Impact of an Incentive-Based Health Promotion Program on Employee Satisfaction, Engagement at Work, and Self-Reported Health Ron Z. Goetzel, Ph.D. Research Professor, Emory University Rollins School of Public Health 141st APHA Annual Meeting Boston MA – November 2013

Presenter Disclosures Ron Goetzel The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: BMS funded the research being presented today

Project Team J. Ross Maclean, MD , Bristol-Myers Squibb, New York City, NY Teresa Gibson, PhD , Truven Health Analytics, Ann Arbor, MI Emily Ehrlich, MPH , Truven Health Analytics, Ann Arbor, MI Enid Chung Roemer, PhD , Rollins School of Public Health, Institute for Health and Productivity Studies, Emory University, Washington, DC Ginger Carls, PhD, Truven Health Analytics, Ann Arbor, MI David Shepperly, MD , Bristol-Myers Squibb, New York City, NY Study Sponsor: Bristol-Myers Squibb

Bristol-Myers Squibb Program Evolution January 2011 livinglifebetter with value-based benefit design (VBBD) launched Pre-2011 Company sponsored health and wellness programs January 2013 Two year anniversary of livinglifebetter with VBBD Claims and participant survey data available for analysis Screenings Health risk assessments Incentives for health and wellness program participation Health and wellness program enhanced with VBBD VBBD: lowered or eliminated financial barriers to high-value drugs and services for employees and dependents with diabetes and comorbid CVD

A Multi-Component Wellness and Incentive Program With Enhanced VBBD The livinglifebetter Health and Wellness Program 1 Know Your Numbers 2 Assess Your Health 3 Manage Your Health VBBD with Enhanced Diabetes/Comorbid CVD Benefit Added to For BMS employees & dependents

The livinglifebetter Health and Wellness Program 1. Biometric Screening The livinglifebetter Health and Wellness Program Employees obtain vital measures and predictors of future health at no cost: Hemoglobin A1c Blood Pressure Cholesterol At worksite for corporate employees At Quest Diagnostics labs for remote workers 1 Know Your Numbers 3 Manage Your Health 2 Assess Your Health

The livinglifebetter Health and Wellness Program 2. Health Assessment The livinglifebetter Health and Wellness Program Consumer-friendly online health-risk assessment (HRA) that enables employees and dependents to receive a personalized assessment of their health. Accessed through livinglifebetter program website Instant results reporting to users 1 Know Your Numbers 3 Manage Your Health 2 Assess Your Health

The livinglifebetter Health and Wellness Program 3. Reward Platform The livinglifebetter Health and Wellness Program Employees manage their risk by selecting activities and health behaviors appropriate to their health status Platform includes multiple tracking tools, mobile access, online health “journeys,” consultations, and employee-initiated telephonic counseling Modest cash incentives for participation 1 Know Your Numbers 3 Manage Your Health 2 Assess Your Health

+ Novel Value-Based Benefit Design VBBD Enhanced Diabetes and Comorbid CVD Benefit Value-based benefit design (VBBD) focused on diabetes and comorbid cardiovascular conditions. Employees with diabetes have $0 copays for: Prescription drugs for diabetes and related CVD conditions In-network physician visits Diabetes equipment and supplies Lab tests

SURVEY PURPOSE AND FOCUS To assess the process of how the Living Life Better campaign was implemented Focus Living Life Better Participation and Satisfaction Program Impact on Health and Employee Engagement Appeal of Incentives Future Plans for Participation

SUMMARY OF SURVEY ADMINISTRATION Year 2 Employee Survey – 22 months post- implementation of the Living Life Better Program Launched December 3, 2012 Closed December 21, 2012 Response Rate 2,259 employees randomly selected and invited to participate in the study 1,202 employees responded to the survey Response rate = 53% Locations Responses from all US locations Both corporate and field offices

RESPONDENT INFORMATION

LIVING LIFE BETTER PROGRAM PARTICIPATION More than half of respondents indicated that they had participated in the program last year (54%)

LIVING LIFE BETTER PROGRAM SATISFACTION The majority of respondents, who participated in at least one of the program elements, indicated that they were satisfied with the Living Life Better program (68%)

HEALTH IMPACT OF LIVING LIFE BETTER PROGRAM Living Life Better exerted a positive effect on workers’ physical health Half of the respondents saw a positive effect on their physical health (50%)

OVERALL IMPRESSIONS – EMPLOYEE ENGAGEMENT Most agreed with the statement: “The Living Life Better and Enhanced Benefits for Diabetes Program at BMS show that BMS cares for its employees.” (79%) “I appreciate BMS’s concern for their employee’s health and wellness.” (89%)

APPEAL OF PROGRAM INCENTIVES Direct cash payments were reported to be the most appealing incentive for participation -- 68% cited this as "very appealing”   Incentive Type Response Rate for Very Appealing 1. Direct cash payment (as a check or extra compensation) 68% 2. Reduced premiums on health insurance 66% 3. Reduced co-payments or co-insurance 63% 4. Gift cards for retail businesses (e.g., Starbucks, Target) 61% 5. Time off from work (e.g., extra hours or days of personal leave time) 55% 6. Entry tickets into a lottery for a large prize (e.g., iPad) 18% 7. Specific rewards while at work (e.g., free chair massage) 17% 8. Branded gift items (e.g., pedometer w/BMS & LivingLifeBetter logo on it) 8% Response format: 3 point scale from “not at all appealing” to “very appealing”

LIVING LIFE BETTER – PLANS FOR FUTURE PARTICIPATION Most respondents plan to participate in the Living Life Better Program next year (63%)

CONCLUSION More than half of the 2,259 randomly selected BMS employees responded to The Living Life Better Survey administered in November 2012 (53%) Participation with Living Life Better was good, 54% of respondents indicated that they had participated in the overall program Satisfaction was high, 68% were satisfied with the overall Living Life Better program, 81% with the Enhanced Benefit Living Life Better exerted a positive effect on workers’ physical health (50% agreed) Living Life Better exerted a positive effect on employee engagement, 89% of respondents indicated that the program shows that BMS cares for its employees Survey findings provide context to the quantitative program evaluation and contribute to understanding program quality, success and value-based benefit design (VBBD) impact on health and financial outcomes