Work, Health, and Productivity:

The Johnson & Johnson StoryFikry Isaac, MD Vice President Global Health Services and Chief Medical Officer, Wellness & Prevention Inc.

Global Leader inHealth Care

More than 250 Operating Companies

In 60 Countries

Selling Products in More Than 175 Countries

125,000 EmployeesWorldwide

Company Overview

“It’s an investment, not a cost”–Alex Gorsky, Johnson & Johnson CEO

“It's an investment, not a cost. Spending money before people get sick, to help keep them well, makes sense.”

“It starts with personal accountability for our health. I hope all our employees recognize that and take advantage of the programs we offer for them to get and stay healthy.”

“You can look at the outcomes from our Johnson & Johnson health and wellness programs for proof. In the US, where we've sponsored health and wellness programs for over 20 years, we have lower rates of tobacco use and cardiovascular disease, for example, than the workforce in general.”

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Culture of Health within Johnson & Johnson - Our Journey

Fix The Health Care Crisis One Employee at a Time

2007

harmonization

2004

global launch

1978

big goals

2015

healthy future

2008

new business

1995

integration

1886

visionary

2013

one health

“I’m talking about prevention, specifically in the workplace. …Johnson & Johnson

has been making substantial, systematic, and effective investments in prevention

for more than 30 years. We dedicate resources to prevention because, like any successful

investment we’ve made, it yields steady returns.”

Bill Weldon, Former Chief Executive Officer, Johnson & Johnson

Harvard Business Review

Benefits of a Culture of Health

Transform Employee Health from an accelerating burden to a competitive advantage

Reduce the burden of chronic disease and instill prevention & wellness behaviors in work places as well as communities

Allows for partnership with policy makers to improve labor productivity ,economic competitiveness, and ultimately reduce healthcare spending

Global Health ServicesIntegrating Protection, Prevention & Performance

ProtectionKeep people safe: Compliance, Assurance & Quality Care

PreventionKeep the well well and manage the ill/injured: Innovation in Intervention

PerformanceLeading in business by leading in health: Health is a key business imperative

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Health Strategy- Five Pillars

Does management lead by example ?

Does management establish organizational health goals?

How effective is the health strategic plan?

What are participation and retention rates?

What is the level of deployment and integration of key policies?

Have you Implemented effective communication strategies?

How can you Continue to evaluate results and end user satisfaction?

Enterprise Programs

Leadership & Commitment

Policy & Procedures

Measurements & Outcomes

Has the organization achieved company-wide health goals?

What is the level of accountability for these goals?

Engagement & Participation

Leadership - Top Down Goal Setting

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• 90% of employees have access to “culture of health” 1 programs

• 80% of employees have completed a health risk profile and know their key health indicators

• 80% of measured population health risk will be characterized as low health risk

Established by senior leadership 125 years ago…until today

Leadership & Commitment

Integrated Holistic Program DeliveryIntegrate service delivery with innovative solutions that focus on prevention, behavior modification, and linkage to benefit design

Enterprise Programs

A Multimodality ApproachProviding tools, resources and environment support

Allows a choice of value-added services that meet people where they are in their health continuum

Enterprise Programs

Standardized Approach

• Globally harmonized procedures– Tobacco-free sites– Wellness programs, occupational health

programs, employee assistance programs– HIV/AIDS– Others

• Standardized procedures (“toolkits”) that support program implementation worldwide

Policy & Procedures

Sustaining our Standards Management Action and Assessment Review System (MAARS)

•Annual self assessment of EHS programs against J&J standards (GHS included)

•Every 3 year external “joint” assessment

•Results part of Supply Chain dashboard

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Meeting Key Standards

Zero Class 1, 2, & 3A issues Some (up to 3) Class 3B issues

Some Gaps in Standards Implementation

Zero Class 1 issues Some (up to 3) minor Class 21 issues Some (up to 3) Class 3A issues Multiple (more than 3) Class 3B issues

Significant Gaps in Standards Implementation

One or more Class 1 issues One or more significant Class 2 issues Multiple (more than 3) Class 3A issues

Policy & Procedures

Tracking UtilizationUsing electronic medical recordsQ1 US and PR Utilization

•23,280 Individual Health Encounters

•357 Health Programs & Events with 10,117 Participants

•101,801 Fitness Center Visits

• 6,622 Medical Surveillance Evaluations

• 88% of Occupational Injuries & Illnesses treated “in-house” (No Workers Compensation Claim Costs)

• Case Management Metrics*:• Recordable cases avoided due to case

management: 20 (Valued at $255,780)• Restricted work day cases avoided due to

case management: 19 (Valued at $287,071)

• Lost work day cases avoided due to case management: 17 (Valued at $843,047)

Engagement & Participation

Measure Outcomes Not Effort

Accessible via Johnson & Johnson intranet

•Reporting by all operating companies annually

•In-depth validation of stated culture of health and program elements including population risk data

Reporting by all operating companies annually •Reports can be broken down by region (seen here) or•Enterprise•Sector•Location

2011 Worldwide Reporting- 424 locations (100%)

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Program Offerings % sites with FULL

programs

Region 1 Region 2

Tobacco Free Worksites 92% 97%

HIV Aids in the Workplace 58% 78%

Mental Health Services (EAP) 96% 91%

Medical Surveillance Programs 78% 81%

Physical Activity Opportunities 100% 99%

Health Profile Assessments 96% 100%

Stress Mgmt. & Resiliency 79% 85%

Cancer Awareness & Prevention 96% 95%

Health Promotion Programs 92% 98%

Healthy Eating Cafeteria 38% 63%

Travel Health Resources 71% 82%

Modified Work Programs 96% 95%

example

Measurements & Outcomes

Global Health Assessment Tool

Ongoing MeasurementOccupational Health Index

•Quarterly/Annual metric used to evaluate clinical service delivery

•Measures: Compliance, Quality, Satisfaction and Efficiency

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Compliance Quality Satisfaction Efficiency

Medical Surveillance Process

Medical Record Reviews Stakeholder SurveyMedical surveillance

Compliance

Modified Duty/Return to Work

Health Clinic Inspection Employee Survey

Record keeping

Travel health

Health Audit Management Action Plan

Closure

•Each element rated to give Green-Amber-Red and scored (3 – 2 – 1)

•Overall score calculated from the 10 elements

Measurements & Outcomes

Measurement tools- next generationHealth and Performance Index (HaPI)

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•The index combines health, productivity, well-being and culture of health and program sustainability measures.

•Scoring can provide a scorecard, and benchmark against other companies.

•Correlations to business value and financial

Business Value / Financial Linkages

Engagement & Participation

Measurements & Outcomes

Population Health Risks(U.S. Outcomes)

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2011/2012 High Risk Data: J&J Lower Compared To US And comparable employers

Overall reduction in health risks over time

Health risks lower compared to benchmark

Measurements & Outcomes

Centralized Health Management - Impact2002 Journal of Occupational & Environmental Medicine

•This study estimated the longer-term impact of the Johnson & Johnson Health & Wellness Program on medical care utilization and expenditures. Employees were followed for up to 5 years before and 4 years after Program implementation.

•Results indicated a large reduction in medical care expenditures (approximately $224.66 per employee per year) over the 4-year Program period. These benefits came from reduced inpatient use, fewer mental health visits, and fewer outpatient visits compared with the baseline period. (J Occup Environ Med. 2002;44:21–29)

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Healthcare Expenditures in Dollars

Measurements & Outcomes

External validation of program success & opportunities

“Company employees benefited from meaningful reductions in rates of obesity, high blood pressure, high cholesterol, tobacco use, physical inactivity and poor nutrition. Average annual per employee savings were $565 in 2009 dollars, producing a return on investment equal to a range of $1.88-$3.92 saved for every dollar spent on the program.”

Long Term OutcomesMeasurements

& Outcomes

J&J Study – Health Affairs, March 2011

Overall Long Term Program Impact 2002-2008 Health Outcomes and Cost

• Johnson & Johnson health risk trends significantly better than US and other industries

• Company employees benefited from meaningful reductions in rates of obesity, high blood pressure, high cholesterol, tobacco use, physical inactivity and poor nutrition.

• Johnson & Johnson’s Health & Wellness program had a projected return on investment (ROI) of $1.88-$3.92 for every $1.00 spent

• Average annual per employee savings were $565 in 2009 dollars,

• Benchmarking against similar industry shows an average rate of growth in medical and pharmaceutical costs that is 3.7% lower

• Lower increases in ER and Inpatient admissions and higher increases in doctor visits and prescription drug fills compared to other large companies

• US Medical Program ranks in top 1/3 compared against other Peer Companies

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Measurements & Outcomes

Summary

• Success springs from a culture of health, which is built into the fabric of

the business

• Senior leadership support - commit to the long-term

• Set standards, short & long term goals and measure outcomes

• Phased approaches, pilots and cultural adaptability are critical to

successful implementation

• Integrated service delivery with a focus on prevention, protection, and

performance yields positive health, wellbeing and economic results

Thank you