Transcript Worksite Health Case Study: Large Employer (Kimberly

Kimberly-Clark
Tom Fariss, MD, MPH
April 1, 2014
Agenda
• Background – Global Health Services at K-C
• Medical Strategy / Health & Wellness Link
• Programs
• Problems with Wellness
• Conclusions
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About Kimberly-Clark
• History
• Business and Brands
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THEN: Formed in 1872
A Paper and Newsprint Company
Leading the world in essentials for a better life.
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NOW: Leading the World in Essentials for a Better Life
58,000 employees worldwide
$21.1 Billion in Net Sales in 2012
Well-known global brands
HUGGIES® KLEENEX® SCOTT® KOTEX®
PULL-UPS® DEPEND®
#1 or #2 position in more
than 80 countries
Nearly one-quarter of the world’s
population use our products daily
Leading the world in essentials for a better life.
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Our Businesses
Personal Care
Health Care
Leading the world in essentials for a better life.
Consumer Tissue
K-C Professional
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Global Brands
Leading the world in essentials for a better life.
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Our Culture
Values
Authentic
We continue our heritage of
honesty, integrity, and courageously
doing the right thing
Accountable
We take ownership for our
business and our future
Innovative
We are committed to new
ideas that add value
Caring
We respect each other and
care for the communities
where we live and work
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K-C People Philosophy
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K-C Health Services Mission
To build and sustain a culture of health, energy, and
vitality, providing a competitive edge for K-C and a
lifelong advantage for employees.
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Health Services Organization
Sr. VP & Chief
HR Officer
VP Comp,
Benefits, &
Health Services
Corporate Medical
Director
LAO Team
Europe Team
North America Team
Asia Pacific
MEA
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Value Proposition of Corporate Medical Dept.
• Access to experienced medical professionals when work impacts
health and health impacts work
– Personal and occupational health issues
– Crisis management, emerging health issues, pandemics
• Occupational health compliance
– Legal and regulatory requirements
– Impacts employee injuries/illnesses, company reputation
• Health promotion and wellness
– Best Place to Work, attract and retain top talent
– Employee health, performance, resilience, morale
– Competitive advantage for company
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Global Health Services Model
•Global Health Risk Appraisal
•Legal & Regulatory Health
Compliance
•General Population Risk Intervention
•Exercise Facilities/Programs
Healthy
Company
•Medical Consults/Health Advocacy
•Case Management
•Medical Surveillance
•Return-To-Work Programs
•Drug & Alcohol Testing
•Employee Assistance Program
•Injury/Illness Reporting
•Executive Health
•Maintenance of Health Records
•Travel Medicine
•Health Screening
•Acute Care/Emergency Care
Occupational
Health/Compliance
•Health Education Programs
•Global Assignee Health Mgmt
•Corporate Athlete
Business and
Policy Support
•Alcohol & Drug Policy
•Pre-Employment/Fit for Duty
•Stress Management Programs
•Health Care Cost Control
•Disability Management
•Crisis Management/Threat Assessments
•Ergonomics
•Clinical Governance of Occupational Health
Function
•Product Toxicology
•Consult to Business Units on Health-Related
Issues
•Epidemiology
•Emergency Responder Training
•Health Hazard/Risk Assessment
•Product Safety Support & New Product
Development
•Health Risk Management and Litigation
Prevention
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K-C Health Services – Neenah, WI
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K-C Health Center – Roswell, GA
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K-C Health Services - LAO
Bolivia - Employee Health
Checks
Peru
Ecuador
Costa Rica
Health Fair
Bolivia
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Medical Plan Strategy and Wellness
• Affordable Care Act Implications (Cadillac Tax, etc.)
• How to Control Medical Costs?
• What is the Role of Wellness and Health Promotion?
• Assumptions:
– Medical plan design drives costs more than any other factor
– Wellness programs have limited impact on overall costs
– Health and wellness programs are worth doing as an adjunct to
future medical plan changes
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Health Promotion & Wellness
• LiveWell Health Programs
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Health Screenings
Weight Watchers
Lose Big
Endurance Challenge
Get Up and Ride
Maintain Don’t Gain
Fox Cities Marathon
Breast Cancer Awareness Week
Blood Drives (on site)
• Fitness, Nutrition, Weight Management, Tobacco-Free Campuses
• Broad Array of Health Enhancement Tools
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Live Well Challenge 2014
• Wellness program designed to leverage group
involvement to improve individual health and
build a healthy company.
• 1st & 4th quarter health assessments
– HRA & Blood Tests
– Fitness Testing
– Health Coaching
• Three Components:
– Exercise
– Nutrition
– Sleep
• Fitbit Flex
– Goal Setting
Password: openkc
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Live Well Challenge 2014
• 2,580 out of 6,500 employees (40%)
• Top Four Personal Goals Set by Category
– Weight loss or changes in body composition = 49%
– Cardiovascular improvements = 32%
– Strength = 9%
– Flexibility = 9%
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Global
Corporate
Challenge
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GCC: K-C EMEA
• 861 employees formed 123 teams
• Over the 16 week program
– 63% reported losing weight
– 59% decreased stress
– 80% improved exercise
– 88% of employees now rate their overall health as good, very good
or excellent (vs. 64% pre-GCC)
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NBGH Award - 2012
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Problems With Wellness
1. Inadequate or Misinformed Science
2. Incentives Often Don’t Work
3. Minimal Cost Savings
4. Behavior Change is Difficult
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1.
Wellness is Not Science
• Science vs. Program Management
– “If you do this, then that will happen” - Richard Feynman
• Bad Science = Bad Advice
• Screenings – Harms May Outweigh Benefits
• Cholesterol – The Lower the Better?
• Overdiagnosis
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Wellness Checklist – Good Science?
• Drink 64 oz. Water Every Day
• Take Multivitamins, Fish Oil, etc.
• Take a Baby Aspirin Every Day
• Get a Mammogram (or PSA)
• Take Lipitor! (Shouldn’t This be in the Water Supply?)
• Have a Drink of Wine Every Night
• Get an Annual Physical (and Screening CT Scan)
• Eat a Low Fat (or Low Carb) Diet
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2. Incentives Often Don’t Work
• Carrot vs. Stick
• Intrinsic vs. Extrinsic Motivation
• Can We Pay People To Be Healthy?
• “Health Insurance” is not Insurance, it is a Payment Plan
• Most Medical Costs are Paid by “Someone Else”
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The Lancet – April 19, 2008
Can you pay people to be healthy? Emma Wilkinson; The Lancet - 19 April 2008 ( Vol. 371, Issue 9621, Pages 1325-1326 )
DOI: 10.1016/S0140-6736(08)60578-4
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3. Minimal Cost Savings
• Can Medical Costs be Controlled by Wellness Programs?
• Impact on Costs Often Unclear
• ROI Always Problematic
• Prevention May Actually Increase Medical Costs
• Wellness Claims Often Not Credible
• “Best Practices” – Do They Exist?
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4. Behavior Change is Difficult
• Entitlement Mentality Without Personal Accountability
• Prevalence of “No Risk Factor” Group is Very Low
• Obesity Trends Correlate With Growth of Wellness Industry
and Poor Dietary Advice
• Change or Die
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What Motivates People to Change?
• Role of Leadership
• Policies and Legal Mandates
• What Everybody Else is Doing
• Individual Accountability for Health (Costs)
– Bring Back the “Insurance” in Health Insurance
• Prochaska’s Stages of Change
• Intrinsic vs. Extrinsic
• Drive – 3 Elements of Motivation:
– Autonomy
– Mastery
– Purpose
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What We Believe
1. Healthy behaviors and preventable risk factors can have a
profound impact on health, performance, productivity.
2. Wellness programs are problematic, often underperform,
and current approaches may have little to no impact on
overall medical costs (but may be worthwhile for other
reasons).
3. Behavior change is difficult but can be catalyzed by many
factors within the bounds of company culture
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