The purpose of this white paper is to highlight Sodexo’s PHM initiatives, with specific emphasis on nutrition and wellness solutions that go beyond food, to help employees and other populations achieve optimal health. The role of the RDN (Registered Dietitian Nutritionist) in these efforts will also be discussed, and case studies and examples will be provided to illustrate the outcomes achieved by Sodexo’s PHM solutions.

1. CORPORATE SERVICES
Sodexo’s Population
Health Management
Approach & the Key
Role of Registered
Dietitian Nutritionists

2. 2 | Sodexo’s Population Health Management Approach | 2015
Population Health Management
(PHM Defined)
Population Health Management, or PHM, is a broad effort
whereby individual-, organizational- and cultural-level
interventions are planned and implemented to improve the
disease burden of entire groups or populations. By keeping
people well at the onset, PHM strategies can be used to decrease
overall health care usage and to encourage primary prevention
efforts that avoid future overuse of the health care system.
Taking into consideration the social, economic, environmental
and behavioral factors that contribute to health disparities
and continuum of care, PHM takes a systematic approach
by stratifying populations across health-risk profiles and
applying different behavioral strategies to mitigate further
risk.
The purpose of this white paper is to highlight Sodexo’s PHM
initiatives, with specific emphasis on nutrition and wellness
solutions that go beyond food, to help employees and other
populations achieve optimal health. The role of the RDN
(Registered Dietitian Nutritionist) in these efforts will also be
discussed, and case studies and examples will be provided to
illustrate the outcomes achieved by Sodexo’s PHM solutions.
“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
andcostwillbesustainablyimpacted.”
- Care Continuum Alliance, 2012
POPULATION HEALTH MANAGEMENT
Sodexo’s Population Health Management
(PHM) Approach and the Key Role of RDNs
(Registered Dietitian Nutritionists)
Jennifer M. Petrelli, SM, MPH, Nutritional Epidemiologist, Innovations 2 Solutions by Sodexo

3. Published by Innovations 2 Solutions | 3
Why does Sodexo Focus on PHM?
The CDC reports that nearly 50% of all adults (or 117 million
people) have one or more chronic health conditions and 25%
have two or more chronic health conditions. Many of these
issues are caused by preventable risk factors, such as poor
nutrition, lack of physical activity, sleep deprivation, alcohol
dependency, or smoking addiction. Employee health and well-
being can have a significant impact on the overall performance
of the organization. In addition to having healthier, happier
employees, organizations can save millions on health care
and disability costs. They can also benefit from increased
workforce productivity, reduced employee absenteeism, and
decreased rates of injuries and accidents.
Sodexo partners with organizations to develop and deliver
programs that improve the health and well-being of employees
through modification of one or more of these risk factors.
Company-sponsored wellness programs offer structure,
motivation and tools that drive positive change. However,
many institutions don’t follow through with their plans for
a Population Health Management strategy. 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.
AHarvardUniversitystudyof100peer-
reviewed journal articles, Workplace
Wellness Programs Can Generate
Savings, found that a properly
designed wellness program that
includes chronic disease management
yields impressive ROI. The analysis
showed that medical costs fall $3.27
for every dollar spent on wellness
programs, and absentee day costs fall
by $2.73 for every dollar spent after
three years.
The Role of RDNs in Population Health
Management
When we think of professionals working in the Population
Health Management (PHM) arena, we often think of doctors,
nurses, epidemiologists and other public health professionals.
However, Registered Dietitian Nutritionists (RDNs) are an
overlooked and untapped resource in PHM efforts.
RDNs translate the science of nutrition into practical solutions
for healthy living. They have a unique skill set coupled with
the ability to bring about behavior change in a wide range of
populations. Specifically, RDNs bring value to multidisciplinary
teams by providing care that can lead to improved outcomes
for people with a variety of health risks, morbidities or medical
conditions.
“Allstakeholderswithinthehealthcare
systemneedtorecognizeandembrace
the value and multidimensional role
of the RDN. Studies confirm positive
outcomes and cost-effectiveness of
medical nutrition therapy (MNT). As
the population changes to include a
greater number of older individuals
withmultiplechronicdiseases,therole
of the registered dietitian nutritionist
will become even more crucial to
effectively manage this population.”
- Sonja L. Connor, MS, RDN, LD, FAND,
President of Academy of Nutrition & Dietetics
A large body of research has shown that disease prevention and
intervention via nutrition can have a significant public health
impact. In addition to providing nourishment and preventing
the onset of chronic disease, 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.
Sodexo fully recognizes that RDNs are the force multiplier in
PHM strategies to maintain or improve health and well-being
among low-risk populations, and combat chronic disease
and other medical conditions among high-risk populations.
Our more than 4,700 RDNs play a key role in developing and
implementing our PHM solutions, which will be subsequently
described.

4. 4 | Sodexo’s Population Health Management Approach | 2015
Meeting Population Health Needs: Sodexo’s
Suite of Solutions
Our partners recognize that disease prevention via nutrition
and wellness solutions 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.
Sodexo creates tailored nutrition and wellness programs
based on client needs (see Figure 1). The following sections
will describe these solutions in greater detail, and case studies
will be provided that showcase some of the outcomes we have
achieved with our partners.
Medical Nutrition Therapy for Diabetes and Kidney
Disease
As part of our community outreach, Sodexo’s RDNs have
counseled over 20,000 people with diabetes in 86 locations —
from Hawaii to New York. The resulting statistical outcomes,
HgbA1C (lab test indicative of diabetes management) and
weight, were assessed at very significant and greater than
national averages.
Sodexo’s Core4™ Programs
Sodexo offers three Core4™
programs: Core4™ for Adult
Weight Management, Core4™
for Pediatrics, and Core4™ for
Diabetes. All of these programs
were developed by RDNs
using proven evidence-based
methods. The Core4™ programs are also taught by RDNs, who
help participants learn how to improve their eating habits,
lifestyle and activity choices. In addition, participants are
taught how to maintain their weight loss and lifestyle changes
in the long-term. The program is 100% reimbursable by some
insurance plans.
Sodexo’s Core4™ for Adult Weight Management is offered as
a 3-month or 12-month program. Both programs include 12
one-hour weekly sessions; however, after the first 12 weeks
the 12-month program continues with 9 additional monthly
sessions. Each week, different aspects of weight loss are
addressed, including portion control, choosing foods wisely,
why extreme diets don’t work, food labels and exercise.
Core4™ gives participants the support they need not only to
lose weight, but also to maintain weight loss.
Core 4™ for Adult Weight Management has been included in
several hospitals’ employee wellness programs with significant
ROIs. Over 5,000 people have completed the program at 26
sites from New York to Texas. Many clients include Core4™ in
their employee wellness program free of charge or subsidized.
The program has been shown to have statistically significant
outcomes: the 3-month program produced an average weight
loss of 4%, and the 12-month program’s weight loss increased
to 7.6%.
Figure 1

5. Published by Innovations 2 Solutions | 5
CASESTUDY Core4™ for Adult Weight Management Case Study: Fairview Hospital and the
University of Minnesota in Minneapolis
• Preferred One pays 100% for Core4™ for all beneficiaries regardless of weight
• 634 participants completed Core4™ over 3 years
• Average weight loss in 12 weeks: 4%
• Average waist inches lost: 2.5 inches
• Total weight lost: 4,150 pounds
• Total inches lost: 1,160 inches
Virtual Counseling: Denver Wellness and Nutrition, a
Sodexo Company
Virtual nutrition services
through Sodexo’s Denver
Wellness Center can provide
services anywhere in the
U.S. The Center’s RDNs
provide expert, evidence-
based nutrition counseling
through individual sessions,
group classes and virtual
appointments. They are
trained specialists in family
meal planning, weight
loss, weight management,
diabetes, gestational
diabetes, high cholesterol,
hypertension, cancer, food
intolerance allergies, pregnancy, pediatrics, gastric bypass,
lap band, Celiac Disease (gluten sensitivity), inflammatory
bowel disease, and renal insufficiency and have training in
the scientific principles of medical nutrition therapy. Clients
include Google, AOL, Cronkey Sports, Trust American Rose
Preventative Medicine, and Skyridge Medical Center.
Sodexo’s Comprehensive Malnutrition Platform
Sodexo’s Comprehensive Malnutrition Platform is a program
that coordinates identification and documentation of
malnourished patients, and provides interventions to improve
their quality of care, optimize outcomes and maximize
reimbursement. The program addresses the challenge of
identifying and treating patients with nutritional needs, as
it is not always easy to recognize malnourished patients.
Malnutrition can lead to chronic disease, and during an acute
illness, can slow patient recovery and may lead to death.
Training dietitians to identify, document and treat patients
early in their hospital stay improves overall patient outcomes
and plays a key role in reducing readmissions. The results of
Sodexo’s Malnutrition Coding Study show that the average
300-bed hospital will capture an additional $250,000 a year
with program implementation.
CASESTUDY
Essentia Health
Essentia Health partnered with Sodexo and successfully addressed the challenges of identifying and treating
patients with nutritional needs. Sodexo’s National Nutrition Team provided solutions to this complex problem
by implementing Sodexo’s Malnutrition Documentation Program, which includes proper training for clinical
and nutrition-focused clinical assessment of patients, accurate medical record documentation and coding
procedure to ensure compliance with CMS regulations, as well as technical support to identify and capture all
allowable reimbursements. The program results were positive: Essentia Health achieved a substantial increase
in potential reimbursement dollars, annualized at $216,760, in the first seven months of implementation.
Key Highlights of Essentia Health and Sodexo’s Comprehensive Malnutrition Program Partnership:
• Successful implementation of malnutrition coding assessment and training program
• Ensures regulatory Compliance with CMS Conditions of Participation for Malnutrition coding
• Improves malnutrition diagnosis capture rate and allowable reimbursements
Client Perspective
“Talk about hitting a wall and climbing right over it. This program is proactive,
innovative and brings value and best practices to our organization.”
-Doug Vang, Vice President Inpatient Care, Essentia Health

6. 6 | Sodexo’s Population Health Management Approach | 2015
CASESTUDY Lehigh Valley Network provides the following services:
• Sodexo’s Core4™ for Adult Weight Management program is reimbursed for Lehigh Valley Network
employees under their wellness benefits.
• Dietitians provide community education programs via Million HeartsR, a national initiative co-led
by CDC and the Centers for Medicare and Medicaid Services (CMS), to meet the national goal of
preventing 1 million heart attacks and strokes by 2017.
• Sodexo Dietetic Interns engage consumers in food deserts to support Cooking Matters, a
collaboration between Share Our Strength and local program partners. Cooking Matters provides
families with hands-on education as they shop for food, teaching them how to compare foods
based upon cost and nutrition.
• Sodexo’s Sports Nutrition services at LVHN Fitness use Olympic guidelines to assess, educate and
provide counseling based on the type of activity in which you engage.
• A Healing Herb Garden was created under the leadership of Sodexo’s Executive Chef, a cofounding
member of Grow Leigh Valley, which is a collaboration of Sodexo culinary teams in the Lehigh
Valley that sources fresh, local, sustainable and seasonal ingredients.
“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
learnedandsuccessfulstrategiestoliftupworksitewellnesscultureinhospitals
and businesses throughout SC, as a Working Well Center of Excellence.”
-Jen Wright, Working Well Manager
CASESTUDY
MUSC, Sodexo, and the Gold Apple Hospital Award
Sodexo has partnered with the Medical University of South Carolina (MUSC), a 725-bed acute care academic
medical center, to deploy key PHM strategies tailored to the MUSC culture and environment. 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 acknowledgment for the first time in 2012 from Working Well, which 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. MUSC also received the 2013 Prevention Excellence award
from NCPP in recognition of their efforts to create a culture of wellness.
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. 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.
The complete MUSC case study can be found on Sodexo’s I2S Knowledge Library.

7. Published by Innovations 2 Solutions | 7
Conclusion
Population Health Management is an approach designed to
shift the focus toward wellness using a broader perspective
that promotes improved health outcomes for entire groups or
populations. In order to be optimally effective, however, PHM
efforts must be developed and implemented by collaborative,
multidisciplinary teams. Registered Dietitian Nutritionists
are an essential part of PHM initiatives, and Sodexo fully
recognizes and embraces the value and multidimensional role
of RDNs on any PHM team.
The goal of Sodexo’s PHM approach is to engage partners to
improve population and community health in a comprehensive
way, with an emphasis on prevention. Whether in the
workplace or in healthcare settings, 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.
We strive to create unprecedented opportunities with our
partners to implement evidence-based programming that
drives real health and fiscal outcomes. Our suite of nutrition
solutions – including Medical Nutrition Therapy, Core4™,
Virtual Counseling, and our Comprehensive Malnutrition
Platform – establish best practices in population health and
have been proven to be effective in transforming health, well-
being and care. In fact, Sodexo has improved the wellness state
of the organizations we partner with, and we are confident we
can do the same for other clients.

8. Sodexo
9801 Washingtonian Blvd.
Gaithersburg, MD 20878
888 SODEXO 7
www.sodexo.com