1. CHANGE STARTS WITH ME A JOURNEY TO EXCELLENCE

2. THE INTEGRIS WELLNESS JOURNEY TIMELINE INTEGRIS EMPLOYEE WELLNESS 1978 PACER Fitness Center 1994 Begin non- smoker credit 1998 Wellness $60 for HRA 1999 Biometric screening added 2001 Wellness Program enhanced for system 2001 Incentive expanded to $250

3. HOW WAS $250 INCENTIVE AWARDED? Incentives provided for participation: Annual Health Assessment Biometric Screenings Personal Health Journals Physical Activity Logs Food Diaries 5-a-Day Challenge Health Education Weight Management Programs Disease Management Preventive Exam Logs INTEGRIS EMPLOYEE WELLNESS

4. THE INTEGRIS WELLNESS JOURNEY TIMELINE INTEGRIS EMPLOYEE WELLNESS 2004 Tobacco Free Campuses Metro OKC 2005 WELCOA Bronze Award 2005 Begin WW@W 2006 Tobacco Free Campuses Statewide 2006 WELCOA Gold Award 2007 to Present Certified Excellent Business

5. THE INTEGRIS WELLNESS JOURNEY TIMELINE INTEGRIS EMPLOYEE WELLNESS 2014 WorkHealthy Hospital & WHH Gold Star Tobacco Free 2010 Tobacco Freedom for Employees and Patients 2011 Tobacco Freedom national recognition Leading by Example Tobacco Freedom 20?? WorkHealthy Gold Apple Nutrition 20?? WorkHealthy Gold Medal Physical Activity 20?? WorkHealthy Center of Excellence

6. The Journey INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME

7. THE JOURNEY BEGINS  The health of INTEGRIS employees and their spouses mirrored the health of Oklahomans in general  Bottom line: We needed to change.  Culture  Environment to foster healthy behaviors  Partnerships to improve health  The passion that we put into the health of our patients needed to match the passion for our own health and the health of our families INTEGRIS EMPLOYEE WELLNESS

8. CATALYST FOR CHANGE Realizing the importance of focusing on our health now, not later. Hearing studies that show a shorter life expectancy for our children. Taking ownership for our daily choices that affect our children and grandchildren, not just us as an individual. INTEGRIS EMPLOYEE WELLNESS

9. CATALYST FOR CHANGE Reduced absenteeism Health plan savings for employer and employee Better employee retention Increased productivity Healthier and happier workforce Better health = Better business INTEGRIS EMPLOYEE WELLNESS

10. SYSTEM-WIDE MOTIVATION We want to move our state from a culture of illness to a culture of wellness. INTEGRIS EMPLOYEE WELLNESS Living our mission Change Starts with ME Strives to be role model for the state

11. OUR ROLE IN COMMUNITIES Hospitals, health systems and their employees are critical to their communities because of their leadership and mission. We need to lead the way and serve as role models for healthy living and fitness throughout our communities. INTEGRIS EMPLOYEE WELLNESS

12. VISION OF WELLNESS  INTEGRIS made a commitment to improve the health of our employees  Increase participation  Greater emphasis on a culture/environment of wellness  Encourage physician and patient interaction  Increase participation in our disease management program  Inspire and reward healthy behavioral changes  Explore partnerships INTEGRIS EMPLOYEE WELLNESS

13. Successful Partnerships INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME

14. TOBACCO TOBACCO FREEDOM To obtain excellence businesses must have in effect 100% tobacco free workplace policy that applies to the entire property under their control, both indoors and outdoors. INTEGRIS EMPLOYEE WELLNESS

15. TOBACCO TOBACCO FREEDOM Greater OKC Hospital Council (2004) Executive Leadership decision to partner with Oklahoma Hospital Association (2009) TSET funded initiative (2010): Pilot for metro hospitals Policy Update: Tobacco Free Campuses includes e-cigs Process: Evidence based “best practice” Enhanced Implementation: Patients and Employees INTEGRIS EMPLOYEE WELLNESS

16. TOBACCO AND EMPLOYEES 6 months preparation: Allow employees to prepare for quit attempts Tools Available: HR / Employee Wellness Meds – 7 FDA approved E-cigarettes/Vapes: Not Recommended – Not FDA approved – Propylene glycol; glycerin; nicotine; flavors – E-juice poisonings on rise nationally and locally INTEGRIS EMPLOYEE WELLNESS

17. Challenges INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME

18. CHALLENGES THE PROGRAM FACED 2008 Participation Numbers: – HRA Participation: 2,652 – Screening Participation: 3,213 – Out of 9,500 employees (roughly 34%) Employee Engagement Low Physician Interaction Low Program was “Siloed” – Most important partnerships INTEGRIS EMPLOYEE WELLNESS

19. NEW PROGRAM DESIGN INTEGRIS EMPLOYEE WELLNESS Incentive Model shifts away from numerous small rewards Proposed Year 1 Model provided: – Large incentive for participation in HRA/Biometrics and – Additional incentive for Well Visit with PCP Incentive provided as “Preferred Pricing” Make Spouses Eligible Select vendor to provide online HRA/Communication & Education Tool

20. 2009 STRATEGIC WELLNESS PLANNING INTEGRIS EMPLOYEE WELLNESS Formed cross-functional team to evaluate past program successes, current best practices* and develop future model. Stated Goals: – Affect Behavioral Change – Increase Individual Accountability – Educate Consumer – Focus Culture on Prevention & Wellness – Reduce Cost * HERO, WELCOA, Healthy People 2020, Certified Healthy Business

21. PROGRAM BRANDING AND ROLL-OUT INTEGRIS EMPLOYEE WELLNESS Created a Culture of Wellness Opened with “Change Starts with Me” Series of videos where INTEGRIS employees, including the CEO, shared their personal wellness stories Personal Letter & Invitation from CEO Cafeteria Initiatives introduced the “e-meal” Total Rewards Fairs

22. PHYSICIAN INVOLVEMENT INTEGRIS EMPLOYEE WELLNESS Program introduced to physicians through letter from INTEGRIS CMO and two respected physicians Provide physician referral to IH Physician Physicians asked to discuss results, risks and plans on how to improve or maintain healthy behaviors Goal: To ensure our employees are on the right track and getting the support they need to make changes and/or manage chronic conditions

23. 2011 PLAN YEAR INTEGRIS EMPLOYEE WELLNESS Use Baseline to focus on Accountability Set Specific Goals – Tobacco Use – Blood Pressure – Cholesterol – BMI/Waist Circumference Incentive Aligned with Goals – Meet the Goal, or – Engaged in a Health Improvement Program to meet goal, or – Working with your physician to address risk

24. CHANGE STARTS WITH ME INTEGRIS EMPLOYEE WELLNESS

25. HEALTH IMPROVEMENT PROGRAMS Care Coordination Changing Your Weighs Tobacco Freedom Corporate Assistance Program Diabetes Education FIT Coach Maternal WellnessMove for Life PACER Fitness CenterSurvivorFit Tools for Living with Chronic Conditions Walk Well Weight Watchers INTEGRIS EMPLOYEE WELLNESS

26. Achieving Excellence INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME

27. SITUATIONAL OPPORTUNITIES Health Care Reform – Free Preventive Care required for non- grandfathered plans – Focus on Wellness and Future Incentives – Accountable Care Organization Concept Organizations Move Towards Total Health Management INTEGRIS EMPLOYEE WELLNESS

28. BUSINESS CRITERIA Preventive Health Screenings Health Education Physical Activity Tobacco Use Prevention Healthy Food Options Management Support for Health & Safety Role of Business in Community Health Wellness Policy in the Workplace Behavioral Health Options in the Workplace INTEGRIS EMPLOYEE WELLNESS

29. CERTIFIED HEALTHY RESTAURANT Recognizes restaurants who offer healthy food options Recognizes restaurants who provide healthy environments for customers 2013 INTEGRIS Baptist, Southwest and Canadian Valley INTEGRIS EMPLOYEE WELLNESS

30. CERTIFIED HEALTHY PARTNERSHIPS INTEGRIS EMPLOYEE WELLNESS

31. The Journey Continues INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME

32. FUTURE CONSIDERATIONS/IDEAS Continue to turn the dial from awareness to engagement to results Invert incentives so smaller incentive on participation and larger incentive on goals Add meeting or improving measurements as standard instead of just participation in health improvement program Strict accountability where incentive available only to those who meet goals INTEGRIS EMPLOYEE WELLNESS

33. GOALS TO LEVERAGE TECHNOLOGY Interface Wellness with INTEGRIS Personal Health Record Interface Wellness with INTEGRIS Electronic Medical Record – Logs – Biometrics – Health Risk Profile INTEGRIS EMPLOYEE WELLNESS

34. SIGNS OF SUCCESS INTEGRIS EMPLOYEE WELLNESS Higher Engagement Strategic Plan for INTEGRIS Certified Excellent Business since 2007 Breastfeeding Friendly Worksite – Gold Star E-Meal leads to Weight Loss Success Memorial Marathon Challenge – Top 3 Corporate Team

35. SIGNS OF SUCCESS INTEGRIS EMPLOYEE WELLNESS Physician Visits - Identified Diagnosis Grassroots Initiatives Health Improvement Programs = Improved Health Outcomes Reduced Health Care Claims Tobacco Program - Nationally Published 3 Times Being-Well: Journal Record Success Stories

36. KEYS TO SUCCESS Create Culture: Executive Support & Leadership Create Ownership: Involving diverse team, including finance, in program design and implementation Create Trust: Begin with awareness, move towards engagement, end with accountability Create the Environment: If you are going to set the expectations, you must provide the tools for success Create Momentum: Recognize that “Zero Trend” (not getting worse) is success & a good starting point INTEGRIS EMPLOYEE WELLNESS

37. Questions? INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME

38. References INTEGRIS EMPLOYEE WELLNESS CHANGE STARTS WITH ME *HERO, WELCOA, Healthy People 2020, Certified Healthy Business, Clinical Practice Guideline: Treating Tobacco Use and Dependence, update 2008