Health And Wellness Programs

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 personnel became more widespread during the following decade, and credible evidence for their economic viability started 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 health insurance costs escalate with both age and number of risks present.8,10   the number of risks is also strongly related to sick time absenteeism, Employee’s Compensation costs, short-term disability, and reduced productivity (”presenteeism”).

Early staff member health promotion programs were relatively basic and normally produced a ROI of less than one dollar for every dollar spent operating the program (ROI = <1 - 1).8

Such programs could  be characterized as “fun-oriented”.  Participation is entirely voluntary, and there is no particular focus on the reduction of specifically identified high risks.  

Interventions and activities are not personalized, and there is no emphasis on the management of health care costs.  These programs are typically site-based only, lack options 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 aren’t available.  Most such programs lack meaningful analysis.  

More conventional programs are “activity-oriented” and have shown an ROI of between 1 – 2.5 and 1 – 3.5.8 These programs might have a greater emphasis on health and risk reduction, although the efforts are relatively broad and not customized.  

They might have some generalized emphasis on health 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 evaluation might  be weak.

The newest and most economically viable programs are “results-oriented” and exemplify the health and productivity management model.  These programs consistently produce return rates of 1 – 4 or greater within a 12-24 month period.8  

Such programs are strongly focused on the reduction of namely identified high risks and the management of healthcare 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 on-site and virtual modalities of operation.  The interventions are highly targeted and individualized, and offered to spouses in addition to workforce.

For organizations, the cost of providing medical insurance for their workforce is of great importance.  Those costs have been increasing at annual rates between 6 percent and 14 percent.

Chapman’s 2007 systematic review7 reported an typical reduction in health care costs of 26.5% thus of staff member health promotion programs.  His review covered 60 of the most scientifically precise studies, with an typical of 3.77 years of study.

Absenteeism because of illness is another cost driver.  Chapman’s review7 reports an average reduction in sick time of 25.3 percent.   Cost for Employee’s Compensation was lowered by 40.7 percent, and disability costs by 24.2 percent.

There is also an emerging literature on the costs of presenteeism (reduced productivity).11,13  In one study, every risk decreased through a health promotion program yielded a 9 percent reduction in presenteeism (and a 2 percent reduction in absenteeism).11

Some corporations 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 employee population in focused health promotion programs, with 75%-85% of the workers 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 personnel must be addressed as well to avoid increases in risk-status.   

Given the size of the federal workforce, significant cost savings in the government’s contribution to medical insurance premiums for personnel can be achieved if a majority of that population were participating in active wellness programs.     

Similarly, improvements in absenteeism, staff member’s compensation, disability, presenteeism, and turnover so of robust employee wellness programs would yield substantial fiscal benefits for the government.   

References   

1   Aldana, Steven G.  (2001)   Financial Impact of Wellness Programs –   A Robust Review of the Literature.   Am J Wellness 15(5) – 296-320.

2   Chapman, Larry.  (1998)   the Role of Incentives in Wellness.  The Art of Health Promotion  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 Company Health Promotion Economic Return Studies –  2005 Update.  The Art of Wellness, July/August, 1-15.

5   Chapman, Larry.   (2006)   Worker Participation in Company Health Promotion and Health Promotion Programs –   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 Company Wellness.   the Art of Wellness, July/August, 1-12.

7   Chapman, Larry.  (2007)   Proof Positive –   an Analysis of the cost-Effectiveness of Corporate Health Promotion.  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 Companys” 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 Business Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Corporations” 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 Wellness Practices for Workplaces.   http – //www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.