Do Workplace Health Promotion (Wellness) Programs Work? Goetzel, Ron Z.; Henke, Rachel Mosher; Tabrizi, Maryam ...
Journal of occupational and environmental medicine,
2014-September, Letnik:
56, Številka:
9
Journal Article
Recenzirano
OBJECTIVE:To respond to the question, “Do workplace health promotion programs work?”
METHODS:A compilation of the evidence on workplace programsʼ effectiveness coupled with recommendations for ...critical review of outcome studies. Also, reviewed are recent studies questioning the value of workplace programs.
RESULTS:Evidence accumulated over the past three decades shows that well-designed and well-executed programs that are founded on evidence-based principles can achieve positive health and financial outcomes.
CONCLUSIONS:Employers seeking a program that “works” are urged to consider their goals and whether they have an organizational culture that can facilitate success. Employers who choose to adopt a health promotion program should use best and promising practices to maximize the likelihood of achieving positive results.
To measure adherence and assess medical utilization among employees enrolled in a disease management (DM) program offering copayment waivers (value-based insurance design VBID).
Retrospective matched ...case control study.
Cases were defined as those enrolled in DM, of whom 800 received health education mailings (HEMs) and 476 received telephonic nurse counseling (NC). Controls were eligible for the DM program but did not enroll. Cases and controls were matched 1:1 based on propensity score (n = 2552). Adherence, defined by proportion of days covered, was calculated for 4 diseases using incurred drug claims 1 year before and after the DM program was implemented. Unadjusted and adjusted linear regression compared changes in adherence. Costs and utilization were compared at 1 year and 1.5 years after versus 1 year before implementation.
Members receiving NC had improved adherence for antihypertensives, diabetes medications, and statins (β = 0.050, P = .025; β = 0.108, P < .001; β = 0.058, P = .017). Members receiving HEMs had improved adherence only for diabetes medications (β = 0.052, P = .019). Total healthcare costs for NC members increased by $44 ± $467 versus $1861 ± $401 per member per year (PMPY) for controls (P = .003) at 1.5 years post-implementation. Total healthcare costs for HEM members significantly increased ($1261 ± $199 vs $182 ± $181 PMPY for controls; P < .001) at 1.5 years.
VBID may be effective in improving medication adherence and reducing total healthcare costs when active counseling is provided to high utilizers of care.
Integrated health management programs combining disease prevention and disease management services, although popular with employers, have been insufficiently researched with respect to their effect ...on costs.
To estimate the overall impact of a population health management program and its components on cost and utilization. STUDY DESIGN, SETTING, AND PARTICIPANTS: Observational study of 2 employer-sponsored health management programs involving more than 200,000 health plan members.
We used claims data for the first program year and the 2 preceding years to calculate cost and utilization metrics, and program activity data to determine program uptake. Using an intent-to-treat approach and regression-based risk adjustment, we estimated whether the program was associated with changes in cost and utilization. Data on program fees were unavailable.
Overall, the program was associated with a nonsignificant cost increase of $13.75 per member per month (PMPM). The wellness component alone was associated with a significant increase of $20.14 PMPM. Case and disease management were associated with a significant decrease in hospital admissions of 4 and 1 per 1000 patient-years, respectively.
Our results suggest that the programs did not reduce medical cost in their first year, despite a beneficial effect on hospital admissions. If we had been able to include program fees, it is likely that the overall cost would have increased significantly. Although this study had important limitations, the results suggest that a belief that these programs will save money may be too optimistic and better evaluation is needed.
The purpose of this research was to determine whether participation in the health risk assessment (HRA) component of a comprehensive health promotion program has an impact on medical costs, and ...whether the addition of participation in interventions has an incremental impact. Program participants (n = 13,048) were compared with nonparticipants (n = 13,363) to determine program impact on paid medical costs. Overall, HRA participants cost an average of $212 less than eligible nonparticipants. As HRA participation increased, cost saving aho increased. Additionally, although participation in either an HRA or activities alone resulted in savings, participation in both yielded even greater benefits. The findings indicate that there is an independent benefit of each of these elements of participation, and that the sum of the elements provides a greater benefit than the impact of either of the individual elements alone. (J Occup Environ Med. 2003;45: 1196-1200)
The relationship between behavioral health risks and worker absenteeism was investigated. Data on absenteeism and on 10 behavioral health risk areas were collected from 35,451 employees. Analyses ...examined whether higher health risks are associated with higher absenteeism, and whether a reduction in health risks translates into a reduction in absenteeism. Results revealed that a significant relationship existed between health risks and absenteeism in 8 of the 10 risk areas examined. Individuals who are at risk are more likely to be absent than individuals at low risk. Additional analyses revealed that individuals who reduce their risks in the areas of mental health, stress, and back are absent less often than individuals who remain at risk. These findings suggest that absenteeism, and the costs associated with it, may be controlled by health promotion programs and the reduction of health risks.
Purpose.
To compare changes in medical costs between participants and nonparticipants in five
different health and productivity management (HPM) programs.
Design.
Quasi-experimental pre/post ...intervention study.
Setting.
A large financial services corporation.
Subjects.
A cohort population of employees enrolled in medical plans (n = 49,793).
Intervention.
A comprehensive HPM program, which addressed health risks, acute and chronic
conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to
encourage health risk assessment participation in years 2 and 3.
Measures.
Program participation and medical claims data were collected for members at the end of
each program year to assess the change in total costs from the baseline period.
Analysis.
Multivariate analyses for participation categories were conducted comparing baseline
versus program year cost differences, controlling for demographics.
Results.
All participation categories yielded a lower cost increase compared to nonparticipation
and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45:1 ROI
for the combined program years.
Conclusion.
Medical cost savings exceeded program costs in a wide variety of health and
productivity management programs by the second year.
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