BUSINESS CASE FOR JOURNEY TO WELL-BEING June 16, 2014 © 2014 MVP Health Care, Inc.

©2013 MVP Health Care, Inc. 2 CONTENTS Key definitions & MVP’s definition of well-being through Journey to Well-Being The need for wellness in the workplace Economic rationale for worksite wellness Journey to Well-Being Mission, Vision and Objectives Conclusion and message to Managers Note to readers: Notes sections for selected slides provide more information about that topic

©2013 MVP Health Care, Inc. 3 Wellness: “An intentional choice of a lifestyle characterized by personal responsibility, moderation, and maximum personal enhancement of physical, mental, emotional and spiritual health.” Worksite Wellness Program: “An organized program in the worksite that is intended to assist employees and their family members (and/or retirees) in making voluntary behavior changes which reduce their health and injury risks, improve their health consumer skills and enhance their individual productivity and well-being.”

…….almost two thirds of the growth in national health spending over the past 20 years can be attributed to Americans’ worsening lifestyle habits and, in particular, the epidemic rise in obesity rates.” Source: Goetzel, R.Z., Pickens, G.T., Kowlessar, N.M., The Workforce Wellness Index: A Method for Valuing U.S. Workers’ Health, J Occup Environ Med, Feb 2013, 55(2):1-8. © Chapman Institute. All rights reserved. 4

MOST OF US ARE CONNECTED TO A WORKSITE 82% of U.S. population has employer connection Source: The National Data Book, © Chapman Institute. All rights reserved. 5

Relationship of Risk Factors to Medical Conditions Source: Bolnick, H., Millard, F., and Dugas, J., Medical Care Savings from Workplace Wellness Programs, JOEM 2012, Jan, 55(1): 4-9. © Chapman Institute. All rights reserved. 6

7 7 WELLNESS IN THE WORKPLACE: THE NEED IS CLEAR Nationally increasing health care costs, without meaningful improvements in health Most health care spending is related to existing chronic disease, not to promoting prevention A significant amount of disease-related costs are directly related to modifiable health risk factors High-risk individuals cost more; improvements in a member’s risk profile reduce health-related costs Health promotion and disease prevention programs provide significant return on investment Journey to Well-Being can support MVP by empowering coworkers to be healthy and productively engaged at work

EVIDENCE SUPPORTED COST SAVINGS ©2014 MVP Health Care, Inc. 8 Many studies have been done over the years to prove the growing need for effective population health management wellness programming in the workplace The following studies provide a better understanding of health risks and how they effect medical costs, workers compensation and sick leave use Note to readers: The following slides contain notes section to elaborate on each study

Source: Goetzel RZ, et. al. (1998, October). The relationship between modifiable health risks and health care expenditures: An analysis of the multi-employer HERO health risk and cost database. JOEM, 40(10): Percent Higher Annual Health Plan Costs Health Risks Increase Health Costs (Original HERO Study) N = 46,000+ X 3 yrs © Chapman Institute. All rights reserved.

Source: Serxner, S., et al., (2001). The impact of behavioral health risks on worker absenteeism. JOEM, 43(4), Percent Higher Absenteeism Health Risks Increase Sick Leave Use (Early Study) N = 35,451 X 1 yr © Chapman Institute. All rights reserved.

Source: Musich, S., et. al., (2001, June). The Association of Health Risks with Workers’ Compensation Costs, JOEM,, p Percent Higher Annual WC Costs Health Risks Increase Workers’ Comp Cost (Early Study) N = 3,388 X 4 yrs © Chapman Institute. All rights reserved.

Source: Yen, Louis, et al., (2004, Sept/Oct). Associations between health risk appraisal scores and employee medical claims costs in a manufacturing co., AJHP, 11(1), p Multiple Health Risks Multiply Cost (Early Study) Multiples of annual healthcare costs compared to someone with no health risks Number of Risks Multiples N = 1,838 © Chapman Institute. All rights reserved.

Source: Proof Positive: An Analysis of the Cost-Effectiveness of Worksite Wellness, Chapman Institute, Seventh Edition, SUMMARY OF COST/BENEFIT RESULTS Bank of America Blue Shield of CA Duke University Citibank City of Birmingham Coors DuPont General Foods General Motors GlaxoSmithKline Indiana BCBS Johnson & Johnson Life Assurance Nortel Prudential Travelers Union Pacific Washoe County Traditional Newer Programs Outliers C/B Ratio Study Number © Chapman Institute. All rights reserved. 13

ECONOMIC RATIONALE FOR WORKSITE WELLNESS Source: Goetzel, JOEM, (2004) data adjusted to 2010 by Mercer Employer Survey Results and by Collins Presenteeism study (2005) of Dow Chemical that was used for determining the Presenteeism cost. Total = $28,541* © Chapman Institute. All rights reserved. * = 2010 Dollars 14

15 Relationship Between Health Status and Health Cost Goals Objectives Programs / Tools Keep Low Risk Reduce Risk Manage Disease / Illness / Injury - Prevention & Wellness - Demand Management - Health Advocacy - Decision Support - Identify Health Risks - Behavior Change Info & support leading to improved mgmt of diseases & conditions - Work Well, Live Well - Medical Self-Care - Online Health & Wellness Classes - Personal Lifestyle Coaching by phone - WellStyle Rewards - Case Mgmt - Disease Mgmt - Utilization mgmt For All Journey to Well-Being / 24/7 Nurse Advice Line / ChooseHealthy TM Discounts / Online Tools Benefit Design / Transparency / Personal Health Record (PHR) WORKSITE WELLNESS PROGRAM GOALS

©2013 MVP Health Care, Inc. 16 JOURNEY TO WELL-BEING DIRECTIONAL STRATEGIES Mission (what is our purpose, why do we exist?) Vision (what do we hope to achieve in the future and how to we hope to be perceived?) MVP Health Care Corporate M/V Improving health. Providing peace of mind. MVP Health Care ®, through collaboration and innovation, will create the healthiest communities in the United States. Journey to Well- Being M/V Statements Creating solutions and a supportive environment to engage and educate coworkers to improve and maintain optimal well- being. MVP, along its Journey to Well-Being, will empower coworkers to be the healthiest workforce in the United States.

©2013 MVP Health Care, Inc. 17 JOURNEY TO WELL-BEING 2014 OBJECTIVES Journey to Well-Being Program Goals/ Objectives Data RequiredData Source 1. Reduce financial-related stress by improving coworker money management skills. Pre/post financial well-being program survey data measures (TBD). Financial program pre/post surveys. 2. Increase by 10% coworkers who feel as though the work environment makes it easy to make healthy dietary choices by instituting 2 wellness-related policy changes in % coworkers agree or strongly agree work environment makes it easy to make healthy dietary choices. Policy implementation data, action taken or not. Annual well-being survey Quarterly program report 3. Reduce coworker obesity and increase % of coworkers with BMI/Coaching premium discount by 1% per year. % Coworkers with BMI/Coaching Premium DiscountBenefit enrollment data 4. Improve overall mental well-being among coworkers and improve their overall home, health and work stress levels by 0.1 (on a 10-point scale) each year. Ave. Rate of Home Stress, 1-10 scale, 10=highest Ave. Rate of Health Stress 1-10 scale, 10=highest Ave. Rate of Work Stress 1-10 scale, 10=highest Aggregate PHA report 5. Increase management support/encouragement of well-being programs and culture by 2% each year. % Coworkers who agree/strongly agree management is committed to the health and wellness of its employees. Annual well-being survey 6. Increase ability to evaluate the results/outcomes of the well-being program across the entire population by developing an effective evaluation plan and reporting processes. Evaluation plan completion and approval. Report compilation and review. Program work plan 7. Increase awareness of the resources available to coworkers to help them maintain a healthy lifestyle. % Employees agree or strongly agree that they are taught skills needed to achieve a healthy lifestyle. Incorporate new question into annual survey, ie. “How confident are you that you understand the resources available to you to help you maintain a healthy lifestyle.” Annual well-being survey 8. Ensure equity of well-being program initiatives in all work areas. # long-term programs implemented in each office. # well-being activities implemented in each office. # well-being resources/tools in each office. Access to/presence of well-being solutions in all offices (i.e. gym) Program work plan

©2013 MVP Health Care, Inc. 18 CONCLUSION As a manager, it is important to support MVP initiatives. Now, more than ever, Journey to Well-Being can help coworkers become healthier and more productive. It is up to the manager, and the tone the manager sets in their department, to give permission to their team to participate in Journey to Well-Being initiatives such as fitness classes, health challenges, etc. Management can also do their part by becoming aware of the health and wellness offerings available through MVP such as WellStyle Extras, Telephonic Health Coaching, Care Advantage, Good Measures, and more. With your help, we can become the healthiest workforce in the United States!

©2013 MVP Health Care, Inc. 19 Questions/Comments? Clinical Account Manager, dedicated to the coworkers of MVP Health Care: Jana Wolff,