1. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. The Business Case for Wellness Michael Richards Executive Director Gundersen Health System

2. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Tom

3. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. What is Wellness Wellness is a dynamic process of becoming aware of and making conscious choices toward a more balanced and healthy lifestyle. Tom’s story is an example of how health and well- being can improve when you successfully connect with an employee to make healthier choices that have paid off Wellness Body - Physical Mind- Intellectual Feelings- Emotional Work- Occupational Community- Environmental Spirit- Spiritual Relationships- Social

4. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Why Wellness? Health problems resulting from unhealthy lifestyle choices are costing the US economy well over $100 billion annually – Healthcare costs may use up 50% of company profits – 25% of these costs are attributed to behaviors Unhealthy workers – Require more medical care – Take more sick days – Are less productive (presenteeism)

5. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd.

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7. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Bottom Line 42 companies studied (Aflac, 2012) that have worksite wellness programming – 28% reduction in sick days – 26% reduction in healthcare costs – 30% reduction in workers comp and disability claims – Avg $5.93 to $1 savings-to-cost ratio! And… 28% workers more satisfied and loyal to employer

8. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. What is Offered? 50% of large employers offer health risk assessment – 62% provide incentives to complete – 75% employees complete 50% large employers and 13% small employers offer biometric screening – 56% offer incentive 20% reward or penalty for meeting outcomes $150 to $1,0000

9. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Wellness Programming 81% large employers and 49% small employers offer wellness programming – 38% of large companies and 15% of small companies offer financial incentive to participate 27% of these employers believe the incentive is ‘very effective’ at encouraging employees to participate – 68% of large employers and 32% small employers offer disease management programs

10. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Carrot or Stick (incentive or penalty) Review with legal counsel! 69% of employers offering wellness programs use a financial incentive (WELCOA, 2015)* – Cash or cash equivalents (i.e. gym memberships) – T-shirts, gift cards – Employee share of health plan premium, health reimbursement account contribution, adjustment to health plan cost-sharing (could be incentive or surcharge for not participating) 20% participation rate if no incentive

11. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Yes – Consult Legal Laws behind wellness programming and incentives – Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA) Nondiscrimination rules Participatory vs health contingent Limits for financial incentives or penalty for health contingent programs – GINA Cannot tie to family medical history

12. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Consult Legal Americans with Disability Act (ADA)enforced by EEOC – Workplace wellness programs –screenings and hra (medical history) must be voluntary – Financial incentive maximums include financial and in-kind value – Reasonable accommodation Equal access to all incentives for all employees

13. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Healthy Companies Connect to Healthy Communities Healthier Communities – Clean and safe neighborhoods – Clean air – Healthy food options Healthier Company – Healthier employees – A more educated, prepared workforce pool – Stronger local economy

14. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. So, where do you start? Lots of options; lots of regulation; company strategy; employee buy-in Soft start – education, bulletin board Anchor your wellness program – Screenings – Health risk assessment – Identify intervention – Brenda will be going into detail examples – Measure impact

15. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. What do we do at Gundersen? MyHealth Reward Program Health risk assessment and screening Pre-determined criteria Opportunity to achieve outcomes to meet criteria Cash payout 60-70% participation

16. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Programs to Meet Need and Interest Physical activity – Workout spaces and classes – Challenges – Walking trails – Active commute incentives and challenges – Community walks/runs Nicotine Cessation Programs Healthy eating – Weight management programs – Refrigerators and microwaves – Ice water – Healthy food options in cafeteria and vending machines/pricing incentives – 500 club and dining guide for local restaurants

17. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Programs to Meet Need and Interest Stress Management – EAP – HeartMath – DeStress – Resilience spaces/rooms Environment – Active commute incentives/challenges – Envision engagement – MVC Partnership Professional Development Education and information – Newsletters – Bathroom Banter – Enews – Designated web page – Manager information

18. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Outcomes With consistent participation, healthcare costs are declining

19. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Resources CDC WELCOA Gundersen Health System Mayo Local Y County Health Department Local Healthy Community initiative

20. Gundersen Lutheran Medical Center, Inc. | Gundersen Clinic, Ltd. Thank You Questions?