Posted by admin | Posted in Employee Wellness, wellness program | Posted on 03-09-2010
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 workers 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 medical 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 lowered productivity (”presenteeism”).
Early employee health promotion programs were relatively basic and ordinarily produced a Return On Investment of less than one dollar for every dollar spent operating the health promotion program (Return On Investment = <1 - 1).8
Such health promotion programs may be characterized as “fun-oriented”. Participation is entirely voluntary, and there’s no particular focus on the reduction of especially identified high risks.
Interventions and activities aren’t customized, and there’s no emphasis on the management of medical costs. These wellness programs are generally site-based only, lack options to address all the major behaviorally-related health risks, and lack multimodal presentation.
Minimal or no incentives are provided to workforce for participation, and services to spouses and family members are not available. Most such wellness programs lack meaningful investigation.
More conventional health promotion programs are “activity-oriented” and have shown an Return On Investment (ROI) of between 1 – 2.5 and 1 – 3.5.8 These health promotion programs may have a greater emphasis on health and risk reduction, although the efforts are relatively broad and not personalized.
They may have some generalized emphasis on health care 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 health promotion programs are “results-oriented” and exemplify the health and productivity management model. These health promotion 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 health costs. They’re usually 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 as well as employees.
For corporations, the cost of providing health insurance for their personnel is of excellent 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 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 disease is another cost driver. Chapman’s review7 reports an typical 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 lowered through a wellness program yielded a 9% reduction in presenteeism (and a 2% 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 employee population in focused wellness programs, with 75%-85% of the employees 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 healthy staff 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 health insurance premiums for workers may be achieved when a majority of that population were participating in active wellness programs.
Likewise, improvements in absenteeism, staff member’s compensation, disability, presenteeism, and turnover so of extensive staff member health promotion 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 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-Investigation of Employee Wellness Economic Return Studies – 2005 Update. The Art of Wellness, July/August, 1-15.
5 Chapman, Larry. (2006) Worker Participation in Employee Wellness and Wellness Programs – Just 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 Health Promotion Coaching in Employee Wellness. the Art of Wellness, July/August, 1-12.
7 Chapman, Larry. (2007) Proof Positive – an Analysis of the cost-Effectiveness of Employee 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 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 Corporation Strategy. Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Businesss” Conference, Orlando, FL, January 23-24.
11 Pelletier, Barbara, Boles, Myde, and Lunch, Wendy. (2004) Changes in Health Risks and Be 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 extensive Health and Illness ManagementPrograms at the Worksite – Update VI 2000-2004. JOEM 47(10)1051-1058.
13 DeVol, Ross, Bedroussian, Armen, et. Al. (2007) an Unhealthful America – the Economic Burden of Chronic Disease. 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.