Results from Humana Wellness Program

Evaluating wellness programs is a difficult task.  There are selection issues, design issues, many confounding variables and other problems.  There is little well-designed research either proving or disproving cost savings.  Humana issued a report evaluating the effect of its HumanaVitality wellness program.   (Humana Report)   The study was conducted on 8000 Humana employees using the program since 2011.  The program includes pretty typical risk assessment, coaching, educational and other elements and provides an incentive to participate and meet objectives.  Employees in the program supposedly had 6% lower health costs in the first year and 10% lower by the third year, compared with people not engaged in the program.  Unengaged members had 56% more ER usage and 57% higher hospital visits.  People with lifestyle-related chronic conditions showed the greatest decline in costs and usage.  In addition, engaged employees had 6 fewer hours of unscheduled absences.  Now, this study is an example of why people are so skeptical of wellness program claims.  Unless you dig in pretty good, you don’t see that Humana makes up its own definition of “engaged”.  Apparently all employees were judged to be in the program, but only some were “engaged”.  Obviously there is room for all sorts of confounders here in terms of comparing these populations.   A strange form of propensity matching was further used in the comparison.  To my somewhat untrained eye, this is a suspect study with suspect conclusions.