The Robert Wood Johnson Foundation has a series of synthesis reports which look at current health care issues. The most recent is on The Cost Savings and Cost-Effectiveness of Clinical Preventive Care. (Report) The report does an excellent job of explaining conceptual issues in evaluating cost consequences of various interventions. It then summarizes and analyzes several other organizations’ systematic reviews of the value of these interventions. Few interventions have outright cost savings associated with them. Many create significant health improvements. After reading reports such as this, the reluctance of the Congressional Budget Office to attribute significant overall savings or cost reductions to preventive measures such as screenings is understandable. The calculations and methodology are complex, with high levels of uncertainty.
It should be noted, however, that very little systematic research has been done on the kind of wellness programs which have become common in corporate settings. But the studies which have been conducted by the programs’ vendors and sponsors suggest that they may create significant short and long-term savings. So although those savings may not be certain enough to be counted on to pay the cost of expanded access in a reform program, they should be encouraged and facilitated by any such reform.