The HERO Think Tank is a nation wide group of employer and stakeholder (provider) members who have taken the lead to create employee health management
policy, strategy, leadership, and infrastructure.

The HERO Think Tank mission is to move EHM forward as a widely accepted and accurately measured strategy to enhance the health of employees and their dependents and thereby, moderate health care costs increases, improve work performance, and maximize well-being.

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It is recommended this e-newsletter be printed and reviewed at your leisure. ________________________________________________________________________

A Note from Bill Whitmer, CEO – HERO

This issue of the HERO Think Tank e-newsletter provides information on the global application of employee health management (EHM). This is prompted for several reasons. First, many employers are global with significant interest in employee health, work performance, and well-being at dozens of locations around the world. Second, I recently had the opportunity to deliver a Keynote presentation at the Global Forum on Corporate Health in San Paulo, Brazil. I was asked to address the status of EHM in the United States and explain how a coalition such as the Think Tank operates. This was a wonderful opportunity to personally be a part of, and experience EHM beyond the borders of the U.S. The meeting was three full days from 8:00 am – 7:00 pm each day. Several of the U.S. corporations presenting EHM information and data were IBM, General Electric, Caterpillar, and Dow Chemical Company. In addition, there were numerous presentations by Brazil based corporations, health care plans / providers, government agencies, associations, and universities. The majority of employers had over 5,000 employees, with about 20% having 25,000 or more employees. I was impressed with the organization of the meeting, along with the delivery, content, and discussions of EHM activities. However, even more impressive was that on the last day, which was Friday, about 80-85% of the participants were present and engaged when the meeting adjourned at 7:00 pm. To speculate that there is ultra-high interest in EHM in Brazil is in no way an over statement. To provide a snap-shot of two mature and successful approach to the globalization of EHM, following are over views of how Think Tank members Dow Chemical Company and Johnson & Johnson provide EHM programs and services to employees around the world and what they have learned in the process.

HERO Forum for Employee Health Management Solutions and C. Everett Koop National Health Awards - October 1-3, 2007 – InterContinental – New Orleans – Registration is brisk and limited to 225. After the HERO Think Tank members and associates register there are less than 90 registrations available to the general public. Please register early. For more information and to register, go to http://www.the-hero.org.

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Dow Chemical Global Approach to Employee Health Management

By: Gary Billotti – Global Leader, Health & Human Performance

Dow is a diversified chemical company that harnesses the power of innovation, science, and technology to constantly improve what is essential to human progress. The company offers a broad range of products and services to customers in over 175 countries. Dow is the FORTUNE 36 company and has 43,000 employees.

Dow has always provided occupational health services for all global locations, and for well over a decade has had a centrally coordinated health and human performance effort in conjunction with occupational services. The Health Services function has led the way with a global operating discipline designed to assure consistent application of fundamental health services around the globe. The implementation of services is managed through a group of Regional Health Directors which cover all locations worldwide. In addition, a core group of subject matter experts, primarily located at the corporate headquarters in Midland, Michigan, supports the regions through the development and/or identification of health promotion and educational programs, materials, and toolkits that meet their region or site-specific needs. Also, Regional Health Promotion Coordinators are located in each global Region to support implementation. A unique aspect of this structure is the accountability of the Regional Health Directors as well as the entire Health Services staff, for employee health outcomes. Essentially, year-end performance awards are partially based on the achievement of actual employee health outcomes, based on goals set independently by each region, based on their specific needs.

The adoption of a global Dow Health Strategy in 2004 has established a clear business case and insured a more coordinated approach to the delivery of a broadened scope of services. These go beyond the typical occupational health and health promotion, to include medical benefits, work life programs, employee assistance program, and government advocacy efforts. This Dow Health Strategy is a cross-functional effort that is sponsored by two executive VPs. There is also a senior level steering team and an implementation team that guide the strategy development and delivery of services include multi-function, business, and global representation. This approach insures the strategy is indeed global and is globally applicable.

The actual programs and services delivered are data driven. There are several vehicles for collecting data globally to measure progress against their primary outcome objectives of improved health, reduced health risk, reduced cost, and improved productivity (including absenteeism and presenteeism). The primary tools used include: 1) a globally standardized health assessment delivered through the occupational health groups; 2) a global health questionnaire administered in 12 languages to sites in 16 countries. This is actually a compilation of several established instruments along with a series of other “HRA type” questions to collect information about functional health, presenteeism, self-reported absenteeism, primary health condition prevalence, essential healthy lifestyle behaviors, and employee perception of whether they have a “healthy culture”; 3) a Healthy Workplace Index developed to assess the site contributions to creating a healthy environment and culture; 4) a total cost of health analysis that captures medical benefit costs along with al other health-related costs globally.

These data are collected annually and used to monitor trends to assess needs and priorities. It is reviewed with the Health Strategy Implementation team and Regional Health Directors and provided to the Health Strategy steering team.

Dow has collected extensive information and knowledge about the global application of employee health management. Following are some of the most important key learnings:

• Creation of a business case is essential to secure management commitment.
   
• Determine the total economic impact of all health related costs both direct and indirect.
   
• Establishment of a corporate strategy is essential.

• Have a long term view and commitment for the health strategy.

• Have a measurement strategy to set priorities and track outcomes.

• Create internal partnerships of related functional groups.

• Implementation strategies should include individuals, small groups, and cultural aspects.

• Efforts must align to company priorities or they will not be supported.

• Consider involvement of labor organizations in the strategy and implementation.

• Insure confidentiality of all personal health data by meeting any government requirements.

• One size does not fit all, and program/services design and implementation must be culturally sensitive.

• Develop and adhere to a clearly documented operating discipline that is supported by all applicable functions within the organization.

The Dow Chemical Company is committed to the health and well-being of employees around the world, regardless of the location. Time has proven that global investment in human capitol is a win-win situation.

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Creating a Global Culture of Health

By: Jennifer Bruno – Worldwide Director, Wellness & Health Promotion

Johnson & Johnson (J&J), the FORTUNE 32 Company, is the world’s most comprehensive and broadly based manufacturer of consumer, pharmaceutical, medical device, diagnostic, and health care products. The 230 operating J & J companies have about 116,000 employees in 57 countries around the world.

J&J has a long-standing commitment to improve and sustain the health of its workforce. The mission of Global Health Services is to optimize medical services, health, and productivity of J&J employees worldwide. A decentralized corporate structure allows for a Corporate led approach that provides overarching goals, standards and guidelines, while allowing Operating Companies to implement local solutions. Planning and programming varies by country, region, and company location, due to different health care systems, diseases, disease states, culturally specific behaviors, and accessibility to services. The principles that drive the strategy include:

Worldwide Policies
J&J launched two significant health-related worldwide policies in the past two years:

• The Worldwide Tobacco Free Workplace Policy was announced in October of 2005 to provide an optimal environment for employee health. J&J strives to set the gold standard for preventing health risks related to tobacco usage worldwide.
  
  
• In February 2005, J&J distributed its Global Workplace Policy on HIV/AIDS. The policy has several core elements, including provisions on non-discrimination, confidentiality, voluntary testing, and counseling, and addresses treatment, care, and support while focusing on the importance of prevention-based education and awareness.
  
  

A Menu of Health Service Offerings
Thirteen health services offerings have been identified as fundamental to creating, promoting, and sustaining a culture of health. J&J has set goals and metrics to drive expansion of services over the next five years. This approach allows for flexibility and culturally sensitive customization based on specific health risk, stage of readiness and the maturity of such programs within the Operating Company sites. Some examples of the Global Health Service offerings provided are: the Worldwide Policies outlined above, implementation of a Health Risk Assessment (HRA), and access to Employee Assistance Services.

Tools and Templates
Realizing the professionals who are responsible for globalizing health have varying backgrounds, J&J Corporate assists Operating Companies by developing guidelines to assist in the implementation of the menu of services. A number of tool kits, resources, and programs are standardized and available for use if appropriate and allow for customization and localization. To support planning and implementation of employee health programs and services worldwide, a Global Health Calendar was developed featuring a monthly health theme and global health observances. A monthly newsletter template, called the Healthy People News, is provided for local customization and distribution. To share global success stories, best practices, photos, events and activities, a quarterly Healthy People Update is circulated to professionals involved in Global Health Services.

Data Assessment Tools & Audits
A vital component to Global Health Services is assessment and evaluation. Implementation of the Health Profile, the J&J HRA, is one of the Global Health Service offerings supporting an organizational Culture of Health. Assessing employee health needs through the Health Profile establishes a baseline for health risks, identifies which health risks and/or concerns should have the greatest priority within the Health Promotion and Wellness program, and provides an educational opportunity for the employee to understand their health risks. J&J recently completed a successful Global Health Profile pilot in 7 Operating Companies in Europe and Asia Pacific. The pilot utilized a multi-language HRA, coordinated and implemented by in country coordinators (such as an Occupational Health, Safety, or Human Resources Professional) with corporate led training and support materials.

In conclusion, the development of global goals and metrics will help J&J create, promote and sustain a culture of health, affect the health status of the employee and subsequently, the effectiveness and productivity of the company. The availability of guidelines, tools and resources to support implementation while allowing flexibility in planning and programming to customize to each culture further assist in the deployment of services. Appropriate data tracking tools should allow J&J to benchmark progress, focus on continual improvement, and evaluate evolution towards a Global Culture of Health.

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Things You May Like to Know

Companies Shift More Medical Costs to Workers
According to kaisernetwork.org, the annual Milliman Medical Index report indicates employers are continuing to shift more health care expenses to their employees. The average total medical spending for a typical family of 4 with a PPO health plan will be $14,500 for 2007, an increase of $1,118 over 2006. On average, employers pay $ 8,900 (62% of total medical costs), and employees pay $5,591 (32%). Milliman estimates $3,171 of the employees share is in payroll deductions for premiums and $2,420 is for deductibles, co-pays, and co-insurances. Overall, the employee’s share of medical costs will increases by 11.4% in 2007, while the employer’s share will be 6.5%. Pharmacy cost trends are a two-edge sword. In 2007, overall pharmacy cost trends will decrease for the second year, mostly because of a shift to generic medications. However, in the future, expensive specialty drugs will drive costs higher.

Source: http://www.kaisernetwork.org/daily_reports/rep_index.cfm

Obese Employees File Twice as Many Workers’ Comp Claims
A new study of almost 12,000 Duke University employees found that obese workers filed nearly twice as many workers’ comp claims; had 7 times higher medical costs associated with these claims, and 13 times more lost work days due to injury / illness than non-obese employees. In addition, obese workers in high-risk jobs had the highest medical claims of all employees. Employees with a body mass index (BMI) of 30 or more were considered obese. The study found that workers with a BMI of 40 had nearly 12 workers’ comp claims per 100 workers, compared with about 6 claims per 100 workers with a normal BMI (18.5-24.9). Obese workers lost an average of almost 184 work days per 100 workers, compared with just over 14 per 100 for those with an average BMI. Obese employees had an average medical cost claim of $57,019 per 100 workers, compared with $7,503 for non-obese employees.

Source: Duke University News Release – Robert Prelot – 4/23/07

Mental Health – What Do Benefits Directors Think?
A new survey called “Interworkings: A Look at Mental Health in Today’s Workplace”, was conducted and published in the May issue of Employee Benefits News. The survey is based on responses from 515 respondents who were Human Resources – Benefits professionals representing more than 350,000 employees in almost every state and more than 50 business sectors. About 31% of the responding HR-Benefits Directors feel that mental health has far more impact on the indirect cost associated with lost productivity than does physical problems. About 14% said back problems had the greatest impact, while about 10% said substance abuse, asthma/allergies, and smoking had the greatest impact. From the standpoint of screening, the survey indicates the employers are not likely to recommend screening for mental illness. For example, more than 50% of the employers urged employees to get mammograms, blood pressure and cholesterol tests, and more than 33% recommended colonoscopies, prostate exams, and weight monitoring. By comparison, only 12% of the employers actively encouraged mental health screening.

Source: www.benefitnews.com

The Cost of Obesity – Squeezing Texas Employers
In a 2007 report from the Texas Controller of Public Accounts, it was pointed out that 64% of Texans are overweight or obese. It is estimated that obesity cost Texas employers an estimated $3.3 billion in 2005 and the future does not look good. Research indicates that 42% of fourth graders are overweight, along with 39% of eighth graders, and 36% of eleventh graders. If this prevalence of obesity continues to rise at the current rate, obesity could cost Texas businesses $15.8 billion by 2025. To help control the problem of obesity, in 2007 the Texas Legislature introduced legislation aimed at instituting physical education in public schools. In addition, nearly all school districts have removed unhealthy foods with minimal nutritional value from cafeterias and vending machines.

Source: http://www.window.state.tx.us/specialrpt/obesitycost/

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Words of Wisdom

“Obesity has roughly the same association with chronic health conditions as does twenty years of aging. This greatly exceeds the association of smoking or problem drinking with chronic health conditions.”
Roland Sturm - Senior Economist, RAND Corporation, 2002

“At least 50% of health care expenditures are lifestyle related and therefore potentially preventable.”
Dr. Eduardo Sanchez – Director, Institute for Health Policy – University of Texas

“A person who has health has a thousand wishes, a person who doesn’t, has but one.”
Anonymous

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