Johnson & Johnson: The Promotion of Wellness

To be the world’s healthiest company is an ambitious goal. Our mission is to deliver high-quality value- added health care in a sustainable manner, so we must serve as the role model with our own employee population. How are we as a society going to pay for health care in the next 20 to 30 years? We want to be an integral part of the solution and already have a significant track record in this space.

Alex Gorsky, Chief Executive Officer

We want to make health the default because the health of the employee is inseparable from the health of the business.

— Fikry Isaac, Vice President Global Health Services, and Chief Medical Officer

Caring for Employees:
A Legacy of Health and Wellness Program

J&J began offering employees its “Live for Life” wellness program in 1979. The main goal was to cut down costs related to healthcare by focusing on reducing risks that contributed most to these costs. These include obesity, hypertension, blood glucose, inactivity, cholesterol, tobacco use, and stress (Exhibit 9). Employees voluntarily completed a health assessment questionnaire. The company set up on-site clinics to deliver occupational health services, performed medical evaluations, advise on nutrition and weight management, provide flu shots and vaccinations, and manage smoking cessation programs. J&J opened gyms on-site and created one of the first-ever programs that provide employee counseling.

 

Exhibit 9 Population Health Risks by Region 2013 – Health Profile Participants (self-reported and professionally collected data)

This laid the basis for a more inclusive health and wellness program in 1995. A task force looking into the delivery of services in the U.S. saw expensive duplica ons in the provision of Live for Life services across business units. Those services were then brought under the H&W program, and health assessments were connected to benefits plan design. H&W integrated different health aspects such as employee health/assistance, disability management and occupa onal medicine programs. More focus was brought on preven on, self-care and risk-factor reduc on. The J&J clinics also stretched their offerings and so in the year 2013, the clinics reported 48, 751 new cases and 63, 400 visits were seen. The Chairman and CEO William Weldon called for extending J&J’s global wellness programs from the U.S. to the rest of the world in 2004. In 2007, J&J were successful in implementing a worldwide tobacco-free campus policy, banning smoking and tobacco products on all grounds worldwide. By 2014, more than 98% of J&J worldwide workplaces were tobacco free. Smoking was also prohibited in company vehicles and at company-sponsored meetings. This lead to the smoking rate decrease down to 3.2%. This was known by a health risk assessment survey that the employees participated in. (See Exhibit 6.)

The State of Wellness (The Health Profile Program)

J&J conducted a Health Profile program in 2013 in which around 59% of their employees participated. This survey was annual in the United States and biannual internationally. Some locations had full participation whereas others hadn’t launched yet. However, the annual reports exposed the trends and levels of risk. In U.S., the top three risks were unhealthy eating (not eating 5 servings of fruits and vegetables per day) (55% respondents), less than 150 minutes of physical activity (21%), obesity (BMI over 30) (20.5%). In certain countries, the third most noticeable risk was tobacco use. The good thing was that over 40% of U.S. participants said that the program helped them discover a health issue while 73% people said that it helped them improve their lifestyle. Once the respondents completed the Health Profile, all na onal J&J employees with one of the follow- ing Global Popula on Health Risks were eligible for health advising through telephone. The risks include tobacco, inac vity, blood pressure, cholesterol, glucose, BMI and stress. A professional health educator answered ques ons and provided references of support and references. The Health Profile was managed by an outside vendor. J&J outperformed the vendor’s composite company standard for a lot of risks related to health. Overall, the employee risks were much be er than na onal norms for the U.S. Health risk assessments for program par cipants enabled J&J to monitor trends in employee health. J&J in turn supported local managers in organizing interven ons to address the top health risks for their loca ons. Employees par cipa ng in the U.S. Health Profile program received a $500 discount toward their health insurance premiums. If a health risk was iden fied, the employee had to par cipate in a Health Advising session to retain the $500 credit. “Outside the U.S., we adjust the incen ves according to local benefit programs and customs, but in general we offer much smaller financial incen ves,” noted Vice President of Global Total Rewards and Performance Susan Podlogar. J&J also offered, since 2009, financial incen ves to at-risk U.S. employees for par cipa on in CareConnect care management programs; these included a maternity program, a healthy weight program, and preven ve colonoscopies. Poor results and low par cipa on led J&J to suspend its healthy weight program that gave employees with BMIs of over 30 a credit toward their health plan contribu on for losing 10% of their weight in a year. The CareConnect program also helped employees manage chronic or acute condi ons, offering a customized and integrated approach that addressed each individual’s health issues. To test for the connection between corporate focus on be er health and employee ac ons, J&J, starting in 2012, included a new question in its biannual Credo survey. In 2013, 82% of respondents agreed: “My company helps me in my efforts to achieve good health and well-being.” Responses covered 98% of employees. “This enables us to see how the caring theme is playing out,” a manager explained. GHS also gathered data through J&J’s management assessment and ac on review program at manufacturing locations, which surveyed employees about health programs and hazards in the workplace.

Reaching the Unwell

Disease prevention was another focus. A significant cost saving to our health plan is keeping employees from becoming overweight.” Because obesity and poor eating habits could be associated with underly- ing stress, J&J aimed to do even more to help employees ensure their overall health—including physical, mental, and spiritual. “As you address lifestyle management, working toward keeping the well, well and reducing the consequences of unhealthy behaviors, you can achieve good gains by year three,” Isaac noted. “As a culture of health becomes the norm, this helps bring in those who at first don’t trust the process, are not motivated, or want to defer.” Disease preven on wasn’t just limited to the workplace. In the U.S., people who re red could have health benefits, telehealth coaching and also fitness centers in certain loca ons of J&J. Finally, managers felt J&J could do more to ensure the mental health of employees and counter the stigma associated with mental health problems. O en, people who had gone through crises could become the greatest champions for good mental health at work. At J&J, depression was the third most common reason for short-term disability in the U.S. a er pregnancy and musculoskeletal ailments. Overall, stress and depression were the greatest productivity drains, although this varied by region. Employee health profiles provided some risk information. For example, there was a correlation between heavy alcohol use and stress and depression. “We think it is all connected. The healthier you are physically, the be er your mental health and vice versa,” Gorsky said.

Globalizing Wellness

From 2006 to 2013, the percentage of “low risk” U.S. employees increased from 78% to 88%, with a corresponding drop in the “high risk” category. U.S. J&J employees had 41% less incidence of heart disease and 75% less incidence of high blood pressure than the national average, and they exercised more and smoked less. Table A shows global results.

In Conclusion (exhibit 10):

Since 1995, the percentage of Johnson & Johnson employees who smoke has dropped by more than two-thirds. The number who have high blood pressure or who are physically inactive also has declined—by more than half. That’s great, obviously, but should it ma er to managers? Well, it turns out that a comprehensive, strategically designed investment in employees’ social, mental, and physical health pays off. J&J’s leaders estimate that wellness programs have cumulatively saved the company $250 million on health care costs over the past decade; from 2002 to 2008, the return was $2.71 for every dollar spent.

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References: Leonard L. BerryAnn M. MirabitoWilliam B. Baun. “What’s the Hard Return on Employee Wellness Programs?” Harvard Business Review, 31 July 2014, hbr.org/2010/12/whats-the-hard-return-on-employee-wellness-programs.

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