2019 WORKPLACE HEALTH ACHIEVEMENT INDEX Kristin Pham MS

2019 WORKPLACE HEALTH ACHIEVEMENT INDEX Kristin Pham, MS, CSCS Sr. Program Manager Workplace Health Solutions 1

American Heart Association 2020 Impact Goal 2020 20% By 2020, improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases & stroke by 20%. 2 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Getting a picture of the health of your workforce is no small task. The American Heart Association has defined ideal cardiovascular health based on seven risk factors (Life's Simple 7) that impact health and quality of life. We know that even simple, small changes can make a big difference in living a better life, so we explain these complex health concepts in simple, clear ways that are easy to convey to your employees. üPeople with at least 5 ideal Life’s Simple 7® metrics cut risk of heart-related death by 50% compared to people with 1 or no ideal metrics. 1 üPeople with 6 to 7 ideal metrics had 51% lower risk of cancer incidence over 18 years of follow-up than those meeting goals for zero ideal metrics. 2 3 üPeople with at least 4 ideal metrics had 75% lower diabetes incidence compared to people with 2 or fewer ideal metrics. 3 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission References: 1. Ford et. al. , 2012. 2. Rassmussen-Torvik et. al. , 2013. 3. Joseph et. al. , 2016.

Cost Benefits for the Workplace Life’s Simple 7 health behaviors and metrics represent seven out of the top 10 most costly risk factors for employers. 1 In a study of a large, multi-ethnic workforce, employees with at least 6 ideal metrics had, on average, $2, 021 lower health care expenditures compared to employees with 2 or fewer. In the same study, employees with ideal heart health had significantly lower rates of hospitalizations and ED visits. 2 4 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission 1. Goetzel et al. , 2012 2. Osondu et. al. , 2017.

Why Life’s Simple 7 in the Workplace • Abundant scientific evidence supports that moving toward ideal heart health improves overall health, productivity, quality of life, longevity and reduces healthcare costs. 1 • People with at least 5 ideal Life’s Simple 7 metrics cut risk of heart-related death by 50% compared to people with 1 or no ideal metrics. 2 • Moving toward ideal heart health is also associated with lower risk for cancer, diabetes and depression and improved cognitive function in younger and older adults. 1 • In a study of a large, multi-ethnic workforce, employees with at least 6 ideal metrics had, on average, $2, 021 lower health care expenditures compared to employees with 2 or fewer. 3 5 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission Sources: 1. Fonarow et. al. , 2015 2. Ford et. al. , 2011. 3. Osondu et. al. , 2017.

Continuous Quality Improvement for Workplace Health POINT OF ENTRY Index Recognize and Award Achievement Assess Health of Workforce Implement, Improve and Re-assess Guidance Using American Heart Association Resources 6 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission Assess Culture of Health Status Workplace Health Achievement Index

Workplace Health Achievement Index • Structure & Process 1. Leadership 2. Organizational Policies & Environment 3. Communications 4. Programs 5. Engagement “Workplace culture of health” Do we have a healthy workplace? 6. Community Partnerships 7. Reporting Outcomes • Performance • Life’s Simple 7® • My Life Check® • American Heart Association® Health Screening Services™ w/ My Life Check Enhance • Aggregate Data Upload 7 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission Do we have a healthy workforce?

Workplace Health Achievement Index Online Self-Assessment of a Company’s Work Environment and its Workforce PART ONE: ORGANIZATION & DEMOGRAPHIC INFORMATION • Organizational Info (Required) includes name, address, type, industry, size • Workforce Demographic Info (Voluntary) includes aggregate employee characteristics, such as gender, age, ethnicity, job type, work status, annual income, education level, languages spoken, turnover rate PART TWO: STRUCTURE & PROCESS MEASURES Complete 55 -item questionnaire based on 7 best-practice pillars of effective workplace health programs Leadership Policies & Environment Communications Programs Engagement Partnerships Evaluation & Reporting Outcomes PART THREE: PERFORMANCE MEASURES Use My Life Check® or submit aggregated employee health data based on Life’s Simple 7® metrics Measure 1: % of Employee Health Data Submitted Measure 2: Organization Heart Health Score Measure 3: Annual Relative Improvement Score Data must be provided for at least 25% of employees 8 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission Smoking Status Physical Activity Healthy Diet Healthy Weight Is the workplace healthy? Blood Pressure Total Fasting Cholesterol Blood Glucose Is the workforce healthy?

Completing the Index 9 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Getting Started • Visit heart. org • Select the “Workplace Health Achievement Index” from “Professionals” from the main menu 10 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Register • New companies must register as a new account • During registration, companies are asked to review and agree to Terms & Conditions • New companies are also asked to select whether they are going to use My Life Check® Basic. 11 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Logging in Select Workplace Health Achievement Index in the drop-down menu. 12 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Section 2: Structure & Process Questions Answering all 55 Structure & Process questions is required for recognition eligibility. If you are returning from 2018, click the “Update” button on the bottom of the page to carry over all your responses to 2019. You will still be able to make changes. 13 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Section 2: Structure & Process Questions Answering all 55 Structure & Process questions is required for recognition eligibility. To confirm you answered all 55 Structure & Process questions, click on the Review Tab. 14 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Performance Metric Scoring Data Requirements Eligible population = # of employees eligible for wellness programs/HRA/biometric screening. COMPLETION SCORE (PERFORMANCE MEASURE 1): 33 POSSIBLE POINTS • Must provide health data for at least 25% of eligible population • Must provide data for at least five Life’s Simple 7 metrics COMPOSITE SCORE (PERFORMANCE MEASURE 2): 33 POSSIBLE POINTS • Points awarded based on aggregate Heart Health Score (minimum score is 5. 2 to begin receiving points) • Must provide health data for at least 25% of eligible population • Must provide data for at least four Life’s Simple 7 metrics RELATIVE IMPROVEMENT SCORE (PERFORMANCE MEASURE 3): 33 POSSIBLE POINTS • For returning companies that met the 25% threshold in their previous year for Performance Measure 2 • Assesses improvement in Heart Health Score from one year to the next • Must provide health data for at least 25% of eligible population 15 • Points are awarded as “bonus” points toward total score in 2018 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Methods of Submitting Life’s Simple 7 Data • Employees: My Life Check Basic • Health Screening Services w/ My Life Check Enhance integrated (2020) • Aggregate Report For employers that have an existing HRA/Biometric Screening 16 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

My Life Check Basic • 18 Questions (4 -5 min to complete) • Provides aggregate data reporting to employer on average Heart Health Score and participation (does not provide detailed Life’s Simple 7 reports) • Data is automatically captured and used to fulfill the Index data requirements 17 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Aggregate Report (Use existing HRA/biometric screening data) Implemented in 2017 • Uses aggregate employee health data to capture a Heart Health Score • Lowers barriers for submitting performance metrics • No Personal Health Information (PHI) is transmitted • Addresses data privacy concerns • Optimizes opportunity to earn points towards the Performance Metrics component of the Index (40% of the Total Index Score). 18 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

How to Submit via the Aggregate Report STEP 1: View Aggregate Report instructions to confirm that you can submit at least 4 metrics that align with Life’s Simple 7. STEP 2: Contact the Workplace Health Solutions Support team to select the Aggregate Report option in your account. • workplacehealthsolutionssupport@heart. org • 888 -242 -4503 19 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

How to Submit via the Aggregate Report STEP 3: Log in to your Admin portal and view the “Performance Measures” tab to download the aggregate file template. 20 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

How to Submit via the Aggregate Report STEP 4: Fill in the Aggregate Report. See the Aggregate Report instructions for further information on preparing the data file. Keep in mind the main data requirements: Data Requirements In Brief üData must be provided for at least 25% of employees üFor Measure 1, data must be provided for 5 out of 7 metrics üFor Measure 2, data must be provided for 4 out of 7 metrics Note: If the company works with a health risk assessment vendor, the vendor may be able to prepare the file for the company. Companies are welcome to share the Aggregate template and instruction documents with their vendors. It will still be up to the Index Company Admin user to upload the file through the Index portal. 21 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

How to Submit via the Aggregate Report Data Reporting Reminders • Do NOT change the column headings • Do NOT change the file type 500 Screenshot of the Aggregate Report Template (CSV file) with “dummy” data • TIP 1: The numbers for each metric should not add up to the total eligible population. This would indicate that the organization had 100% participation. Likewise, the numbers for each metric do not need to add up to the same number. For example, you may have an eligible population of 1000 with 500 employees who complete the HRA and 250 who complete the biometric screening. • TIP 2: Be careful not to count the same person twice (For example, if you have self-reported biometric data 22 AND data from a biometric screening for some individuals, ensure that individual is only counted once). 22 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

How to Submit via the Aggregate Report STEP 5: After values have been entered in the. CSV file and the file has been saved, the Index Admin user can click on the UPLOAD button and browse for the file. 23 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Confirm Your Results: Viewing the Index Dashboard Recall that data requirements must be met in order to qualify for points for the Performance Measures. If the data submitted did not qualify for points for the 3 Index Performance Measures, you will see the 3 charts, but the bars will be at 0. 24 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Confirm Your Results: Viewing the Index Dashboard Recall that data requirements must be met in order to qualify for points for the Performance Measures. If the data submitted Qualified for points for the Index Performance Measures, you will see the results represented by the blue bars. 25 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Confirm Your Results: Viewing the Index Dashboard Recall that data requirements must be met in order to qualify for points for the Performance Measures. Note: Only companies that meet data requirements 2 years in a row can qualify for Points for Performance Measure 3. These are “bonus” points a company can earn in 2018. 26 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

27 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission 5

Benefits of Life’s Simple 7 Journey to Health • Increase in number of individuals who know their numbers, resulting in an increase in physician follow-up • Biometrics from Health Screening Services are prepopulated into My Life Check® Enhance • Nine of the 18 questions in My Life Check Enhance are prepopulated following the screening • My Life Check Enhance takes only 3 to 4 minutes to complete • Personalized health actions can help people take small steps toward improved heart health • My Life Check Enhance data is automatically captured and used to fulfill the Index requirements. • Employers can use data from the screenings and from My Life Check Enhance to tailor wellness programs to their population and prioritize gaps identified when completing the Index Structure & Process questions. 28 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Health Screening Services Stress Free Health Screenings! • Administered by our Licensed Master Services Provider • 9. 4/10 overall client satisfaction • 250, 000+ screenings per year in over 1600 locations • Services all 50 states + Canada and Puerto Rico • State-of-the-art online scheduler and management system • Send customized emails • Manage sign-ups • Five Screening Methods • • • Onsite screenings Primary healthcare provider Lab. Corp® facility (1500 locations) Retail Pharmacy (5500+ Walmart® pharmacy locations) Home test kits • No site minimums • Seamlessly integrates with My Life Check Enhance 29 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

My Life Check Enhance Username WHAT YOU CAN ACT ON WHAT YOU CAN BE PROUD OF FOCUS CELEBRATE IMPROVE Weight Features • Takes 3 to 4 minutes to complete and can be updated anytime (recommend quarterly) • “More information” infographics • Participation reports provided for incentives • Expanded employer reporting • Employer ability to compare corporate vs. divisions vs. geographic locations • Ability to segment reporting by employee vs. dependent adult • Pre-populated lab values when used with the American Heart Association Health Screening Services 30 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission Actions You Can Take Dashboard

My Life Check Enhance: Life’s Simple 7 Reports • • Average Heart Health Score HHS Distribution Participation – Total Participants Participation – Completion Blood Pressure Total Blood Cholesterol Blood Sugar Body Mass Index 31 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission • • Smoking Status Physical Activity Healthy Diet Score Fruits & Vegetables Fish Whole Grains Action Progress • • Sugar/Sweetened Beverages Sodium Gender Age Race Ethnicity Zip Code

Employer Resources for Improvement 32 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Recognition and Awards Index Scale 2019 Recognition Tiers GOLD 175 -217 points SILVER 130 -174 points Benefits of Recognition: • Listing on Heart. org WHS Recognition Page. • Company name in national media listing with social amplification and digital promotion. • Resource toolkit, including a template news release for your company’s localized one-time use. • Congratulatory letter from the American Heart Association’s CEO, Nancy Brown. BRONZE COMPLETION RECOGNITION 86 -129 points • Physical plaque and/or window decal. Over 1, 000 organizations across the country were recognized in 2018! <86 points Note: 33 points are added to subsequent cycles to award companies that improve their aggregate heart score from one cycle to the next. (250 possible points total instead 33 of 217) © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Workplace Health Achievement Index Deadline June 30 11: 59 PST 34 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Next Steps A one-on-one demo for you to learn more about Health Screening Services integrated with My Life Check Enhance WHS@HEART. ORG Carri. Anne Crabill: 630 -485 -9981 (GSA, FDA, GRA, SWA) Adam Simpson: 847 -302 -2795 (GRA, MWA, WSA) 35 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission

Questions? 36 © 2018 American Heart Association, Inc. Confidential: not for use or external distribution without American Heart Association written permission