Kimberly-Clark Tom Fariss, MD, MPH

April 1, 2014

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Agenda• Background – Global Health Services at K-C

• Medical Strategy / Health & Wellness Link

• Programs

• Problems with Wellness

• Conclusions

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About Kimberly-Clark• History

• Business and Brands

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THEN: Formed in 1872A Paper and Newsprint Company

Leading the world in essentials for a better life.

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NOW: Leading the World in Essentials for a Better Life

58,000 employees worldwide

$21.1 Billion in Net Sales in 2012

Well-known global brands HUGGIES® KLEENEX®

SCOTT®

KOTEX® PULL-UPS® DEPEND®

#1 or #2 position in more than 80 countries

Nearly one-quarter of the world’s population use our products daily

Leading the world in essentials for a better life.

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Our BusinessesPersonal Care

Health Care

Consumer Tissue

K-C Professional

Leading the world in essentials for a better life.

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Global Brands

Leading the world in essentials for a better life.

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Authentic

Accountable

Innovative

Caring

Our Culture

We continue our heritage of honesty, integrity, and courageously doing the right thingWe take ownership for our business and our futureWe are committed to new ideas that add valueWe respect each other and care for the communities where we live and work

Values

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K-C People Philosophy

K-C Health Services Mission

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To build and sustain a culture of health, energy, and vitality, providing a competitive

edge for K-C and a lifelong advantage for employees.

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Health Services OrganizationSr. VP & Chief HR Officer

VP Comp, Benefits, &

Health Services

Corporate Medical Director

MEAAsia PacificNorth America TeamEurope TeamLAO Team

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Value Proposition of Corporate Medical Dept.• Access to experienced medical professionals when work

impacts health and health impacts work– Personal and occupational health issues

– Crisis management, emerging health issues, pandemics

• Occupational health compliance– Legal and regulatory requirements

– Impacts employee injuries/illnesses, company reputation

• Health promotion and wellness– Best Place to Work, attract and retain top talent

– Employee health, performance, resilience, morale

– Competitive advantage for company

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Occupational Health/Compliance

Healthy Company

Business and Policy Support

Global Health Services Model•Global Health Risk Appraisal•General Population Risk Intervention•Exercise Facilities/Programs•Medical Consults/Health Advocacy•Case Management•Employee Assistance Program•Executive Health•Travel Medicine•Health Screening•Acute Care/Emergency Care•Health Education Programs•Global Assignee Health Mgmt•Corporate Athlete

•Alcohol & Drug Policy•Health Care Cost Control•Crisis Management/Threat Assessments •Clinical Governance of Occupational Health Function•Consult to Business Units on Health-Related Issues•Health Hazard/Risk Assessment•Product Safety Support & New Product Development•Health Risk Management and Litigation Prevention

•Legal & Regulatory Health Compliance

•Medical Surveillance

•Return-To-Work Programs

•Drug & Alcohol Testing

•Injury/Illness Reporting

•Maintenance of Health Records

•Pre-Employment/Fit for Duty

•Stress Management Programs

•Disability Management

•Ergonomics

•Product Toxicology

•Epidemiology

•Emergency Responder Training

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K-C Health Services – Neenah, WI

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K-C Health Center – Roswell, GA

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K-C Health Services - LAO

Bolivia - Employee Health Checks

Bolivia

Peru

EcuadorCosta Rica

Health Fair

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Medical Plan Strategy and Wellness• Affordable Care Act Implications (Cadillac Tax,

etc.)

• How to Control Medical Costs?

• What is the Role of Wellness and Health Promotion?

• Assumptions:– Medical plan design drives costs more than any other

factor

– Wellness programs have limited impact on overall costs

– Health and wellness programs are worth doing as an adjunct to future medical plan changes

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Health Promotion & Wellness• LiveWell Health Programs

– Health Screenings

– Weight Watchers

– Lose Big

– Endurance Challenge

– Get Up and Ride

– Maintain Don’t Gain

– Fox Cities Marathon

– Breast Cancer Awareness Week

– Blood Drives (on site)

• Fitness, Nutrition, Weight Management, Tobacco-Free Campuses

• Broad Array of Health Enhancement Tools

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Live Well Challenge 2014• Wellness program designed to leverage

group involvement to improve individual health and build a healthy company.

• 1st & 4th quarter health assessments– HRA & Blood Tests

– Fitness Testing

– Health Coaching

• Three Components:– Exercise

– Nutrition

– Sleep

• Fitbit Flex– Goal Setting Password:

openkc

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Live Well Challenge 2014• 2,580 out of 6,500 employees (40%)

• Top Four Personal Goals Set by Category– Weight loss or changes in body composition = 49%

– Cardiovascular improvements = 32%

– Strength = 9%

– Flexibility = 9%

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Global Corpora

te Challen

ge

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GCC: K-C EMEA• 861 employees formed 123 teams

• Over the 16 week program– 63% reported losing weight

– 59% decreased stress

– 80% improved exercise

– 88% of employees now rate their overall health as good, very good or excellent (vs. 64% pre-GCC)

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NBGH Award - 2012

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Problems With Wellness

1. Inadequate or Misinformed Science

2. Incentives Often Don’t Work

3. Minimal Cost Savings

4. Behavior Change is Difficult

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1. Wellness is Not Science• Science vs. Program Management

– “If you do this, then that will happen” - Richard Feynman

• Bad Science = Bad Advice

• Screenings – Harms May Outweigh Benefits

• Cholesterol – The Lower the Better?

• Overdiagnosis

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Wellness Checklist – Good Science?• Drink 64 oz. Water Every Day

• Take Multivitamins, Fish Oil, etc.

• Take a Baby Aspirin Every Day

• Get a Mammogram (or PSA)

• Take Lipitor! (Shouldn’t This be in the Water Supply?)

• Have a Drink of Wine Every Night

• Get an Annual Physical (and Screening CT Scan)

• Eat a Low Fat (or Low Carb) Diet

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2. Incentives Often Don’t Work• Carrot vs. Stick

• Intrinsic vs. Extrinsic Motivation

• Can We Pay People To Be Healthy?

• “Health Insurance” is not Insurance, it is a Payment Plan

• Most Medical Costs are Paid by “Someone Else”

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The Lancet – April 19, 2008

Can you pay people to be healthy? Emma Wilkinson; The Lancet - 19 April 2008 ( Vol. 371, Issue 9621, Pages 1325-1326 )DOI: 10.1016/S0140-6736(08)60578-4

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3. Minimal Cost Savings• Can Medical Costs be Controlled by Wellness

Programs?

• Impact on Costs Often Unclear

• ROI Always Problematic

• Prevention May Actually Increase Medical Costs

• Wellness Claims Often Not Credible

• “Best Practices” – Do They Exist?

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4. Behavior Change is Difficult• Entitlement Mentality Without Personal

Accountability

• Prevalence of “No Risk Factor” Group is Very Low

• Obesity Trends Correlate With Growth of Wellness Industry and Poor Dietary Advice

• Change or Die

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What Motivates People to Change?• Role of Leadership

• Policies and Legal Mandates

• What Everybody Else is Doing

• Individual Accountability for Health (Costs)– Bring Back the “Insurance” in Health Insurance

• Prochaska’s Stages of Change

• Intrinsic vs. Extrinsic

• Drive – 3 Elements of Motivation:– Autonomy

– Mastery

– Purpose

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What We Believe

1. Healthy behaviors and preventable risk factors can have a profound impact on health, performance, productivity.

2. Wellness programs are problematic, often underperform, and current approaches may have little to no impact on overall medical costs (but may be worthwhile for other reasons).

3. Behavior change is difficult but can be catalyzed by many factors within the bounds of company culture

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