The importance of workforce health in small business Presentation objectives: The business case for workforce health Why workforce health is especially important for small businesses Tools and resources available to help create a culture of health at work (built into coverage and worksite support) The importance of workforce health in small business

Alarming trends in chronic conditions Nearly half of Americans suffer from one chronic condition1 25% of Americans have two or more2 Chronic conditions account for 86% of health care costs3 Chronic conditions such as heart disease, high blood pressure, and diabetes have long been cost drivers in the health care industry — but the numbers are growing. Nearly half of Americans suffer from one chronic condition, and 25 percent have two or more. Because chronic conditions require complex care, they’re among the most expensive health problems in the country — accounting for 86 percent of health care costs. There are several factors contributing to the increase in chronic condition rates, from higher levels of inactivity to a boom in the aging population. But one of the fastest growing is obesity, which is the root cause of 60 chronic conditions. Twenty years ago, no state had an obesity rate above 15 percent.*   ________________________________________________ * “Obesity Facts & Resources,” Campaign to End Obesity, obesitycampaign.org/obesity_facts.asp, accessed April 30, 2015. 1 CDC, cdc.gov/chronicdisease/overview/, accessed April 30, 2015. 2 See note 1 3. See note 1

The cost impact on businesses SMALL BUSINESS AND WORKFORCE HEALTH The cost impact on businesses Obesity: related to higher rates of worker absenteeism1 Poor nutrition: 50% more sickness-related absences per year2 Tobacco: $3,077 annually in smoke breaks, per smoking employee3 Unhealthy lifestyles and the chronic conditions they often trigger aren’t just straining the health care industry — they can have a direct impact on business costs as well: Evidence suggests that obesity is associated with a higher likelihood of worker absenteeism related to illness. Excessive weight gain can lead to as many as 6 more absences and 22 more unproductive days per year. One employee who smokes costs employers $5,816 ($3,077 in smoke breaks alone) each year in absenteeism, productivity, and medical and other costs. People who spend more time sitting increase their cardiovascular risk by 147 percent and their diabetes risk by 112 percent.1 Employees with poor nutrition reported 50 percent more sickness-related absences than those with good nutrition.2 Yet, in most cases, obesity and chronic conditions are preventable — for example, 80 percent of heart disease, stroke, and type 2 diabetes are avoidable through better nutrition, physical activity, and eliminating tobacco.3 ________________________________________________ 1 E.G. Wilmot et al., “Sedentary Time in Adults and the Association with Diabetes, Cardiovascular Disease and Death: Systematic Review and Meta-Analysis,” Diabetologia, 2012. 2 “Poor Nutrition Increases Sickness Absence 50%,” Workplace Savings and Benefits, accessed October 22, 2012. 3 “Overview — Preventing Chronic Diseases: A Vital Investment,” World Health Organization, who.int/chp/chronic_disease_report/part1/en/index11.html, accessed April 30, 2015. 1 Howard and Potter, Obesity Research and Clinical Practice, January–February 2014. 2 Utley, Workplace Savings & Benefits, May 9, 2013. 3 Berman et al., tobaccocontrol.bmj.com, June 3, 2013.

Small business and workforce health Challenges Advantages Perceived barriers Expense Limited staff Privacy issues High turnover Fewer barriers to implementation An intimate work culture Change is more evident Employee engagement is impacted Financial incentives That’s why implementing a workforce health program is so important, especially for smaller businesses where even one absent employee can have an effect on the company’s productivity. Building an effective workforce health strategy helps keep employees engaged and at their best, and helps control current cost trends and prevent future costs from escalating. But many small businesses struggle with the idea of workforce health. There’s often a preconceived notion that it can be costly, not just in funds but in time — both of which can be a strain for companies with a smaller staff that fulfills multiple roles. With fewer employees, business owners may be more sensitive to potential privacy concerns. And if the company is experiencing high turnover rates, they may not feel it’s worth investing in employees who won’t be with the company long term. With the right approach, implementing a workforce health program can actually be easier for small businesses. Their size and scale allows for quicker implementation. Small business owners often have close, family-like relationships with their staff, a strength they can leverage to encourage a healthy work environment. With a small number of employees, positive health changes are more visible, creating positive reinforcement and promoting higher productivity. And wellness programs have proven to be an effective tool for both recruitment and retention. Adapted from Leading By Example: The Value of Worksite Health Promotion to Small- and Medium-Sized Employers, Partnership for Prevention, 2011.

Key components for success SMALL BUSINESS AND WORKFORCE HEALTH Key components for success Leadership that’s actively engaged A culture of health and caring A worksite that promotes healthy decisions A strong communication plan Creating a healthy workplace on a smaller scale can be simple, cost-efficient, and done with limited investment in time and resources. The first step is to establish a few key building blocks for success: Leadership engagement — When business owners lead by example, it can energize and encourage people to participate. Healthy culture — The next step is to support a culture that values and promotes healthy choices. Clear, open communication — Highlight the benefits to the employees, how and when they can be involved, and share that the program is here to help them lead healthier, happier lives, without creating a stigma if they choose not to participate. Long-term view — To create a stronger foundation of success, it’s important to: a) evaluate needs and interests before starting a program, b) set goals and benchmarks, c) establish next steps, and d) take a long-term, cohesive view of workforce health. An evaluation plan with goals and objectives

Businesses can benefit from our expertise SMALL BUSINESS AND WORKFORCE HEALTH Businesses can benefit from our expertise At Kaiser Permanente, workforce health isn’t new to us. Preventive care and employee health and safety have been part of our mission for 70 years. Partnering with Kaiser Permanente can help you get those elements in place, setting the stage for success. Preventive care and employee health and safety have been part of our mission of total health for 70 years. And it’s built into their coverage: Early detection — Doctors ask members about risk factors like smoking habits and exercise frequency at every routine office visit. Prevention — When employees visit any of our facilities, electronic health alerts tell caregivers about any upcoming or overdue screenings, even if they’re not related to that day’s visit. If they’re overdue, employees can schedule the test on the spot. Proactive disease management — Symptom profiles and disease registries allow caregivers to identify and screen employees early, before chronic conditions set in or get worse. Based on their risk levels, members are automatically enrolled in care programs — no sign-up required. This means employees aren’t likely to slip through the cracks. Employee engagement — Members have easy access to tools for managing their health wherever they are. Kaiser Permanente is a recognized leader in workplace wellness. The National Business Group on Health has named Kaiser Permanente a “Best Employer for Healthy Lifestyles” for the sixth consecutive year.* _____ * “National Business Group on Health Honors 64 U.S. Employers with Best Employers for Healthy Lifestyles® Awards,” businessgrouphealth.org, June 17, 2015. Early detection Prevention Proactive disease management Employee engagement

No-cost tools and resources at kp.org/choosebetter SMALL BUSINESS AND WORKFORCE HEALTH No-cost tools and resources at kp.org/choosebetter Interactive toolkits Starting a Workforce Health Program toolkit Workforce Health Resource Guide Healthy Meetings Guide Maintain Don’t Gain Toolkit Tobacco-Free Campus Toolkit Walking for Workforce Health Toolkit Rest and Revive Toolkit Healthy Eating at Work food policy toolkit Employers have access to our full range of comprehensive, yet easy-to-follow toolkits — available at no cost — to help launch their strategy. We selected the following resources because they’re simple for small businesses to implement. These and others are available at kp.org/choosebetter: Starting a Workforce Health Program toolkit — lays out the building blocks for beginning a workforce health program Workforce Health Resource Guide — an overview of resources and tools available for weight management, tobacco cessation, stress and mental health, and heart health Healthy Meetings Guide — how to make a few small changes at meetings to support overall health and productivity, such as healthier food options and simple stretch breaks Maintain Don’t Gain Toolkit — a step-by-step guide to encourage employees to make healthier choices to avoid holiday weight gain Tobacco-Free Campus Toolkit — how to establish policies to make the workplace and company events tobacco-free Walking for Workforce Health Toolkit — assessment tools, trackers, and communication materials to start a walking program at work Rest and Revive Toolkit — tools to help employees establish better sleep habits, such as a daytime activity log to show how food, drinks, and activity affect sleep Healthy Eating at Work food policy toolkit — a guide to developing and implementing a food policy that encourages employees to make healthy choices The Resource Center contains a wealth of useful materials to support your workforce health efforts. Resource Center Insights blog

kp.org: A hub for managing health SMALL BUSINESS AND WORKFORCE HEALTH kp.org: A hub for managing health Tools and resources for members Total Health Assessment Healthy lifestyle programs Health and drug encyclopedias Health videos Symptom checker Total Health Radio online radio show and podcast And at kp.org, members can find useful tools and information to help them get the most out of their Kaiser Permanente coverage. The site serves as a central hub for managing their health. Here’s just some of what they’ll find there: Total Health Assessment (for Kaiser Permanente members only) educational tools, including health and drug encyclopedias and a symptom checker healthy lifestyle programs (coaching for health conditions — for Kaiser Permanente members only) health videos Total Health Radio online radio show and podcast

Talking to small business customers about workforce health SMALL BUSINESS AND WORKFORCE HEALTH Talking to small business customers about workforce health Help them understand the impact the health of their employees has on the health of their business Help them improve their business performance Help their Kaiser Permanente members use the tools built into their coverage When you talk to your small business customers about workforce health: Highlight the effect poor employee health can have on business performance — not just in higher health care and disability costs, but in absenteeism, productivity, lack of focus and energy, and staff turnover. Explain that taking even small, subtle steps in creating a culture of health can have a positive effect on the workplace environment and morale. Let them know they have a number of tools built into their Kaiser Permanente coverage they can download to start building a workforce health program. Direct them to the resources available on kp.org/choosebetter. Connect them to kp.org/choosebetter and the free tools and resources available to create a culture of health Help them launch a workforce health program

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