CHANGE STARTS WITH ME a JOURNEY TO excellence

1. CHANGE STARTS WITH MEa JOURNEY TO excellence Integris EMPLOYEE WELLNESS

2. The INTEGRIS Wellness Journey Timeline INTEGRIS Employee wellness

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

5. The INTEGRIS Wellness Journey Timeline 2014 WorkHealthy Hospital & WHH Gold Star Tobacco Free 20?? WorkHealthy Gold Medal Physical Activity 2010 Tobacco Freedom for Employees and Patients Tobacco Freedom 2011 Tobacco Freedom national recognition Leading by Example 20?? WorkHealthyCenter of Excellence 20?? WorkHealthyGold Apple Nutrition INTEGRIS Employee wellness

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

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 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 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 • 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 INTEGRIS Employee wellness

20. 2009 Strategic Wellness Planning • 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 Integris Employee wellness

21. Program Branding and Roll-Out 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 Integris Employee wellness

22. Physician Involvement • 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 Integris Employee wellness

23. 2011 Plan Year • 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 Integris Employee wellness

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 Wellness Move for Life PACER Fitness Center SurvivorFit Tools for Living with Chronic Conditions Walk Well Weight Watchers INTEGRIS Employee wellness

26. AchievingExcellence 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 • 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 Integris Employee wellness

35. Signs of Success • 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 Integris Employee wellness

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 *HERO, WELCOA, Healthy People 2020, Certified Healthy Business, Clinical Practice Guideline: Treating Tobacco Use and Dependence, update 2008 Integris Employee wellness Change starts with me