Case Study J&J
J&J (Johnson & Johnson) has created a global health & wellness legacy creating comprehensive, holistic onsite wellness programs since 1979. J&J has 115,500 employees living throughout the world, and approximately 40,000 in the United States.
- Encourage J&J employees to become the healthiest in the world through education and easy access to health promotion programs.
- Implement on-site programs and services to increase employee engagement and productivity while reducing the cost of health care for the corporation.
- To optimize medical services, health and productivity of J&J employees worldwide.
- To provide leadership, consultation, guidance and support for the delivery of quality integrated health programs and services worldwide.
- In the U.S. and Puerto Rico, J&J operates a comprehensive, multicomponent, holistic onsite wellness program that combines health coaching and prevention, occupational health, and mental health services.
- Health and Wellness is fully integrated within the organization's culture and operations.
- J&J restructured its U.S. wellness program into one that focuses on the shared services concept — integrating employee health, wellness, disability management, employee assistance and occupational medicine programs.
- The programs are overseen by a centralized department and includes a core set of services offered at each of the company's 200+ business units, with additional services provided as needed based on site- specific and employee needs.
- Under the program, participants receive a financial incentive to complete a health risk assessment and depending on their risks, meet one or more times with a health adviser to develop a specific, customized plan for reducing identified risks.
- The program has achieved very high participation rates, significantly reduced risk factors (such as physical inactivity, smoking, and high blood pressure and cholesterol), and led to lower overall corporate health care spending, less absenteeism, and a positive return on investment.
- Outside the US and Puerto Rico, health and wellness centers are decentralized- managed by individual business locations. However, the corporate Global Health Services group continues to function as a consultative body for core services and provides direct management of all worldwide employee assistance programs (EAP) and contracts (with EAP access to > 80% of all J&J employees).
Multiple programs, many opportunities for success: “Global Health Services Wellness & Health Promotion”.
Continual Analysis and Insights of Workplace Wellness
- Link between lifestyle-related risk factors and costs, presenteeism, absenteeism: employees with many health risk factors tend to use more health care resources, miss more days of work, and perform at less- than-optimal levels of efficiency and productivity.
- Unrealized potential of worksite wellness and health promotion: Well-constructed worksite health and wellness programs can be effective in reducing risk factors among employees and dependents.
Innovative Activity to Address Problems
- Financial incentive to complete health risk assessment and health advising process: employees who agree to complete a voluntary assessment that includes biometric screening and to receive follow up coaching qualify for a $500 medical benefit plan credit.
- Ongoing advice, plan of action: in the US, qualifying employees are offered a telephonic health adviser counseling once annually. discussing their health profile results and providing them information on resources available to assist with their health needs. Employees also have the opportunity to access other health professionals through on site , in-person meetings ( where available), telephonically, and/or via email at most of their facilities. Based on these conversations, individual's health needs are addressed and action plans are developed to optimize their health and wellbeing.
- Broad menu of integrated services and support, customized by site: to help employees execute their plans of action, each business unit offers a broad menu of integrated services and support, including wellness, health promotion and prevention, occupational health, and mental health services. With support and oversight from corporate Global Health Services staff, each site offers a core set of services along with additional services based on the specific needs of the employee population and the unique culture of the specific site.
- Core offerings for all employees: each J&J site offers a wide array of core services.
- Integrated professional team support: employees have access to an EAP professional, a wellness professional, occupational health professional, and round-the-clock mental health/well-being counseling. These professionals work together as a Global Health Services team to provide ongoing counseling, advice, referrals, and other support tailored to the individual's needs.
- Robust education, awareness, coaching activities: employees can tap into a variety of sources of knowledge and advice on wellness, health promotion, chronic disease management, and the like. Offerings include both unique individualized online and onsite programs.
- Fitness centers: most J&J sites have a staffed, onsite fitness facility or exercise room. If an employee lives or works more than 10 miles from a J&J fitness center, they can apply for reimbursement of the costs of joining an external fitness center or purchasing approved exercise equipment.
- Onsite biometrics: sites typically offer onsite, instant biometric screenings, including measurement of height, weight, body mass index, blood glucose, and cholesterol.
- Resilience and stress management training: sites typically offer training and support related to managing stress and increasing resilience.
- Nutritional support: sites support employees in eating more healthfully by subsidizing the cost of healthy foods in company cafeterias (so that they cost no more than unhealthy choices). J&J developed the eatcomplete program, which provides employee cafeterias with guidelines for serving high-density nutritional food. Vending machines are audited to make sure they follow program guidelines as well. In addition, employees have access to individual nutritional information and recipes to be used at home.
- Smoke-free campuses: all J&J facilities worldwide ban any use of tobacco products. 12. Ongoing risk/disease management: individuals found to be at high risk during the health risk assessment receive a referral to the CareConnect program (US), which provides ongoing support in managing identified risks and chronic diseases/complex conditions. (Referred individuals must actively participate in this program to qualify for the risk assessment incentive.) CareConnect is designed to encourage eligible individuals with complex or chronic health conditions to participate with a nurse health coach.
- Post event management: anyone who experiences a major health event, such as a hospitalization or emergency department visit, receives additional support.
- Optional, site-specific services: individual sites may offer additional services based on the needs of employees and the culture in place within the site. This includes limited primary care services such as wellness exams, episodic (acute) care and treatment, on-site physical therapy and massage services and pharmacy concierge services.
The US program has achieved very high participation rates, significantly reduced risk factors and led to lower overall corporate health care spending, less absenteeism, and a positive return on investment.
High participation rates: after the introduction of the $500 financial incentive in 1993, participation rates in the program reached roughly 90 percent. Participation rates have remained between 80 and 85 percent since that time, well above the levels achieved in the typical corporate wellness program.
Significant reductions in risk factors: the percentage of J&J employees who exhibit key risk factors has declined significantly between the 1995–1999 time period and 2007–2009, including reductions in the percentage of employees who:
- are sedentary (from 39 to 20.4%),
- smoke (12 percent to 3.9 %), and
- have high blood pressure (14 to 6.3 %)
- or high cholesterol (19 to 5.3%).
In addition from 2006-2009:
- the percentage of employees at “low risk” increased from 78.1 percent to 87.1%
- the percentage at moderate risk fell from 20.5% to 12%, and
- the percentage at high risk fell from 1.4% to 0.9%
- Each of the 2007–2009 figures is well below the average for the entire U.S. population.
Lower health care spending, positive return on investment: a 2002 published analysis of the program's impact on long-term trends in utilization, costs, and behavior change suggest that:
the program has saved approximately $400 per employee per year (in 2007 dollars).
- High-risk intervention programs have saved an estimated $390 per participant per year (as compared with those not participating in these programs).
- Yields an estimated $890,000 per year in savings to the company.
- A separate analysis conducted in 2009 found that the program has achieved a positive return on investment, with combined data showing an overall return on investment of ∼3 to 1. 4.Less absenteeism: The program has reduced absenteeism for 96 percent of employees who use EAP.
Ronald J. Ozminkowski, PhD, Davina Ling, PhD, Ron Z. Goetzel, PhD, Jennifer A. Bruno, B.S., Kathleen
R. Rutter, B.A., Fikry Isaac, MD, MPH, Sara Wang, PhD: Long-Term Impact of Johnson & Johnson’s Health & Wellness Program on Health Care Utilization and Expenditures. JOEM • Volume 44, Number 1, January 2002
Isaac, F.W. (2010). A Legacy of Health and Wellness. Benefits & Compensation Digest, Volume 47, (8), I, 11-17.