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10/25/2012




WELLNESS AT CIANBRO
REVEALING THE SECRET SAUCE




    Occupational Medical Consulting, LLC




                                                   1
10/25/2012




Demographics

•   Ranked 88 on the Engineering News
    Record’s list of the Top 100 US Contractors
•   Cianbro is 100% employee-owned, open
    shop, team oriented company of
    approximately 2,000 team members
    (4,000 including Starcon)
•   Male dominated, blue collar workforce
    who work long 8-12 hour days and
    commute 1-4 hours a day
•   Strong safety culture focused on
    eliminating at-risk behavior.




In the beginning…

What can we influence to change? Change
behavior over time through the Wellness
Program.
       –   Apply the same approach used
           with safety
       –   Change at-risk behavior
       –   Educate and lead by example
       –   Create a total wellness
           environment




                                                          2
10/25/2012




            Change the Mindset

• The Old - Construction workers get hurt and
  people just get sick.

• The New - Preventive maintenance - works on
  our equipment and must be applied to our
  people!



                 www.omcwellness.com




       Uniting safety and health




                                                        3
10/25/2012




Creating a healthy and safe
environment
•   SHARE committees
•   Tobacco-free environment
•   Aligning benefit programs to support the
    behaviors we encourage
•   Daily stretching
•   Health and safety stand and delivers
•   Healthy vending and healthy food and
    beverages at company meals
•   Wellness Champions and exercise routes
    on jobsites
•   Wellness scorecards for jobs to rate how
    “well” their jobsite is




Promoting health and
medical self management
Prevention and self management

•   Preventive care covered at 100%
•   Providing a consumer driven medical plan
    with an HSA
•   Health Advocate service that aids with
    healthcare and insurance issues
•   Employee Assistance Program
•   24 Hour Nurse Health Line to triage health
    concerns




                                                         4
10/25/2012




Promoting health and
medical self management
Education

•   Wellness Matters newsletter
•   Lunch and Learns
•   Safety and Health Focus
•   Intranet with benefit and wellness
    information and links to vendor websites
•   Audio health information library through
    our medical carrier
•   Quality Counts Program promoting Centers
    of Excellence




Maintaining good health
and eliminating at-risk
controllable health
behaviors

•   Senior Manger’s Wellness Challenge
•   Healthy LifeStyle Program
     – Quit Tobacco Today Program
     – Condition Management Program




                                                       5
10/25/2012




Healthy LifeStyle Program

•   Participation is voluntary
•   Focus is on major preventable health risk
    behaviors
•   Administered by Dr. Catlett and the health
    educators at Occupational Medical
    Consulting LLC (OMC)
•   Guides participants toward optimal
    health using motivational interviewing
    techniques
•   Onsite, face-to-face appointments for
    team members
•   Spouse locations for face-to-face
    appointments
•   Incentives for participation




Participating Credit

•   Complete a health risk appraisal (HRA)
•   Identify and commit to eliminate
    controllable at-risk behaviors.
•   Set health related goals and objectives.
•   Schedule and keep face-to-face follow-up
    appointments.




                                                         6
10/25/2012




        Healthy Living Reward

         Be at or below 3 out of 4 health risks:
         • Body mass index (BMI) less than 27.5
         • Total cholesterol less than or equal to 200
            and HDL greater than 40
         • Blood pressure less than 140 over 90
         • Tobacco free for 12 months or more




Healthy Living Reward




                                                                 7
10/25/2012




Help Quit Tobacco Today Program

•   Tobacco-free as of January 1, 2003
•   Education and tobacco cessation assistance for
    team members and spouses
•   Free nicotine replacement therapy
•   January 1, 2010 – tobacco-free workplace includes
    prohibiting possession




Condition Management Program
•   Secondary prevention to help individuals with an already
    diagnosed illness manage it the best way possible.
•   Participants in HLP that have one of the following chronic
    conditions:
     – Diabetes
     – Heart disease
     – Metabolic syndrome
     – Chronic back pain
•   Under the guidance of the condition management nurse,
    participants work with their health coach to set goals that
    are right for them and their condition.
•   Future conditions that will be addressed under program:
    depression, obesity




                                                                          8
10/25/2012




                              Family Encounters

                               •   Children are being invited to take
                                   part in their parents encounter
                                   with a health coach.
                               •   Age specific topics and activities
                                   incorporated into encounter.
                               •   Goal is to help educate children on
                                   nutrition, exercise and other areas
                                   of wellness and influence them to
                                   make healthier choices.




The Motivation?

• Employee owned
• Productivity improvement and decreased health care
  spending puts money directly in the owners pockets
• “It’s the right thing to do!” - Pete Vigue, Chairman, President
  and CEO, The Cianbro Companies
• Extend a chance to maintain quality of life to all TM’s and
  their families




                                                                                 9
10/25/2012




Let’s shift people from this…




       www.omcwellness.com




To this…improved quality of life




       www.omcwellness.com




                                          10
10/25/2012




                              Medical/RX Costs




 F ig . 1 . T o p 1 0 m e d ic a l c o n d itio n s b y a n n u a l m e d ic a l a n d d ru g c o s t p e r 1 0 0 0 F T E s f o r a ll
 c o m p a n ie s .




                                                  www.omcwellness.com




                                                Full Cost View




Fig. 2. Top 10 medical conditions by annual medical, drug, and productivity cost per
1000 FTEs for all companies.



                                                  www.omcwellness.com




                                                                                                                                                11
10/25/2012




                 Full Cost Of
               Employee Benefits




                    (2002 Benefits Data)
           Note: “Absence” includes Presenteeism

                  www.omcwellness.com




               The Essentials
• Management and cultural support
• Employee/spouse engagement in a program
  that changes behavior




                  www.omcwellness.com




                                                          12
10/25/2012




Management & Cultural
    Support



      www.omcwellness.com




The Health & Productivity
     Connection
  What do you think?



      www.omcwellness.com




                                   13
10/25/2012




             Health & Productivity
               Connection
• When I have to work for someone who does
  not value health, it presents an obstacle for
  my own health?




                  www.omcwellness.com




          Health & Productivity
               Connection
• If I improve my health, it will motivate the
  people who work for me to be more healthy.




                  www.omcwellness.com




                                                         14
10/25/2012




           Health & Productivity
                Connection

• When I have to work for someone who does
  not value safety, it presents an obstacle for my
  own safety.




                  www.omcwellness.com




           Health & Productivity
                Connection

• If I improve my safe behavior, it will motivate
  those that work for me to work more safely.




                  www.omcwellness.com




                                                            15
10/25/2012




                Health & Productivity
                     Connection
• When I am in good physical and mental
  condition, I can work harder, longer and more
  safely.




                             www.omcwellness.com




                    Cultural Support

• Cianbro examples (Senior management wellness, vending, benefit
  alignment, company meals, tobacco policy and quit assistance, family/spouse
  inclusion, company leaders leading the activities)

• Most important- wellness must leave the
  benefits section and become a company
  strategy- when health and safety are company strategy
  number ONE, your cultural evolution will sustain wellness
  indefinitely



                             www.omcwellness.com




                                                                                       16
10/25/2012




          ENGAGING PARTICIPANTS




                   www.omcwellness.com




         Effecting and Maintaining
              Behavior Change

•   Educate or Motivate?
•   Collaborate, not confront
•   Evoke, not educate
•   Autonomy, not authority




                   www.omcwellness.com




                                                17
10/25/2012




      MOTIVATIONAL INTERVIEWING
         A different way to talk with a
          participant about smoking



                   www.omcwellness.com




             Barriers to Success
•   Too many programs, not enough outcomes
•   Wellness programs tailored to every “need”
•   Management support
•   Inability to commit to long term investment
•   Misaligned expectations
•   Significant sustainable population behavior
    change comes one person at a time

                   www.omcwellness.com




                                                         18
10/25/2012




      CAN IT WORK?




       www.omcwellness.com




Affects on Health Risks




                                    19
10/25/2012




Decreased Spending on Healthcare




Expected vs Actual Costs




                                          20
10/25/2012




                   Difference in Diabetes Incidence
                          (Co A vs Co B)

90
80
70
60
50
40
30                                           Current
20                                           Benchmark
10
0                                            Per 1,000 Employees
          Diabetes - no    Diabetes -
            wellness        wellness
            program        program


                                   www.omcwellness.com




                      Difference in Heart Incidence
                            (Co A vs Co B)

     30


     25


     20


     15

                                                 Current
     10
                                                 Benchmark
      5
                                             Per 1,000 Employees
      0


           Heart Disease    Heart Disease
           - no wellness     - wellness
              program         program


                                   www.omcwellness.com




                                                                          21
10/25/2012




         Wellness and Productivity
               Connection




               www.omcwellness.com




               Questions

• Dr. Larry Catlett, CMO,Founder

• www.omcwellness.com

• Email: info@omcwellness.com


               www.omcwellness.com




                                            22

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The Cianbro Story

  • 1. 10/25/2012 WELLNESS AT CIANBRO REVEALING THE SECRET SAUCE Occupational Medical Consulting, LLC 1
  • 2. 10/25/2012 Demographics • Ranked 88 on the Engineering News Record’s list of the Top 100 US Contractors • Cianbro is 100% employee-owned, open shop, team oriented company of approximately 2,000 team members (4,000 including Starcon) • Male dominated, blue collar workforce who work long 8-12 hour days and commute 1-4 hours a day • Strong safety culture focused on eliminating at-risk behavior. In the beginning… What can we influence to change? Change behavior over time through the Wellness Program. – Apply the same approach used with safety – Change at-risk behavior – Educate and lead by example – Create a total wellness environment 2
  • 3. 10/25/2012 Change the Mindset • The Old - Construction workers get hurt and people just get sick. • The New - Preventive maintenance - works on our equipment and must be applied to our people! www.omcwellness.com Uniting safety and health 3
  • 4. 10/25/2012 Creating a healthy and safe environment • SHARE committees • Tobacco-free environment • Aligning benefit programs to support the behaviors we encourage • Daily stretching • Health and safety stand and delivers • Healthy vending and healthy food and beverages at company meals • Wellness Champions and exercise routes on jobsites • Wellness scorecards for jobs to rate how “well” their jobsite is Promoting health and medical self management Prevention and self management • Preventive care covered at 100% • Providing a consumer driven medical plan with an HSA • Health Advocate service that aids with healthcare and insurance issues • Employee Assistance Program • 24 Hour Nurse Health Line to triage health concerns 4
  • 5. 10/25/2012 Promoting health and medical self management Education • Wellness Matters newsletter • Lunch and Learns • Safety and Health Focus • Intranet with benefit and wellness information and links to vendor websites • Audio health information library through our medical carrier • Quality Counts Program promoting Centers of Excellence Maintaining good health and eliminating at-risk controllable health behaviors • Senior Manger’s Wellness Challenge • Healthy LifeStyle Program – Quit Tobacco Today Program – Condition Management Program 5
  • 6. 10/25/2012 Healthy LifeStyle Program • Participation is voluntary • Focus is on major preventable health risk behaviors • Administered by Dr. Catlett and the health educators at Occupational Medical Consulting LLC (OMC) • Guides participants toward optimal health using motivational interviewing techniques • Onsite, face-to-face appointments for team members • Spouse locations for face-to-face appointments • Incentives for participation Participating Credit • Complete a health risk appraisal (HRA) • Identify and commit to eliminate controllable at-risk behaviors. • Set health related goals and objectives. • Schedule and keep face-to-face follow-up appointments. 6
  • 7. 10/25/2012 Healthy Living Reward Be at or below 3 out of 4 health risks: • Body mass index (BMI) less than 27.5 • Total cholesterol less than or equal to 200 and HDL greater than 40 • Blood pressure less than 140 over 90 • Tobacco free for 12 months or more Healthy Living Reward 7
  • 8. 10/25/2012 Help Quit Tobacco Today Program • Tobacco-free as of January 1, 2003 • Education and tobacco cessation assistance for team members and spouses • Free nicotine replacement therapy • January 1, 2010 – tobacco-free workplace includes prohibiting possession Condition Management Program • Secondary prevention to help individuals with an already diagnosed illness manage it the best way possible. • Participants in HLP that have one of the following chronic conditions: – Diabetes – Heart disease – Metabolic syndrome – Chronic back pain • Under the guidance of the condition management nurse, participants work with their health coach to set goals that are right for them and their condition. • Future conditions that will be addressed under program: depression, obesity 8
  • 9. 10/25/2012 Family Encounters • Children are being invited to take part in their parents encounter with a health coach. • Age specific topics and activities incorporated into encounter. • Goal is to help educate children on nutrition, exercise and other areas of wellness and influence them to make healthier choices. The Motivation? • Employee owned • Productivity improvement and decreased health care spending puts money directly in the owners pockets • “It’s the right thing to do!” - Pete Vigue, Chairman, President and CEO, The Cianbro Companies • Extend a chance to maintain quality of life to all TM’s and their families 9
  • 10. 10/25/2012 Let’s shift people from this… www.omcwellness.com To this…improved quality of life www.omcwellness.com 10
  • 11. 10/25/2012 Medical/RX Costs F ig . 1 . T o p 1 0 m e d ic a l c o n d itio n s b y a n n u a l m e d ic a l a n d d ru g c o s t p e r 1 0 0 0 F T E s f o r a ll c o m p a n ie s . www.omcwellness.com Full Cost View Fig. 2. Top 10 medical conditions by annual medical, drug, and productivity cost per 1000 FTEs for all companies. www.omcwellness.com 11
  • 12. 10/25/2012 Full Cost Of Employee Benefits (2002 Benefits Data) Note: “Absence” includes Presenteeism www.omcwellness.com The Essentials • Management and cultural support • Employee/spouse engagement in a program that changes behavior www.omcwellness.com 12
  • 13. 10/25/2012 Management & Cultural Support www.omcwellness.com The Health & Productivity Connection What do you think? www.omcwellness.com 13
  • 14. 10/25/2012 Health & Productivity Connection • When I have to work for someone who does not value health, it presents an obstacle for my own health? www.omcwellness.com Health & Productivity Connection • If I improve my health, it will motivate the people who work for me to be more healthy. www.omcwellness.com 14
  • 15. 10/25/2012 Health & Productivity Connection • When I have to work for someone who does not value safety, it presents an obstacle for my own safety. www.omcwellness.com Health & Productivity Connection • If I improve my safe behavior, it will motivate those that work for me to work more safely. www.omcwellness.com 15
  • 16. 10/25/2012 Health & Productivity Connection • When I am in good physical and mental condition, I can work harder, longer and more safely. www.omcwellness.com Cultural Support • Cianbro examples (Senior management wellness, vending, benefit alignment, company meals, tobacco policy and quit assistance, family/spouse inclusion, company leaders leading the activities) • Most important- wellness must leave the benefits section and become a company strategy- when health and safety are company strategy number ONE, your cultural evolution will sustain wellness indefinitely www.omcwellness.com 16
  • 17. 10/25/2012 ENGAGING PARTICIPANTS www.omcwellness.com Effecting and Maintaining Behavior Change • Educate or Motivate? • Collaborate, not confront • Evoke, not educate • Autonomy, not authority www.omcwellness.com 17
  • 18. 10/25/2012 MOTIVATIONAL INTERVIEWING A different way to talk with a participant about smoking www.omcwellness.com Barriers to Success • Too many programs, not enough outcomes • Wellness programs tailored to every “need” • Management support • Inability to commit to long term investment • Misaligned expectations • Significant sustainable population behavior change comes one person at a time www.omcwellness.com 18
  • 19. 10/25/2012 CAN IT WORK? www.omcwellness.com Affects on Health Risks 19
  • 20. 10/25/2012 Decreased Spending on Healthcare Expected vs Actual Costs 20
  • 21. 10/25/2012 Difference in Diabetes Incidence (Co A vs Co B) 90 80 70 60 50 40 30 Current 20 Benchmark 10 0 Per 1,000 Employees Diabetes - no Diabetes - wellness wellness program program www.omcwellness.com Difference in Heart Incidence (Co A vs Co B) 30 25 20 15 Current 10 Benchmark 5 Per 1,000 Employees 0 Heart Disease Heart Disease - no wellness - wellness program program www.omcwellness.com 21
  • 22. 10/25/2012 Wellness and Productivity Connection www.omcwellness.com Questions • Dr. Larry Catlett, CMO,Founder • www.omcwellness.com • Email: info@omcwellness.com www.omcwellness.com 22