1. WE BUILD A BRIGHTER FUTURE together American Hospitals Association Annual Meeting April 29, 2013 Raymond J. Baxter, PhD Senior Vice President, Community Benefit, Research and Health Policy Journey to Excellence: The Role of Total Health

2. Page 2 Kaiser Permanentes History & Mission To provide high quality affordable healthcare and improve the health of our members and the communities we serve.

3. Page 3 Kaiser Permanentes integrated health care delivery system and commitment to preventive care empowers our members to maximize their total healthmind, body, and spirit. We stand for Total Health

4. Page 4 4 Our Aspiration

5. Page 5 5 From Health Advocates to Health Activists

6. Page 6 The Journey We Are On … 6 Total Health Assessment Walking Promotion Healthy Eating Workplace Safety Kaiser on the Job Healthy Schools WorkForce Health Health Education Employee Health Obesity Prevention Community Benefit

7. Page 7 Health and Health Outcomes are Not Equitably Distributed

8. Page 8 Environmental and Social Factors 20% Family History and Genetics 30% Personal Behaviors 40% Source: Determinants of Health and Their Contribution to Premature Death, JAMA 1993 Health is driven by multiple factors that are intricately linked – of which medical care is one component. Medical Care 10% Drivers of Health Health is About More Than Access to Care

9. Page 9 We Have to Disrupt Current Defaults

10. Page 10 Support Individuals Encourage Groups Change Communities Track Outcomes 4 Diseases, 4 Risk Factors* 4 Kaiser Permanente Actions *Aligns with World Health Organizations framework for monitoring non-communicable diseases An Integrated Approach to Diseases and Risk Factors

11. Page 11 Deploying Kaiser Permanente Assets for Total Health 1 Neighborhood / Community Society Individual / Family Home / School / Worksite Community Health Initiatives Environmental Stewardship Clinical Prevention Access to Social and Economic Supports Health Education Public Education Worksite Wellness Public Policy Research Physical and Mental Health Care Walking Promotion We Have to Deploy All Our Assets for Total Health Purchasing and Employment Practices

12. Page 12 12 Places where people spend so much of their time Big opportunities for improving physical activity and healthy food A large Kaiser Permanente membership base in both areas, allowing for greater connection with people Many Kaiser Permanente assets that can be scaled and deployed Focus on Schools and Workforce

13. Page 13 Schools: Total Health in Action Thriving Schools Promotes workforce health and student-focused initiatives like improving school lunches and increasing opportunities for physical activity. Website offers ready-to-use tools and resources at no cost. www.thrivingschools.kaiserpermanente.org

14. Page 14 Workforce Wellness: National Labor Agreement Landmark provisions Incentives to bring down healthcare costs Reward collective group achievement of lowered risk factors Goal: Achieve 5% improvement in key biometric risk indicators for coalition represented employees by the end of 2016. …a commitment to attain industry-leading reductions in smoking rates, cholesterol and blood pressure levels, and BMI averages; increase understanding of how to reduce incidence and severity of chronic disease Work on implementing the provisions of the agreement for employee health can serve as a catalyst for Workforce Wellness improvement across the entire program. http://www.lmpartnership.org/tools/2012-national-agreement-overview

15. Page 15 CLINICAL EXECUTION Reliable and effective delivery system interventions to: screen, advise, assist, refer Health and costs hinge on addressing modifiable risk factors. ONLINE ENGAGEMENT Optimal use of: online resources, health coaching, mobile apps, social media, etc ENVIRONMENTAL AND COMMUNITY STRATEGIES Support healthy choices Total health requires us to systematically identify members behavior change goals, connect members to optimal resources/supports and create optimal defaults. Behavior Change: A Total Health Perspective

16. Page 16 The Road Ahead is Challenging…But We Can Find a Way.

17. Page 17 We Have to Activate Individuals and Communities