As a pioneer in Population Health Management (PHM), our South Carolina hospital clients have capitalized upon their partnership with Sodexo, a leading Quality of Life company, in order to positively impact the wellness states of hospital employees, patients, and visitors. The Medical University of South Carolina (MUSC) is an example of one such partnership. MUSC, a 725-bed acute care academic medical center, is a leader in health education in South Carolina. MUSC strives to create an environment in which people can learn about and pursue healthy eating.

1. Going Beyond the Four Walls:
Population Health Management
(PHM) Partnership Strategies
MUSC & Sodexo
Jennifer M. Petrelli, SM, MPH,
Nutritional Epidemiologist,
Innovations 2 Solutions by Sodexo
Darien T. Kadens, PhD, MBA,
Director of Research, Healthcare Practice

2. 2
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
POPULATION HEALTH
MANAGEMENT (PHM) DEFINED
PHM is a broad effort whereby individual-, organizational-
and cultural-level interventions are planned and
implemented to improve the disease burden of a
particular geographical area. Further, PHM strategies
are used to decrease overall health care usage or to
encourage primary prevention efforts to prevent future
overuse of the health care system by keeping people well
at the onset. PHM is a systematic effort at stratifying
populations across health-risk profiles and applying
different behavioral strategies to mitigate further risk.
As a pioneer in Population Health Management (PHM),
our South Carolina hospital clients have capitalized upon
their partnership with Sodexo, a leading Quality of Life
company, in order to positively impact the wellness states
of hospital employees, patients, and visitors. The Medical
University of South Carolina (MUSC) is an example of one
such partnership. MUSC, a 725-bed acute care academic
medical center, is a leader in health education in South
Carolina. MUSC strives to create an environment in which
people can learn about and pursue healthy eating.
Sodexo has partnered with MUSC to deploy key PHM
strategies tailored to the MUSC culture and environment.
MUSC is one of 10 Sodexo hospital partners in South
Carolina that have been recognized for worksite wellness
with Gold Apple awards. Sodexo’s chefs, nutritionists,
and researchers carefully craft menus, education
initiatives, and nutrition resources for clients that
are informed by the most up-to-date evidence-based
research on diet and health. If adopted more broadly
with enthusiastic partners, this approach has the
potential to meaningfully improve the health and
wellbeing of a broad population in the Southeast.
Many institutions don’t follow through with plans
for PHM. Few understand its theoretical foundations,
and even fewer understand the importance of multi
stakeholder collaboration to make PHM strategies
successful. Sodexo brings together our subject matter
experts in diet and nutrition, epidemiology, and
outcomes-based research to work with the system in
order to leverage research and practice to create the
best possible outcomes. Any true approach to PHM is
collaborative and co-created.
Our partners recognize that disease prevention via
healthy food environments is good business sense. In
the current healthcare climate, what business cannot
afford to invest in prevention? PHM strategies are key to
prevention and cost control.
HOW TO INNOVATE IN A
COMPLEX ECOSYSTEM:
FORMING PARTNERSHIPS
Increasingly, hospitals are being asked to do a better
job communicating health information with a diverse
array of patients. Sodexo recognizes that the healthcare
environment is not static and that each organization
has a unique culture requiring a tailored approach. Our
team is vigilant about staying on the cutting edge of
knowledge in nutrition — and how to communicate it
appropriately to diverse audiences. In addition, we scan
the horizon for new innovations that fit the specific
needs of our clients and add value to our food services.
Meeting Population
Health Needs
“Not only do providers need to
concern themselves with patients
who seek care, they also must
engage whole populations in order
to meet expectations. A population-
driven, patient-centered model
of care can meet the needs of all
consumers regardless of where those
consumers are on the continuum
of health. With primary care at the
center of a model surrounded by
support that includes a combination
of health information technology,
the care team and ancillary providers,
diverse care needs can be met,
quality can be improved and cost will
be sustainably impacted.”
– Care Continuum Alliance, 2012

3. 3
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
By creating a joint PHM Strategy, our teams capitalize
on the strengths of each of our organizations in order to
reduce the disease burdens of the communities we serve.
Partnerships are truly the force multiplier of sound PHM
efforts. Many features of this strategy merit attention.
§§ A dedicated Sodexo team led by Subject Matter
Experts in marketing, nutrition, public health,
hospital administration, biostatistics, and health
communication.
§§ An outcome-focused strategy that leads to
financial savings and hones in on population
outcomes such as behavior change, increased
usage of wellness/preventive services, and better
medication and diet adherence.
§§ An ongoing dialogue with the hospital’s Office of
Health Promotion, Office of Patient Experience, or
equivalent at each site to ensure healthy options
are provided at every station, less expensive
healthy options are available, and nutrition
information is posted for all items in a form that
maximizes health literacy.
§§ Enhanced community partnerships, facilitated by
other Sodexo accounts in the surrounding areas.
For instance, local hospitals are able to liaise
with Campus, Leisure, and Business and Industry
Division accounts in their geographic region.
TAILORED INTERVENTIONS:
FOOD AS PART OF PHM
STRATEGY
An important part of any PHM Strategy is to provide
tailored interventions to numerous segments in a
population. Sodexo works with clients to incorporate
current best practices and interventions and blend in
our own enhancements when applicable. A particular
area of strength for both parties is the provision of
access to healthier food options for patients, guests,
and hospital staff.
Hospitals and medical centers are community leaders
in the area of Health and Wellness. They are well placed
to educate, encourage and inspire not only their own
campus, but the citizens of South Carolina as well.
Sodexo’s Health and Wellness plan for hospitals aligns
seamlessly with medical center missions. It also
embraces the objectives of the Affordable Care Act,
which may make great strides in eliminating penalties
tied to readmissions. What’s more, by impacting highly
preventable Health and Wellness concerns within the
staff population — such as poor nutrition, inactivity,
obesity, diabetes and high blood pressure — hospitals do
their part in containing skyrocketing health care costs.

4. 4
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
Sodexo shares South Carolina hospitals’ commitment
to a healthier lifestyle to improve the quality of life of
those working within the medical campuses it serves.
Our commitment to build wellness is built on a few
simple ideas.
§§ A commitment to improving employee health
§§ A potential reduction in overall benefit costs
stemming from healthier food options and better
quality of life
§§ A heightened reputation as a community wellness
center when hospital employees spread the word
PROVIDING ACCESS TO
HEALTHIER FOOD: EMPLOYEE
AND COMMUNITY WELLNESS
Food and the dining experience can play a powerful role
in contributing to the bottom line, as well as in creating
an optimal workplace experience for employees. In
addition to providing nourishment, research shows
that consuming the right nutritional mix contributes
to cognitive performance and improves mental clarity,
energy, focus and even memory. In the workplace, these
outcomes are especially significant as they are directly
correlated with employee productivity and performance.
It’s not just about decreasing absenteeism via a healthier
workforce; it’s also about decreasing “presenteeism”
among employees — that is, reducing the amount of
time they are at work but not fully focused and engaged.
Furthermore, the choice of food offerings and the design
of on-site café spaces can help shape companies’ image
value, influence the overall workplace experience, and even
foster a certain type of workplace culture. Many forward-
thinking organizations are seeking to promote a culture
of innovation and collaboration — and rethinking the
food offers and dining spaces can help realize that goal. In
addition, today’s competitive labor market requires that
businesses differentiate themselves in order to attract
top talent; again, the food services and spaces can help
convey a company’s unique values and priorities.
MINDFUL BY SODEXO
An environmental approach to employee wellness is to
make eating healthfully easy — by default.
Mindful was introduced
in February of 2013 as
a unique approach to
wellness that focuses
on transparency of
ingredients, appealing flavor profiles, and satisfying
portions. It’s an approach that believes you don’t have
to sacrifice great tasting food to be healthy. In the first
12 months of the program, Sodexo has seen it have
tremendous impact in serving its more than 15 million
consumers daily. The program is currently deployed in
2,000 accounts across the U.S.
Through our carefully selected mix of foods, Mindful
delivers satisfying portions that are not only delicious,
but also meet a wide array of specific nutrition
guidelines that control the level of calories, fat, saturated
and trans fats, cholesterol and sodium, while maximizing
the amount of fiber and other essential nutrients.
Highlights include:
§§ Meals and entrées that fill the plate with less than
600 calories due to the use of more vegetables,
fruits, whole grains and less fat
§§ Significantly reduced sodium in our soups to less
than 700mg per 8-oz. serving by replacing salt
with more fresh herbs and spices
§§ Desserts with less than 200 calories and at least
1g of fiber due to the use of less refined sugar and
more fresh fruits
§§ No trans fat and less than 10% of calories from
saturated fats in all our menu selections
According to the first-year results announced in
February 2014 for the wellness program, Mindful by
Sodexo, an estimated five tons of salt and 14 tons of
sugar were eliminated from the diets of consumers in
2013. Designed to help make lifestyle choices second
nature, Mindful taps into Sodexo’s expertise in health
and well-being.

5. 5
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
“With an obesity rate in the U.S. that touches more
than a third of all adults and 17 percent of youth,
it’s the responsibility of everyone in our industry
to help shape behavior change that promotes
better health and wellness,” said George Chavel,
president and CEO, Sodexo. “That responsibility
includes finding ways for making healthy choices
second nature, and easily accessible.”
Sodexo’s approach to wellness is about more than what
is on the plate. It is also about promoting an active
lifestyle and building a sense of community that is
supportive. The Mindful by Sodexo website features rich
content filled with recipes, nutrition information, access
to registered dietitians, fitness apps, and the ability to
form groups or forums. Visitors can also enjoy games
and daily sweepstakes.
Sodexo believes in healthy eating that’s filled with
choices, satisfying flavors, full plates and healthy
indulgence. Through Mindful, Sodexo’s innovative
approach to healthy eating, patients and staff
experience the Mindful principles of food offerings with
all their senses. They see food portioned correctly and
how chefs honor the ingredients and their preparation.
They smell savory aromas. They taste new ways of
seasoning that enhance flavors. They hear other patrons
comment on how delicious and satisfying the menu
choices are. And, ultimately, they will be motivated to
eat healthier because Mindful makes it easier than ever.
Through Sodexo’s Mindful website and app, patients can
remain plugged into a healthy community and a wellness
mindset. Whether they seek nutrition data, healthy
recipes or diagnosis-specific information, this website
is chock-full of the information your patients need to
remain committed to a healthier lifestyle.
Mindful is about taking a series of small steps to getting
healthy so that eventually, making healthy choices
becomes second nature for your patients. One great
way to move them along on this journey is Fitbit. Fitbit
is a convenient wireless device that can be clipped on a
waistband andthat automatically counts how many steps
are taken in a day, how many flights of stairs are climbed,
how many calories burned and more. It integrates with
MyFitnessPal to easily track daily activity in conjunction
with the food diary. Through its partnerships with
MyFitnessPal and Fitbit, Sodexo extends the Mindful
mindset out your doors and into your community.
MUSC, SODEXO, AND THE GOLD
APPLE HOSPITAL AWARD
MUSC is one of 10 Sodexo hospital partners in South
Carolina that has been recognized as a Gold Apple hospital
for “providing the highest standard of excellence for the
healthy food environments offered to employees, patients
and visitors.” MUSC received this acknowledgement from
Working Well for the first time in 2012. Working Well is a
collaboration between SCHA and NC Prevention Partners
(NCPP). Working Well is an effort to improve the health
of hospital employees across the state of South Carolina
by creating worksite wellness environments where the
healthy choice is the easy choice.
In 2013, MUSC was named a Gold Triple Threat hospital.
To earn the Gold Triple Threat designation, a hospital
must reach the highest standard of excellence and earn
Gold in all three pillars: Gold Star for tobacco, Gold Apple
for nutrition and Gold Medal for physical activity.

6. 6
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
MUSC also received the 2013 Prevention Excellence
award from NCPP in recognition of their efforts to create
a culture of wellness.
“MUSC continues to display their dedication to
population health improvement and innovative
spirit by implementing environments and
programs, supported by policy, that provide
employees, patients, and community with
easy access to the healthiest choice. MUSC has
accomplished amazing things in a short amount
of time, but more impressive is their willingness
to share the lessons learned and successful
strategies to lift up worksite wellness culture in
hospitals and businesses throughout SC, as a
Working Well Center of Excellence.”
– Jen Wright, Working Well Manager
In order to earn Gold Apple recognition, MUSC worked
in collaboration with Sodexo to create healthy food
environments supported by comprehensive policies
and systems. Hospitals earn the Gold Apple Award by
implementing five key components to a healthy food
environment: pricing, access, marketing, benefits, and
incentives.
Pricing: Mindful entrées are offered at a 10% discount
and healthy items in vending machines are also
discounted.
Access: Mindful items are offered at every station, only
healthy snacks are featured at the cash registers and
entrances, and chip racks and beverage coolers have the
healthy items on the top three shelves.
Benefits: Employees get a discounted price at the MUSC
Wellness Center, smoke-free campus with assistance to
help quit, exercise trails (inside & out).
Incentives: A frequent buyer program for Mindful
entrées; buy 9, get the 10th for free.
Marketing: A Mindful Station at the entrance to the
cafés, all menus and station signs have the Mindful
logo on items that fit the criteria, menu line recordings
identify Mindful selections, bar codes for MyFitnessPal,
Lunch & Learns around campus and at the Urban Farm.
In terms of education beyond the food environment,
MUSC provides information on healthy eating and
special events, such as live cooking demonstrations
and “eat this, learn that” lunch and learn sessions, via
newsletters, weekly columns in the MUSC newspaper,
daily broadcast message tips, Facebook. Additionally,
educational resources and teaching opportunities to
faculty and staff are available on MUSC’s Nutrition
Services website.
In the spring of 2012, the MUSC Urban Farm became a
living classroom where a variety of fruits, vegetables,
and herbs grown in SC are harvested and used for
teaching purposes for our employees, patients and the
Charleston community.
Our Sodexo culinary teams have captured 1st, 2nd,
and 3rd place in the last two Cooking Well Invitationals
hosted by SCHA and Working Well.
“It is an honor to be recognized
for creating a healthy campus
and promoting health and
wellness in our community. To
achieve the highest standard
and be named Gold in all pillars
required considerable work
in meeting evidence-based
criteria. I am amazed at what
we have accomplished and the
transformation I’ve witnessed
in such a short time. All around
our campus you’ll see evidence
of MUSC’s commitment
to creating a physical
environment that contributes
to health and well-being.”
– Dr. Susan Johnson, MUSC’s Director of the
Office of Health Promotion

7. 7
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015
CONCLUSION
The path to population health is via well-being improvement. Sodexo recognizes that well-being involves not only
keeping people healthy, but also reducing lifestyle risks, and optimizing care for those with known conditions or chronic
disease. Through our partnerships we establish the best practices in total population health via nutrition and truly
transform health and care.
Sodexo and its South Carolina partners have successfully increased access to healthy foods, shifted the proportion of
healthy foods on site, and utilized behavioral economic strategies to promote healthful eating behaviors. Our goal is to
engage partners to improve population and community health in a comprehensive way. We are proud that 10 Sodexo
hospitals in SC have attained Gold Apple recognition. We strive to create unprecedented opportunities with our partners
to implement evidence-based programming that drives real health and fiscal outcomes. Sodexo has improved the
wellness state at its partner facilities and can do the same for other hospitals.
HEALTHY FOOD ENVIRONMENT INTERVENTIONS DEVELOPED
AND IMPLEMENTED BY MUSC AND SODEXO
§§ Healthy options available at every station
§§ Healthy options made less expensive
§§ Nutrition information posted for 100% of items in
cafeteria
§§ Healthy vending machines serving only all-natural,
organic, preservative-free items
§§ Existing vending machines feature a “traffic lite”
system to identify healthy choices with a surcharge
of 5 cents added to unhealthy items with proceeds
benefiting the MUSC Heart Health Pediatric weight
management program.
§§ Promote the “Mindful at Home” program through
cooking demos and videos along with recipes to take
home
§§ Guest Chef program featuring Mindful recipes
§§ On-site Urban Farm hosts lunch & learns, cooking
demos and serves as an outdoor classroom for
patients and the community
§§ Promote monthly, campus-wide wellness themes
§§ Nutrition topics are presented to staff meetings as
requested
§§ Weekly Nutrition huddles with staff
§§ Leveraging social media to engage employees on
what’s happening around nutrition on campus
§§ Provide nutrition expertise to the local media
through articles for newspapers, online news
outlets, TV and radio
§§ Numerous Community Events: Fit Family Challenge,
Charleston Healthy Business Challenge, A Taste of
African Heritage Cooking Series, Meals on Wheels
for post-kidney transplant patients, Lowcountry
Food Day Crawl, Working Well Initiative, Cooking
Well Invitational, National Eat Healthy Day,
National Start Walking Day, Lowcountry Heart
Walk, Go Red for Women

8. 8
The information and concepts contained in this document are the proprietary property of Sodexo.
As such, they cannot be reproduced or utilized without permission. ©2015