1. Worksite Wellness Summit May 14, 2009 Motivating Employees to a Healthier Lifestyle by Supporting a Culture of Health and Fitness at the Workplace Michael Motta, President Plus One Health Management, Inc. New York, NY

2. Founded in 1986 in NYC Total of 95 Facilities Over 1,500 Dedicated Employees Custom Corporate Wellness Centers Wellness and Nutrition Services Health Promotion and Wellness Technology Design & Development Capabilities Integrated Therapeutic Services Plus One Health Management, Inc.

3. Plus One Perspective

4. Objectives Is there economic benefit? A healthy “fitness as wellness” culture is best achieved in action (“act as if”) Change and live Creating the active environment Linking mission to values

5. 1. Pelletier, K. A review and analysis of the health care and cost-effectiveness outcome studies of comprehensive health promotion and disease prevention programs at the worksite: 1995-1998 Update American Journal of Health Promotion. 1999;13:333-345 Is There an Economic Benefit?

6. Is there an Economic Benefit? OBJECTIVE: Describe the relationship among modifiable health behaviors and short-term medical costs using a prospective study linking cross-sectional survey data that assessed modifiable risk behaviors with insurance claims. SUBJECTS: A stratified, random sample of 7983 members. Eighteen months of medical costs were analyzed. Independent variables, included self-reported health behaviors of smoking, heavy drinking, nutrition, and physical activity. RESULTS: Physical inactivity and smoking were significant predictors of higher medical costs. Each day a member did not exercise there was a 2.9% difference in cost. Compared with never smokers, current smokers had 16% higher costs. CONCLUSION: Physical inactivity and smoking were associated with higher short-term medical costs among health plan members. 2. Bland PC, An L, Foldes SS, Garrett N, Alesci NL. Modifiable health behaviors and short-term medical costs among health plan members. Am J Health Promotion. 2009 Mar-Apr;23(4):265-73.Bland PCAn LFoldes SSGarrett NAlesci NL

7. Is there an Economic Benefit? OBJECTIVE: To evaluate the effectiveness of a lifestyle intervention (LI) in reducing work loss and disability days using a one-year randomized controlled trial. SUBJECTS: health plan members (n = 147) with type 2 diabetes and obesity. Members were randomized to modest-cost (LI) or usual care (UC). RESULTS: LI reduced the risk of workdays lost by 64.3% (P <or= 0.001) compared to UC (annual accumulation: UC: 3.49 days vs LI: 0.92 days, P = 0.01). LI decreased the risk of disability days by 87.2% (P = 0.0003) compared to UC (annual accumulation: UC: 5.3 days vs LI: 0.94 days, P <or= 0.001). Similar trends were observed among the subset of people with depression. CONCLUSION: LIs reduce work loss and disability days associated with diabetes and obesity. 3. Wolf AM, Siadaty MS, Crowther JQ, Nadler JL, Wagner DL, Cavalieri SL, Elward KS, Bovbjerg VE. Impact of lifestyle intervention on lost productivity and disability: improving control with activity and nutrition. J Occup Environ Med. 2009 Feb;51(2):139-145.Wolf AMSiadaty MSCrowther JQNadler JLWagner DLCavalieri SL Elward KSBovbjerg VE

8. Is there an Economic Benefit? end of the first follow-up year yielded an average savings of at least 999 euros ($1405.96 US) due to a reduction in productivity loss participants who averaged at least two health club visits per week over 2 years incurred at least $1252 less in health care costs in year 2 than did those who visited on average less than once per week. 4. Hlobil H, Uegaki K, Staal JB, de Bruyne MC, Smid T, van Mechelen W. KLM Health Services, Postbus 7700 (SPL/AG), 1117 ZL Luchthaven, Schiphol, The Netherlands. Eur Spine J. 2007 Jul;16(7):919-24.Hlobil HUegaki KStaal JBde Bruyne MCSmid Tvan Mechelen W 5. Nguyen HQ, Ackermann RT, Maciejewski M, Berke E, Patrick M, Williams B, LoGerfo JP. Managed-Medicare health club benefit and reduced health care costs among older adults. Prev Chronic Dis. 2008 Jan;5(1):A14. Epub 2007 Dec 15.Nguyen HQAckermann RTMaciejewski MBerke EPatrick M Williams BLoGerfo JP

9. A healthy “fitness as wellness” culture is best achieved in action (“act as if”) Relate: getting the participant to believe and expect positive change Repeat: enabling environmental habits Reframe: instilling a renewed sense of purpose 6. Deutschman, A. Change or Die: The Three Keys to Change at Work and in Life. Harper Collins, New York, NY, 2007. Change and Live

10. A clinician/client relationship is formed The clinician inspires hope The clinician creates a team of experts who share the common goal: get the client healthy The foundations of hope –Smart start (in the box) –HRA (outside the box) Relate

12. For physical activity and wellness this is the most important key to change A “Do” function Create active connections –The personal trainer example (in the box) –The Team walking example (outside the box) Repeat

13. Put it in the client’s dialect Program for success Feel the joy Help the client look forward –“Hey Jane” customer service (in the box) –Desk stop outreach (outside the box) Reframe

14. Regardless of where: culture is key Culture = the beliefs and behaviors characteristic of a particular group Culture is a collaboration between the client(s) and the clinician The Team Effort Assumptions

15. Who you are - beliefs Interview compatibility On-boarding Communication “Make yourself a nice place to work” –Make –Nice –Work The Active Mission

16. How you act - behaviors Simplify Recognize Reward: Professional of the Month “Radiate positive energy” –Community outreach –Game face –Overcoming adversity Values

17. Mike Motta President Plus One Health Management, Inc. 75 Maiden Lane Suite 801 New York, NY 10038 (646) 312-6200 mike.motta@plusone.com www.plusone.com mike.motta@plusone.com Thanks