The C. Everett Koop National Health Award recognizes population health promotion and improvement programs. Each year, awards are presented by The Health Project’s leadership to winning organizations as part of the annual HERO Forum each fall. This Thursday Ron Goetzel joins us for an update on the C. Everett Koop National Health Award with information on criteria and how to apply.

1. 1
The Health Project: The C. Everett Koop National
Health Awards – 2014 Update
Ron Z. Goetzel, Ph.D., Johns Hopkins University and Truven Health Analytics
HPCareer.net -- Health Promotion Live – April 24, 2014

2. Agenda
• Introduction to The Health Project and C. Everett
Koop Award
• How to Apply for the Award
• Frequently Asked Questions
• Applied Research Methods – Documenting Health
Improvement and Cost Savings
• Summary and Q&A
2

3. We Honor
Dr. C. Everett Koop Former U.S. Surgeon General, 1916 - 2013

4. Dr. C. Everett Koop
• Born in 1916 in Brooklyn, NY
• Served as the 13th Surgeon General of the US under President
Reagan from 1982 to 1989
• In the 1940s and 1950s, became Professor of Pediatrics at the
University of Pennsylvania School of Medicine
• As a surgeon in Philadelphia, performed groundbreaking surgical
procedures on conjoined twins, invented techniques today commonly
used for infant surgery, and saved the lives of countless children
• Remembered for his stance on
– Abortion
– Tobacco use
– HIV/AIDS
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5. Dr. Koop With President Reagan
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6. The Health Project
C. Everett Koop National Health Award
• Non-profit, public-private partnership,
that recognizes organizations that have
demonstrated health improvements and
cost savings from health promotion and
disease prevention programs.
• At its launch in 1994, The Health Project
recognized the following organizations:
Johnson & Johnson, Aetna, Dow
Chemical Company, L.L. Bean, Inc.,
Quaker Oats Company, Steelcase, Inc.,
and Union Pacific Railroad.
• The Health Project is dedicated to
improving Americans’ health and
reducing the need and demand for
medical services through good health
practices.
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7. The Health Project Board of Directors
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• Chairman and Co-Founder: Carson E. Beadle
• President and CEO: Ron Z. Goetzel, PhD
– Johns Hopkins University, Institute for Health and Productivity
Studies and Truven Health Analytics
• Vice President: Seth Serxner, Ph.D., Optum
• Chief Science Officer : James F. Fries, MD
– Stanford University School of Medicine
• Secretary/Treasurer: James Wiehl, JD
– Fulbright & Jaworski

8. The Health Project Board Members
• Steve Aldana, PhD WellSteps
• David R. Anderson, PhD StayWell Health Management
• David Ballard, PsyD, MBA American Psychological Association
• Dan Gold, PhD Mercer
• Michelle Hatzis, PhD. Google
• Rebecca Kelly, RD, CDE, PhD University of Alabama
• Debra Lerner, MS, PhD Tufts Medical Center
• Joseph A. Leutzinger, PhD Health Improvement Solutions, Inc.
• Wendy Lynch, PhD Altarum Institute
• Michael O’Donnell, PhD American Journal of Health Promotion
• Ken Pelletier, PhD, MD (hc) University of Arizona and UCSF Schools of Medicine
• Bruce Pyenson, FSA, MAAA Milliman
• Seth Serxner, PhD, MPH Optum
• Stewart Sill, MS IBM Integrated Health Services
• John F. Troy, JD Public Policy Consulting
Ex Officio:
• Jason Lang, MPH Centers for Disease Control and Prevention (CDC)
• Ellen Exum IBM
• Tre McCalister Mercer
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9. Friends and Supporters
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10. Our Website -- http://www.thehealthproject.com
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11. Koop Award Application – Available at: www.thehealthproject.com
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12. Winner of the 2013 Koop Award
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13. 2013 Honorable Mentions
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14. Recent Winners
• Alcon Laboratories, Alcon’s Vitality Program
• Alliance Data, healthyAlliance
• Eastman Chemical Company, HealthE Connections
• L.L. Bean, Inc., Healthy Bean
• Nationwide Mutual Insurance Company, My life. My choice. My health
• Prudential Financial, HealthSolutions
• State of Nebraska, wellnessoptions
• The Dow Chemical Company, LightenUp Program
• Energy Corporation of America (“ECA”), ECA Platinum Wellness
• International Business Machines (IBM), Wellness for Life
• Lincoln Industries, Wellness – go! Platinum
• Vanderbilt University, Go for the Gold Wellness Program
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15. Dr. Koop with Winner -- IBM
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16. Dr. Koop with Winner – Vanderbilt University
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17. Dr. Koop with Winner – Dow Chemical
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18. Dr. Koop With Winner Lincoln Industries

19. Dr. Koop With Winner Energy Corporation Of America

20. The Health Project –
C. Everett Koop National Health Award
• To receive the Koop Award, there are three considerations:
– 1) The program must meet The Health Project’s goal of
reducing the need and demand for medical services,
– 2) Share the objectives of the Healthy People health
promotion targets, and
– 3) Prove net health care and/or productivity cost
reductions while improving population health.
20

21. Frequently Asked Questions (1)
• Are there minimum requirements for application?
– No specific requirements are set regarding participation rates, risk
reduction, and cost outcomes because of unique challenges that may
face any given applicant. However, it would benefit the applicant to
demonstrate high participation in a program, which is comprehensive in
nature (not single focus), net risk reduction, and cost savings that
exceed program expenses. Longer term programs (3+ years) are
generally higher rated than those in their beginning stages.
• What are programs evaluated on?
– Adherence to evidence-based practices, comprehensiveness,
participation rates, health improvement/risk reduction, and net cost
savings.
• Are requirements different for small and large organizations?
– Smaller organizations are not expected to do a sophisticated claims
analysis. If they can document cost stabilization over 3-5 years (without
significant benefit plan design changes or other utilization management
measures), that is often considered sufficient in terms of demonstrating
cost savings.
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22. Frequently Asked Questions (2)
• Does a published article serve as a gold standard?
– Yes, if it informative of evaluation results demonstrating health
improvement and cost savings. But, it is not a requirement.
• Is financial impact required or is change in risk status and utilization
sufficient?
– Health behavior change/risk reduction plus cost savings are required. If
the organization claims a positive return-on-investment (ROI), then both
savings and program costs need to be documented. Reduced utilization
translated into financial impact may be considered as long as this is not
achieved through benefit plan design, rationing, outsourcing, or
utilization review. There needs to be a link to health improvement and
risk reduction.
• Are vendor reports as good as independent third party analyses?
– Independent analyses wield greater influence, but vendor reports are
acceptable if they have well-documented methodology and are credible.
• What supporting materials are required?
– N’s, tables/graphs with clear annotation, statistics.
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23. Frequently Asked Questions (3)
• How are Winners determined?
– Applications are independently reviewed and scored by Board members.
Reviewing Board Members rate applications on a 100-500 scale, where
a score of 100 represents a superior program. Reviewers score
applications using their best judgment, and specific criteria, with greater
emphasis placed on program evaluation and results. Scores of 300 or
above indicate that the reviewer considers the application to be non-
competitive for a Koop Award.
– Scores from all reviewers are averaged with and without outliers (i.e.,
before and after dropping the lowest and highest values). Applicants with
average scores below 300 are considered for the Koop Award.
Applications with scores greater than 300 remain eligible for an
Honorable Mention Award as determined by the reviewers’ discussions.
– Final determination of Winners and Honorable Mentions are made at a
Board meeting that follows an independent review of applications.
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24. 24
Convince Me…
Did your organization improve health and
save money?

25. Setting A High Bar For Winning The Koop Award
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26. Research Methods -- Study Design 101
• Pre-experimental
• Quasi-experimental
• True experimental
Validity of results increases as
you move down this list
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27. 27
Notation In Study Design
• X=Intervention or program
• O=observation (data collection point)

28. 28
Research Design: Non-experimental
(Pre-experimental)
One group posttest only
X 02
One group before and after (pre-test/posttest)
01 X 02

29. Non-experimental Design -- (Pre-experimental)
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Program start

30. General Trend Or Program Effect?
30
Program start

31. 31
Research Designs: Quasi-experimental
Pretest posttest with comparison group
01 X 02 Intervention Group
--------------------------
01 02 Comparison Group

32. 32
Research Design: Experimental
TRUE EXPERIMENTAL – RANDOMIZED CLINICAL TRIAL (RCT)
01 X 02 EXPERIMENTALGROUP
(R) -------------------
01 02 CONTROL GROUP

33. 33
Adjusted Risk Factor Status -- Change In Percent Prevalence
% High Risk (Number of Respondents)
% Change^
Risk Factor T1 T3
All Respondents
Poor nutrition 79.0% (4711) 80.3% (3125) 1.3%*
Poor physical activity/exercise 39.6% (4742) 34.7% (3140) -4.9%*
Obesity 26.6% (4630) 27.0% (3079) 0.4%
High blood pressure 5.0% (4244) 4.2% (2810) -0.8%*
High cholesterol 6.1% (2995) 3.8% (2001) -2.3%*
High blood glucose (sugar) 5.2% (2392) 3.9% (1633) -1.3%*
Poor emotional health 21.6% (4626) 18.6% (3072) -2.9%*
Poor safety behaviors 21.4% (4544) 18.4% (2989) -3.0%*
Smoking & tobacco 13.8% (4747) 12.7% (3135) -1.1%*
High alcohol use 11.7% (4642) 9.6% (3045) -2.0%*
Lack of preventive screenings (Age 50+) 40.4% (1537) 39.3% (1015) -1.1%*
High stress 3.6% (4716) 2.8% (3132) -0.8%*
* denotes significance at the 0.05 level
^ Negative numbers indicate greater program impact
For each time, the first column displays the prevalence of high risk respondents, the second column shows the number of respondents providing valid answers
to the corresponding HRA question.

34. Intervention Sites N= 1,142 Control Sites N= 374
T1 T3
Change
T1 T3
Change
Difference
-in-
DifferenceMean SD Mean SD Mean SD Mean SD
Weight (lbs)
189.4 42.5 189.0 41.3 -0.3 187.9 38.5 189.2 39.9 1.3** -1.6**
BMI (kg/m2
)
28.3 5.3 28.2 5.2 -0.1 28.0 4.6 28.2 5.0 0.2** -0.3**
Systolic BP
(mm Hg) 124.4 14.1 122.3 13.3 -2.1*** 123.1 12.2 128.1 12.6 4.9*** -7.0***
Diastolic BP
(mm Hg) 80.3 9.1 78.2 8.8 -2.1*** 79.6 8.5 79.1 8.9 -0.5 -1.6**
Cholesterol
(mg/dL) 196.1 35.5 192.8 34.6 -3.2*** 193.3 36.4 193.7 37.8 0.4 -3.6*
Blood glucose
(mg/dL) 94.3 18.3 96.2 18.5 1.9*** 95.1 13.6 95.8 21.4 0.7 1.2
Biometric Values: (T1 – T3)
Statistically significant *p<0.05, **p<0.01 ***p<0.001
Cohort Data

35. J&J Study – Health Affairs, March 2011

36. Health Risks – Biometric Measures -- Adjusted
Results adjusted for age, sex, region * p<0.05 ** p<0.01

37. Health Risks – Health Behaviors -- Adjusted
Results adjusted for age, sex, region * p<0.05 ** p<0.01

38. Health Risks – Psychosocial -- Adjusted
Results adjusted for age, sex, region * p<0.05 ** p<0.01

39. Propensity Score Matching Results

40. Adjusted Medical and Drug Costs
Vs. Expected Costs From Comparison Group
Average Savings 2002-2008 = $565/employee/year
Estimated ROI: $1.88 - $3.92 to $1.00

41. 41
Summary
The Health Project aims to recognize
organizations that have documented health
improvements AND cost savings.
Size is not important – results are!
A growing body of scientific literature, and real-
world examples, suggest that well-designed,
evidence-based health promotion programs can:
• Improve the health of workers and lower their risk
for disease;
• Save businesses money by reducing health-
related losses and limiting absence and disability;
• Heighten worker morale and work relations;
• Improve worker productivity; and
• Improve the financial performance of
organizations instituting these programs.