Looking for a healthier investment strategy? A new study by The Health Project (THP) finds that a portfolio of stock in companies that have won the prestigious C. Everett Koop National Health Award -- recognizing effective workplace health promotion programs -- has significantly outperformed the Standard & Poor's (S&P) 500 Index over the past 14 years. Since 2000, investing in Koop Award winners would have produced more than double the returns of the S&P 500, according to the new research led by THP President and CEO Dr. Ron Goetzel. Tune in to this webinar to hear more about this and related studies.

1. Is There a Link Between Stock Market Price and Having a
Great Workplace Health Promotion (Wellness) Program?
Ron Z. Goetzel Ph.D. , Johns Hopkins University - Truven Health Analytics
Health Promotion Live Webinar – February 25, 2016

2. AGENDA
• Revisiting the Controversy: Do Workplace Wellness
Programs Work?
• Wall Street Studies
• Best and Promising Practices
• Q&A

3. Do Health Promotion Programs Work?
3

4. The Confusion

5. The Latest from Sharon Begley

6. What Do We Mean When We Say:
A Wellness Program Works?
• “Make workers aware of their health and how it
improves quality of 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.”
6

7. 7

8. What Do We Mean When We Say:
A Wellness Program Works? (con’t)
“Produce a positive return on investment (ROI)?”
8

9. 9

10. Baxter et al., Review
AJHP, July/August 2014.

11. Baxter et al. Literature Review
• Fifty-one studies (61 intervention arms) published between 1984 and
2012 included 261,901 participants and 122,242 controls from nine
industry types across 12 countries.
• Overall weighted ROI was 1.38 : 1.00, which indicated a 138% return
on investment.
• When accounting for methodological quality, an inverse relationship
to ROI was found.
• Randomized control trials (RCTs) (n = 12) exhibited negative ROI,
−0.22 ± 2.41(−.27 to −.16).
• Conclusion. Overall, mean weighted ROI in workplace health
promotion demonstrated a positive ROI.

12. RCT Studies Intervention
Period
Sample Size
Intervention
Type
Vaccine Interventions

13. Quasi-Experimental and Modeling Studies
Johnson & Johnson Study

14. Johnson & Johnson – “Low Quality Study”

15. Dell Inc. Research – AJHP, Jan/Feb 2015

16. ROI Analysis – 2.48:1.00

17. Duke University Study

18. ROI Estimate: 2.53:1.00

19. Michael O’Donnell Analysis of Baxter et al.
ROI Review
–AJHP, Jan/Feb 2015, 29:3, v-viii

20. ©2008ThomsonReuters
Goetzel’s New Rule: An ROI of 1:1 is good
enough…

21. ©2008ThomsonReuters
…if you can demonstrate health improvement!

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

23. It all started with Ray Fabius’ 2013 study

24. AECOM CHAA Winners – 1996 - 2013

25. ACOEM Winners vs. S&P 500

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

27. HERO Scorecard Study

28. Average Change In Medical Expenditures
28
Average Percent Change in Medical Expenditures Over Three Years for the Study
Sample (Adjusted to 2012 Dollars – Not Adjusted for Confounders)
0
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%
TotalHeroScorecardScore
Average Percent Change in Medical Expenditures from 2009 - 2011

29. 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
AdjustedAnnualCost
HERO Score
(0.05%) (0.05%)
(-1.6%) (-1.6%)

30. Grossmeier et al., HERO S&P Study

31. HERO Study Results

32. Fabius et al. ACOEM II Study

33. High Health Promotion Scores vs. S&P 500

34. High Safety Scores vs. S&P 500

35. High Health and Safety Scores vs. S&P 500

36. Koop Award Winners and S&P 500 Index

37. 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

38. Goetzel et al., Koop S&P Study

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

41. Best/Promising Practice Dissemination
• Robert Wood Johnson Foundation – Promoting Healthy
Workplaces
• Transamerica Center for Health Studies – Employer
Guide to Workplace Health Promotion
• American Heart Association -- Developing a Culture of
Health “Playbook”
• Centers for Disease Control and Prevention – Workplace
Health Research Network
• Centers for Disease Control and Prevention – Workplace
Health Promotion Resource Center (coming soon)

44. Kent et al. JOEM Study

45. Transamerica Center for Health Studies

46. American Heart Association

50. ©2008ThomsonReuters
The Secret Sauce

51. 1. Culture of Health
• More than just a wellness
program – It’s a way of life
• Ingrained in every part of
the organization
• Business Mission
• Built Environment
• Performance Metrics
• Programs, Policies,
Health Benefits

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

53. 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

54. 4. Strategic Communications
• Messages need to be:
• Consistent
• Constant
• Engaging
• Targeted
• Two-way dialogue using a
variety of channels
• Wellness champions
Relentless Surround Sound

55. 5. Employee Engagement in Program
Design/Implementation
• Wellness
Committees
• Employee Feedback
Surveys
• Participatory Based
Program Design
• Focus Groups

56. 6. Best Practice Interventions
• Convenience, removing
barriers
• Many choices
• Making the healthy choice
the easy choice
• Applying behavior change
theory/practice

57. 7. Effective Screening and Triage
• Health Risk Assessments
with Follow-up -- PLUS
• Biometric Screenings
(USPSTF Guidelines)
• On-site Clinics and
Counselors

58. 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

59. 9. Effective Implementation
• Tailored to the company’s culture
• Integrated solutions
• Flexibility
• Fresh ideas
• Fun

60.  Structure:
 Process:
 Outcomes:
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
HEALTH, SAFETY, AND
PRODUCTIVITY MANAGEMENT
Employees

61. This Is Hard!

62. Workplace Health Promotion (Wellness) 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

63. Another Benefit:
Engaged Workers Who Love Their job!

64. Learn More at….
http://www.jhsph.edu/promoting-healthy-workplaces