Work, Health, and Productivity:
The Johnson & Johnson Story
Fikry Isaac, MD
Vice President Global Health Services and Chief Medical Officer, Wellness & Prevention Inc.
Company Overview
Global Leader in
Health Care
More than 250
Operating Companies
In 60 Countries
Selling Products in More Than
175 Countries
125,000 Employees
Worldwide
“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.”
3
Culture of Health within Johnson & Johnson - Our Journey
1886
1978
1995
2004
visionary
big goals
integration
global launch
2007
2008
Fix The Health Care Crisis One Employee at a Time
harmonization new business
2013
2015
one health
healthy future
“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 Services
Integrating Protection, Prevention & Performance
Protection
Keep people safe: Compliance,
Assurance & Quality Care
Prevention
Keep the well well and manage the
ill/injured: Innovation in Intervention
Performance
Leading in business by leading in
health: Health is a key business
imperative
6
Health Strategy- Five Pillars
Leadership &
Commitment
Enterprise
Programs
Does
management lead
by example ?
How effective is
the health
strategic plan?
Does
management
establish
organizational
health goals?
What are
participation and
retention rates?
Policy &
Procedures
Engagement &
Participation
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?
Measurements &
Outcomes
Has the
organization
achieved
company-wide
health goals?
What is the level
of accountability
for these goals?
Leadership - Top Down Goal Setting
Leadership &
Commitment
Established by senior leadership 125 years ago…until today
•
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
8
Integrated Holistic Program Delivery
Integrate service delivery with
innovative solutions that focus
on prevention, behavior
modification, and linkage to
benefit design
Enterprise
Programs
Enterprise
Programs
A Multimodality Approach
Providing tools, resources and environment support
Person to Person
• Fitness/Wellness
Professional
• Occupational Health
Nurse, Nurse
Practitioners
• Employee Assistance
Program Counselors
• Health Advisors
• Group Workshops
(Weight Watchers™ at
work and in the
community, energy
mgmt.)
Behavioral Change
Offerings
• Exercise Classes
• Health Campaigns (Lose
to Win, Pedometer Million Step Challenge,
Steps for Caring, Family
Activity Challenge, etc.)
• Energy Management
principles
• Local events and
educational seminars
Online
Culture and
• HealthMedia Move™,
Nourish™, Balance™,
Overcoming Binge Eating
• My Live for Life™ website
(Cool Tools, Resources)
• Weight Watchers™
Online
• Mental health screenings
Environmental Support
• Fitness Centers or
Exercise Reimbursement
• walking / running routes
• eatcomplete
• Energy for Performance
in Life
• Health Champions
• Communications &
Marketing
• Incentives
• Toolkits (i.e. Mental
wellbeing)
Allows a choice of value-added services that meet people where they are in their health continuum
Standardized Approach
Policy &
Procedures
• 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
Sustaining our Standards
Policy &
Procedures
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
Meeting Key
Standards
 Zero Class 1, 2, & 3A issues
 Some (up to 3) Class 3B issues
Some Gaps in
Standards
Implementation




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
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
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Engagement &
Participation
Tracking Utilization
Using electronic medical records
Q1 US and PR Utilization
• 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)
• 23,280 Individual Health
Encounters
• 357 Health Programs & Events
with 10,117 Participants
• 101,801 Fitness Center Visits
Measure Outcomes Not Effort
Measurements &
Outcomes
Global Health Assessment Tool
Program Offerings
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
% 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%
•Reports can be broken down
by region (seen here) or
•Enterprise
•Sector
•Location
2011 Worldwide Reporting- 424 locations (100%)
14
Measurements &
Outcomes
Ongoing Measurement
Occupational Health Index
• Quarterly/Annual metric used to evaluate clinical
service delivery
• Measures: Compliance, Quality, Satisfaction
and Efficiency
Compliance
Quality
Satisfaction
Efficiency
Medical Surveillance
Process
Medical Record Reviews
Stakeholder Survey
Medical 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
15
Engagement &
Participation
Measurement tools- next generation
Measurements &
Outcomes
Health and Performance Index (HaPI)
The Fulfilling
Workplace
• The index combines
health, productivity, wellbeing and culture of
health and program
sustainability measures.
• Scoring can provide a
scorecard, and
benchmark against other
companies.
• Correlations to business
value and financial
Next generation
metrics
Your Culture
of Health &
Sustainability
Your Health
& Wellbeing
Index
Score
Business Value / Financial Linkages
Global Health &
Performance
Platform
Value-based
decision making
Transforming
healthcare debate
to preventionfocused
16
Measurements &
Outcomes
Population Health Risks
(U.S. Outcomes)
 Overall reduction in
health risks over time
 Health risks lower
compared to benchmark
2011/2012 High Risk Data: J&J Lower Compared To US And comparable employers
17
Centralized Health Management - Impact
Measurements &
Outcomes
2002 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)
Healthcare Expenditures in Dollars
18
Long Term 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.”
Measurements &
Outcomes
Measurements &
Outcomes
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
J&J Study – Health Affairs, March 2011
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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