The idea of corporate wellness programs have always appealed to me but there has never been strong evidence about the extent to which they improve health and reduce costs (see: Trucking Company Offers On-the-Road Wellness Services for Drivers; Adding a DAT Option to Corporate Wellness Programs). A recent JAMA article addressed this topic (see: JAMA Forum: Do Employee Wellness Programs Improve Health and Reduce Spending?). Below is an excerpt from it:
For some time, Wellness Programs have been growing in popularity across the United States. At this point, it appears that about half of employers with more than 50 employees offer them. But almost all really large employers, those with at least 50 000 employees, do....A recently published study adds some important information that might inform such programs in the future. The researchers looked an initiative that PepsiCo began in 2003 that eventually became their Healthy Living program. The program involved 2 separate components, what we might consider a “lifestyle” offering and a disease management component....Online or telephonic coaching were offered in areas like weight, nutrition, or stress management, fitness, and smoking cessation. The disease management component was available only to employees with 1 of 10 chronic conditions....The overall result, which will please proponents of wellness programs, is that the program reduced health care spending by $30 per member per month, or $360 per year. For every dollar spent, $1.46 was returned in savings....
But a further analysis showed that things were not so simple. The disease management component accounted for almost all of the savings. Those who participated in that part of the program saw a reduction in health care costs of about $136 a month, or more than $1600 a year. This was driven largely by a 29% decrease in hospital admissions. In fact, for each dollar spent on disease management, the company saw a return of $3.78. For each dollar spent on lifestyle management, they only saw a return of $0.48. In other words, lifestyle management cost more than they saw in return....[Lifestyle management programs] are offered to all employees and dependents, and are an attempt to get beneficiaries to better manage things like weight, diabetes, or blood pressure. Some of them, though, can be a form of cost-shifting. Those who do not comply with the program can be subject to penalties of $100 a month or more. In other words, unhealthier employees, or those who don’t meet certain criteria, pay more so that employers pay less. Disease management is somewhat different. This is money spent only on those who already have chronic conditions. It’s an investment by a company into the health of its sickest employees. It appears to work, in the sense that it saves more money than it costs. But it doesn’t have the widespread appeal of “wellness” programs.
All of this makes perfect sense. The advantages including cost savings of the corporate lifestyle programs like weight reduction, nutrition, stress management, fitness, and smoking cessation are relatively long-term. They also include an element of cost-shifting with financial penalties for those not motivated to participate. Direct intervention with employees with chronic diseases such as diabetes and hypertension will surely result in more financial savings because so much of our health expenditures relate to patients with chronic diseases (see: Chronic Disease Prevention and Health Promotion). Here are a few key points from this article about the costs associated with chronic diseases:
- Chronic diseases cause 7 in 10 deaths each year in the United States.
- About 133 million Americans—nearly 1 in 2 adults—live with at least one chronic illness.
- More than 75% of health care costs are due to chronic conditions.
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