Corporate Wellness : Health Promotion Programs Economic Considerations.
Posted by Corporate Wellness | Posted in Corporate Wellness, Wellness Programs | Posted on 16-07-2010
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Initially introduced by Halbert Dunn in the 1950’s, wellness became a well-liked buzzword during the late 1970’s and received considerable academic attention in the 1980’s.
Health promotion programs for employees became more widespread during the following decade, and credible evidence for their economic viability began to be published.
There have now been over 100 published studies on this topic and a number of systematic reviews.
Health risks increase costs. Medical and medical insurance costs escalate with both age and number of risks present.8,10 the number of risks is also strongly related to sick leave absenteeism, Employee’s Compensation costs, short-term disability, and reduced productivity (”presenteeism”).
Early employee health promotion programs were relatively basic and ordinarily produced a Return On Investment (ROI) of less than one dollar for every dollar spent operating the health promotion program (Return On Investment (ROI) = <1 - 1).8
Such health promotion programs could be characterized as “fun-oriented”. Participation is entirely voluntary, and there’s no particular focus on the reduction of specifically identified high risks.
Interventions and activities aren’t personalized, and there’s no emphasis on the management of medical costs. These wellness programs are normally site-based only, lack choices to address all of the major behaviorally-related health risks, and lack multimodal presentation.
Minimal or no incentives are provided to employees for participation, and services to spouses and family members are not available. Most such wellness programs lack meaningful analysis.
More conventional health promotion programs are “activity-oriented” and have shown an ROI of between 1 – 2.5 and 1 – 3.5.8 These health promotion programs might have a greater emphasis on health and risk reduction, although the efforts are relatively broad and not personalized.
They could have some generalized emphasis on medical cost management, although not necessarily aimed at specific high risks. Most are site-based and voluntary, with spouses included only rarely.
Modest incentives might be utilized to encourage participation. Formal analysis might be weak.
The newest and most economically viable wellness programs are “results-oriented” and exemplify the health and productivity management model. These wellness programs consistently produce return rates of 1 – 4 or greater within a 12-24 month period.8
Such wellness programs are strongly focused on the reduction of especially identified high risks and the management of medical costs. They’re normally voluntary, but use strong financial and other incentives to promote participation.
They are multi-component in nature (address all major risks), and have both onsite and virtual modalities of operation. The interventions are highly targeted and individualized, and offered to spouses as well as workforce.
For companies, the cost of providing health insurance for their workers is of great importance. Those costs have been increasing at annual rates between 6% and 14%.
Chapman’s 2007 systematic review7 stated an typical reduction in healthcare costs of 26.5 percent so of employee health promotion programs. His review covered 60 of the most scientifically precise studies, with an typical of 3.77 years of study.
Absenteeism due to illness is another cost driver. Chapman’s review7 reports an average reduction in sick time of 25.3%. Cost for Employee’s Compensation was reduced by 40.7%, and disability costs by 24.2%.
There’s also an emerging literature on the costs of presenteeism (reduced productivity).11,13 In one study, every risk reduced through a wellness program yielded a 9 percent reduction in presenteeism (and a 2 percent reduction in absenteeism).11
Some businesses have achieved a zero% increase in health care costs across at least brief periods of time.10 Doing so requires 90-95% participation of the worker population in focused health promotion programs, with 75%-85% of the workforce falling into the low risk category.10
Although comprehensive efforts to lower the risk status of those in moderate or high risk categories must be made, the needs of currently healthful workforce must be addressed as well to avoid increases in risk-status.
Given the size of the federal workforce, meaningful cost savings in the government’s contribution to medical insurance premiums for personnel may be achieved when a majority of that population were participating in active wellness programs.
In like fashion, improvements in absenteeism, employee’s compensation, disability, presenteeism, and turnover so of robust worker health promotion programs would yield substantial fiscal benefits for the government.
References
1 Aldana, Steven G. (2001) Financial Impact of Health Promotion Programs – A Extensive Review of the Literature. Am J Health Promotion 15(5) – 296-320.
2 Chapman, Larry. (1998) the Role of Incentives in Wellness. The Art of Wellness 2(3) – 1-8.
3 Chapman, Larry. (2003) Biometric Screening in Health Promotion – is it Really as Important as We Think? the Art of Health Promotion 7(2) – 1-12.
4 Chapman, Larry. (2005) Meta-Examination of Corporate Wellness Economic Return Studies – 2005 Update. The Art of Wellness, July/August, 1-15.
5 Chapman, Larry. (2006) Employee Participation in Corporate Wellness and Health Promotion Programs – Exactly how Important are Incentives, and Which Ones work Best? North Carolina Medical Journal 67(6) – 431-432.
6 Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth. (2007) the Role of Wellness Coaching in Corporate Wellness. the Art of Wellness, July/August, 1-12.
7 Chapman, Larry. (2007) Proof Positive – an Analysis of the cost-Effectiveness of Corporate Wellness. Northwest Health Management Publishing, Seattle, WA.
8 Chapman, Larry. (2007) an In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change. Workshop presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Businesss” Conference, Orlando, FL, January 23-24.
9 Edington, Dee. (2001) Emerging Research – A View from One Research Center. American Journal of Health Promotion 15(5) – 341-349.
10 Edington, Dee W. (2007) Health Management as a Serious Company Strategy. Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Companys” Conference, Orlando, FL, January 23-24.
11 Pelletier, Barbara, Boles, Myde, and Lunch, Wendy. (2004) Changes in Health Risks and Make certain to work Productivity. Journal of Occupational and Environmental Medicine, 46(7) – 746-754.
12 Pelletier, Kenneth R. (2005) A Review and Analysis of the Clinical and Cost-Effectiveness Studies of comprehensive Health and Disease ManagementPrograms at the Worksite – Update VI 2000-2004. JOEM 47(10)1051-1058.
13 DeVol, Ross, Bedroussian, Armen, et. Al. (2007) an Unhealthy America – the Economic Burden of Chronic Condition. Report released by the Milken Institute. www.milkeninstitute.org.
14 Partnership for Prevention. (2008) Investing in Health – Proven Health Promotion Practices for Worksites. http – //www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.

