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 2 3 About Kimberly-Clark • History • Business and Brands 4 THEN: Formed in 1872 A Paper and Newsprint Company Leading the world in essentials for a better life. 5 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. 6 Our Businesses Personal Care Health Care Leading the world in essentials for a better life. Consumer Tissue K-C Professional 7 Global Brands Leading the world in essentials for a better life. 8 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 9 K-C People Philosophy 10 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. 11 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 12 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 13 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 14 K-C Health Services – Neenah, WI 15 16 K-C Health Center – Roswell, GA 17 K-C Health Services - LAO Bolivia - Employee Health Checks Peru Ecuador Costa Rica Health Fair Bolivia 18 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 19 Health Promotion & Wellness • LiveWell Health Programs – – – – – – – – – 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 20 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 21 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% 22 Global Corporate Challenge 23 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) 24 NBGH Award - 2012 25 Problems With Wellness 1. Inadequate or Misinformed Science 2. Incentives Often Don’t Work 3. Minimal Cost Savings 4. Behavior Change is Difficult 26 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 27 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 28 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” 29 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 30 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? 31 32 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 33 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 35 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 37 38