According to a study published last month in Health Affairs, wellness programs linked to health plan enrollment don’t seem to lower overall healthcare costs, however, they have been shown to reduce hospitalizations.
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Gautam Gowrisankaran, a professor of economics at the University of Arizona in Tucson and a research associate with the National Bureau of Economic Research, and his coauthors examined in their study the effectiveness of a program put in place by BJC HealthCare, a hospital system based in St. Louis. BJC’s program tied employees’ eligibility to participate in the system’s most generous health plan with participation in a wellness program.
According to Gowrisankaran, to participate in the health insurance plan, employees had to complete a web-based health risk assessment including blood pressure, serum glucose, height, weight, cholesterol readings and waist circumference. They also had to sign a pledge promising to eat healthy food and exercise regularly, and enroll in a smoking cessation program if they smoked. People completing the health risk assessment were given automated feedback identifying their possible risk status and suggestions for follow-up actions.
Tied in with the health plan, starting in February 2004, the hospital system began providing health fairs at each employment site, according to the report. The fairs, staffed by the hospital system’s physicians, aimed to facilitate both employees’ awareness of their own health conditions and the collection of the biometrics for the health risk assessment. On-site clinicians screened employees, and those identified with one or more health risks were given physician referrals and reminder calls if necessary. In addition, employees participating in the wellness program received discounted premiums, Gowrisankaran said.
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The intervention, which began in 2005, he said, was associated with a 41 percent decrease, relative to a comparison group, in hospitalizations for conditions targeted by the wellness program but with no significant decrease in other hospitalizations.
“We found overall reductions in inpatient costs but similar increases in non-inpatient costs. Therefore, we concluded that although the program did cut some hospitalizations, it didn’t save money for the employer in the short term,” said Gowrisankaran.
“It’s actually encouraging that it does show a drop in hospitalizations,” he added. “It does suggest you can actually change behaviors with some of these incentives – if you don’t comply, you don’t get the good health insurance product. But you should think of it as something that will save money in the long run. If you can keep people out of the hospital, that’s a good thing – fewer sick days perhaps? More productive at work perhaps? The message for employers is that these are really good programs to help employees.”
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