Next Generation Health Management as a Serious Business Strategy

23. Relative Value of Health to the Organization: Total Value of Health We have now quantitated Direct vs Indirect costs . Presenteeism costs represent approximately � of the pie and the vast majority Of costs to the corporation.We have now quantitated Direct vs Indirect costs . Presenteeism costs represent approximately � of the pie and the vast majority Of costs to the corporation.

30. Association of Risk Levels with Corporate Cost Measures

40. Medical and Drug Cost (Paid)*

42. Financial Services (Healthcare Spend)

50. Vision from the Senior Leadership Clear Vision within Leadership Vision Connected with Company Strategy Vision Shared with Employees Accountability and Responsibility Assigned to Operations Leadership

52. Environment Interventions (Culture) Management and Leadership of the Company and Unions Mission and Values Aligned with a Healthy and Productive Culture Policies and Procedures Aligned with Healthy and Productive Culture Vending Machines Job Design Cafeteria Flexible Working Hours Stairwells Smoking Policies Other Benefit Design

55. Health Risk Appraisals Comprehensive and Lifestyle Oriented Tested for Reliability and Validity Evidence-Based Tailored Profile returned to Individual Recommendations connected to Local Resources Counseling

59. Observed Program Attrition Rates

60. Observed Program Attrition Rates Patients with Acute/Chronic Episodes

64. Development and Consequences of Metabolic Syndrome

66. Development and Consequences of Mental Health Issues (DRAFT)

68. Population-Based Programs Population Programs Orientation Pedometers, know your numbers, no weight gain Human Resource Orientation People skills/Communications Health Communications Written materials, Online portal, etc Environmental Orientation Stairwells/Vending, Food Services, Other

69. Wellness Programming for Individuals Wellness Modules High-Risk Reduction Ergonomics Smoking cessation Weight Loss Low-Risk Maintenance Stress Management Population based Physical Activity Business Specific Modules Communications Condition Management Career development Blood pressure Cholesterol Special Promotions Diseases Other

71. Incentives Annual Incentive Benefit Options (Co-pays, Deductibles, HSA contributions, � ) Premium Reductions/Premium Plan ($600 to $2000) Throughout the Year Hats and T-Shirts Cash, debit cards ($25 to $200)

73. Measurement, Evaluation and Decision SupportKey Analytics to Drive Success Decisions Based upon Program Results Process Orientation Participation Employee Satisfaction Reduction in Health Risk or Don�t Get Worse Individual�s prioritized risk Lessen Pain and Suffering in Individuals and Families Population based prevalence (Continued)

74. Measurement, Evaluation and Decision SupportKey Analytics to Drive Success 4. Total Value of Health (Medical and Productivity) 5 . Key Analytical Reports HRA summary with benchmarks and with costs Time 1 and Time 2 Risk-Cost Reports Cluster Analyses Productivity Time-Away-From-Work Presenteeism 6. Proof of Concept (Beat Natural Flow/Bend the Trend Lines) 7. Shareholder Value

75. Scorecard Percent Participation: 80% to 95% Over a rolling three years HRA + Three Coaching sessions + Two other sessions Percent Low-Risk: 70% to 85% Percent of the eligible population Estimated Cost of Program: $400 Dollars per Eligible employee Excluding major incentive Estimated Savings: $800 Dollars per Eligible Employee

77. Committee to Assess Worksite Preventive Health Program Needs of NASA Employees The National Academies Institute of Medicine Food and Nutrition Board