExcess Annual Health Care Costs
per Employee with Risk FactorEstimated Cost Avoidance
Tobacco Use 3220 $1074 $3,458,280
High Blood Pressure 1940 $979 $1,801,360
High Cholesterol 5060 $683 $3,455,980
Inactivity 460 $1068 $491,280
Total $9,206,900
Data extrapolated to J&J average population of 46,000 and J&J per capital Health Care Costs
02,0004,0006,0008,000
10,00012,00014,00016,00018,00020,000
SmokingTobacco Use
Blood Pressure Above 140/90
CholesterolAbove 240
InactivityLess than 4 days/wk
30 mins/day
# Em
ploy
ees
at R
isk
J&J 1999 Health Risk Status J&J 2005 Health Risk Status
5,5208,740
6,440
17,940
2,3004,600 3,680
17,480
17,940J&J Inactive Baseline
17,480# Inactive Current
$1068Excess Cost/Inactive
Employee
Potential Cost Avoidance $491,280
Health Risk Reduction Financial Impact: Physical Activity
MINUS
For every 1% improvement in our physical activity risk, the potential cost avoidance is almost $500M.
• In 2005, J&J’s per capita increase was 6% (National Data 9.5%)
• Since 1999, J&J’s average trend was at least 1% below the national trend, despite having a significantly richer plan
• J&J initially attributed its success to their Healthy People programs and initiatives, now being expanded to the Global Employee community
Impact on J&J Salaried Health Care Costs
Health & Financial Outcomes
Modified Risk Factors
% H
ealt
h R
isk
Ch
ang
e
For 4500 Employees identified as High Risk
Impact on Health Risks
Health & Financial Outcomes
$224.66
$118.67
$70.89
$45.17
($10.87)
($50.00) $0.00 $50.00 $100.00 $150.00 $200.00 $250.00
OVERALL SAVINGS
Inpatient Days
Mental Health Visits
Outpatient/Doctor OfficeVisits
ER Visits
Healthcare Expenditures in Dollars
Uti
liza
t io
n T
ype
Financial Impact (per employee per year)