The Pepsi Bottling Group Healthy Living Program offers employees and their families a comprehensive, well-formulated, and well-resourced health and productivity management system for health improvement and cost savings. Starting with the administration of a health risk assessment (HRA), the company offers several engagement opportunities for participants and follow-up lifestyle management, nurseline, disease management and immunization programs. Meaningful incentives are provided to employees who participate in the program, which has resulted in good participation rates. The company uses effective marketing and branding techniques to sell “health” as a product. Further, the program has stimulated increased cross-organizational collaboration and vendor program integration. Pepsi Bottling Group reports meaningful health improvements and risk reduction from its program, and a return on investment of $1.70 for every dollar spent. The company has conducted several evaluations of its efforts using multiple research partners. It is clear that the Healthy Living Program is based on proven methods for designing, implementing and evaluating an effective workforce health promotion initiative.
Narrative Description of Program
PBG’s Healthy Living program is a comprehensive health, productivity and people investment strategy that affects future cost increases by providing employees and their families the tools, resources and incentives to get healthy. Healthy Living’s core goals are to keep health costs below the market trend, improve the health of employees and their families and empower them to make healthy changes. It also encompasses employee financial and workplace health with our Healthy Money and 3600 safety programs.
Healthy Living targets all PBG employees and their families with programs for healthy, at-risk, chronic and catastrophic populations. Healthy Living program components include annual health risk assessments (HRAs), free lifestyle management programs, dedicated nurseline, disease management and case management. Our focus is on integrating across components to motivate behavior change, noticeably increase program participation, drive intended outcomes and maximize return on investment. Key to meeting these objectives is a systematic, results-oriented approach to awareness, skill building, engagement, incentives and strategic communication.
Our mission to build a culture of health is central to our strategy to become one of the top 100 employers to work for. Healthy Living is integrated into PBG’s culture and program components are built into local events such as health fairs, screenings, Black History month, Women @ PBG, group walks on National Health and Fitness Day and participation in charitable events such as the March of Dimes Walk America and Habitat for Humanity. PBG’s efforts to build a culture of health recently were recently recognized by the National Business Group on Health who awarded PBG the 2007 Best Employer-Healthy Lifestyles gold award. We also have invested heavily in a local clinical presence through our partnership with Johns Hopkins University to provide worksite clinics that will reach 40% of employees by the end of 2007. (please see addendum for overview of clinics) We will be leveraging our partnership with Johns Hopkins in 2007 to research stress and depression at the workplace.
Many of our programs address Healthy People 2010 goals such as nutrition and obesity, physical activity, occupational safety, prevention and treatment of specific diseases (e.g., cancer, diabetes, and cardiac). However, preventive screening rates for PBG employees are significantly below Healthy People targets and will be the focus of our 2008 Healthy Living initiatives.
Ownership and funding of Healthy Living is sponsored by the Board of Directors, CEO and SVP of HR. Responsibility for implementing Healthy Living is shared by a dedicated team of PBG specialists from the Benefits, HR, Communications, Safety, and Risk departments under the direction of the VP of Comp, Benefits and Risk. The Healthy Living team also includes vendor partners who participate in weekly meetings.
|Program Name||Healthy Living|
|Company Name and Address||Pepsi Bottling GroupOne Pepsi WaySomers, NY 10589|
|Contact Person||David Kasiarz|
|Program Category||Chronic Disease, High Risk, Integrated Systems of Care, Worksite-based|
|Total number of individual participants||36,316|
|Number of currently actively enrolled||31,887|
|Access to Program||PBG's Healthy Living program targets well, at-risk, chronic, acute and catastrophic employees and covered spouses and domestic partners.|
|Program targeted at Healthy People 2000 and/or Healthy People 2010 goals||Yes|
|Program goals (in priority order)||(1) Keep costs below market(2) Above average employee satisfaction(3) Improve health status(4) Empower individual responsibility|
Narrative Description of Evaluation Results
PBG’s Healthy Living program has delivered significant results with year over year improvements since 2004. Our evaluation approach involves a heavy discipline of quality review of the data, specific performance targets, benchmarking and monitoring. In addition we are applying a rigorous approach to gauge savings, ROI and program impact.
Program Evaluation Highlights
Healthy Living programs reached 82% of PBG’s medical claim dollars in 2006:
- 72% of employees and covered spouses/domestic partners completed a HRA in 2006.
- 35% of employees identified as high/moderate risk participated in at least one lifestyle management program.
- The global flu shot program achieved 33% participation with over 23,000 shots administered in 2006.
- Preliminary results from PBG’s Healthy Challenge 2007 initiative indicate that local wellness champions and inter-business unit competitions may significantly increase employee participation in health screenings, HRAs, lifestyle management and community volunteering. (please see addendum for video clip of interview of a PBG Wellness Champion by Buffalo, NY’s Morning News show).
32% of employees who completed lifestyle programs reduced their risk level in the targeted behavior/risk factor; significant risk reduction occurred from baseline to one-year follow-up in all six areas targeted by interventions.
PBG’s three year medical cost trend of 5.6% has outperformed the national average
PBG’s care management programs demonstrated an estimated savings of $118.55 per participant per month (PPPM) in healthcare costs across all products during the two-year intervention period.
On-site clinics delivered an ROI of $1.70 to $1.00 and $3-5 million projected annual savings.
Over 96% of participants were satisfied with Healthy Living programs.
PBG received the 2007 Best Employer – Healthy Lifestyle Gold Award from the National Business Group on Health. . The Healthy Living program was also featured on ABC World News Tonight in April, 2007. (please see addendum for video clip)
Overview of Evaluation Methods
To evaluate impact on health risks, medical costs and savings, ROI, disability and satisfaction variety of methodologies were applied including: pre/post analyses with control groups, longitudinal trend analyses and multi-variate regression analyses to address issues such as selection bias, regression to mean, and double counting of program impact.
In addition, a wide variety of metrics were analyzed including Healthy Living screening HRA and program participation, engagement and completion rates as well as medical claim utilization and employee satisfaction survey results. The scope of productivity metrics are expanding beyond self-reported measures to include disability claims and absence data will be added to our warehouse by 2008. PBG’s data warehouse currently contains medical/Rx/behavioral, health risk assessment, lifestyle management, STD/LTD, workers’ comp and clinic data.
PBG is currently involved in two health and wellness research initiatives. PBG is one of two employers participating with Mercer and the RAND Corporation in a project entitledBenchmarking Health and Productivity Management Evaluation Methods. The study is designed to compare ROI methodologies that measure the impact of HPM programs and establish an industry-standard approach for measurement that overcomes several of the limitations (Selection Bias and Regression to the Mean) of the current prevailing methods. PBG is also working with Johns Hopkins University on a joint research project to investigate stress and depression in the workplace.
The evaluation efforts require extensive coordination with PBG’s vendor partners including SHPS (clinical management), Staywell (lifestyle management), Medstat (data warehouse) and Mercer HR Consulting. The cross-vendor team includes evaluators with PhDs who have held academic positions in public health and behavior science, are widely published in industry journals and sit on editorial review boards of leading publications including the American Journal of Health Promotion and the Journal of Occupational and Environmental Medicine.
The following are verbatim remarks made by the reviewers:
- This application is one of the strongest this reviewer has seen in several years. It represents a comprehensive health and productivity management system. Participation is good, spouses and dependents are included. It is also clear that the Healthy Living program has received very good direction and professional assistance. Not too many HR professionals understand residual analyses let alone report them. I guess this makes Pepsi the Harvard of the soda world.
- Goals & costs down, satisfaction up, health status up, empowerment comprehensive, very high participation
- Good 3-year cost trend
- ROI 1.70
- 96% satisfied
- Mercer and RAND benchmarking, Staywell, Medstat
- Benchmarked against “like companies”
- Large reduction in targeted health risks
- Reasonably conservative cost analyses
- Program targets employees and families
- High participation in programs – annual HRA (72% -- from 29% in 2005 to 65% in 2007), lifestyle management programs 36% (from 25% -> 36% -> 28%)
- Offer nurseline (2% - 11%), case/disease management (41% -> 65%), flu immunization (33% participation)
- Recognizable trademarks/marketing of programs
- Incentives to complete the HRA
- Appears to be comprehensive and well resourced program
- Good completion rates for LM program (39% for a 28 week program) and 61% completed a 6-month mail based program
- Overall a very good program. It is comprehensive in scope and followed a recommended protocol for putting a program in place and making decisions.
- Focus of the program on high risk, acute and catastrophic conditions. Includes HRA, onsite clinics (in connection with Hopkins, and safety components. Cross organizational collaboration and vendor integration. Offers incentives to drive healthy behaviors, using a variety of options and choices as incentives. Addresses needs across the health continuum. Applies multiple methods of evaluation (pre-post, trends, regression), has a data warehouse. Has calculated ROI by their products and services.
- Good participation (HRA-72%, 28% risk management) and 96% customer satisfaction.
- Provides incentives to managers and supervisors as well.
- Targets specific disease states to impact costs.
- Have integrated prevention into the Benefit plan.
- Documented risk shifts in the positive direction, have lower cost trends and PPPM costs are down.