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

Business SegmentsConsumer

Medical

Devices/DiagnosticsPharmaceutical

Our Credo

The Four Tenets

• Customers

• Employees

• Community

• Stockholders

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

HealthyPeople

Creating a Culture of Health

Motivation Effective Approach

Commitment

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)

Comments? Questions?

Thank You.