As we have discussed several times, wellness programs have great promise for improving both health and cost outcomes. Employers, desperate for anything that will help them limit their health spending increases, have rapidly adopted a variety of wellness techniques. An article in Health Affairs summarizes findings from many workplace wellness program analyses. (Health Affairs Article) The authors limited the work they summarized to fairly rigorous studies and looked both at potential health cost savings and absenteeism prevention.
Thirty-six studies were included, most conducted at large employers in a variety of industries. Most of the wellness programs included health risk assessments, thirty percent featured incentives and many included self-help education materials, coaching and classes. Many of the programs focused on weight loss and smoking cessation and many addressed other risk factors such as high blood pressure, stress, alcohol use and back care.
Twenty-two of the studies reported on health cost impact, the same number looked at absenteeism prevention and eight gave results for both measures. On average, the wellness programs saved over $3 for each $1 spent on the program. Absenteeism savings were similarly around a 3 to 1 return on cost. As the authors point out, most of these wellness programs persist for many years, if not indefinitely, and the costs tend to be front-loaded and savings may grow the longer the program runs, so the total ROI likely improves. Some of these savings accrue to the employee, in the form of lower health premium sharing and copays, and some to the employer.
The authors note several important caveats, including possible program selection bias in regard to which employers decide to offer such efforts; selection bias among participants; and the possibility that smaller employers may not see the same results as large ones. The authors also suggest future research directions, including work on what kinds of incentives and other program design features appear to be most effective. This study is important research, which adds to the clearly emerging consensus that worksite wellness programs not only improve employee health, but also offer very substantial cost savings. No matter what happens to reform, Congress should remove federal and state regulatory barriers to these programs and encourage their adoption.