On-job health efforts weak
Study: Cost saving unlikely
WASHINGTON — Your boss wants you to eat your broccoli, hit the treadmill and pledge you’ll never smoke. But a new study raises doubts that workplace wellness programs save the company money.
In what’s being called the most rigorous look yet at the wellness trend, independent researchers tracked the program at a major St. Louis hospital system for two years. Hospitalizations for employees and family members fell dramatically, by 41 percent overall for six major conditions. But higher outpatient costs erased those savings.
The study in Monday’s issue of the journal Health Affairs has implications for a debate now taking place at companies around the country: How much pressure can you put on workers to quit smoking, lose weight and get exercise before it turns into unwelcome meddling, or worse, a slippery slope toward a new kind of health discrimination?
“The immediate payback in terms of cost is probably not going to be there,” said economist Gautam Gowrisankaran of the University of Arizona at Tucson, lead author of the study.
There’s also a risk, he said. “You are going to be charging people different rates based on their wellness behavior, and that could limit their ability to buy health insurance.”
The study looks at the experience of BJC HealthCare, a hospital system that in 2005 started a comprehensive program linked to insurance discounts. BJC employs 28,000 peo-
ple and provides health insurance for about 40,000, including family members. The overwhelming majority participated in the wellness program.
The program focused on six lifestyle-influenced conditions: high blood pressure, diabetes, heart disease, chronic lung problems, serious respiratory infections and stroke. Employees had to join the program to get the hospital’s most generous health insurance, the Gold Plan.
Participants had to complete a health risk assessment that included height, weight, blood pressure, cholesterol and blood sugar. They signed a pledge to eat a healthy diet and exercise regularly. Smokers had to get help to quit. Spouses were also required to sign the health pledge and, if they smoked, get help.
The study tallied BJC’s medical costs before the program and for two years after. It also compared those costs with expenses of two other big local employers that did not have wellness programs.
The results were counterintuitive: A surprisingly large drop in hospitalizations for the six conditions targeted by the program, but increased costs for medications and outpatient visits. When those were added to the cost of the wellness initiative itself, “it is unlikely that the program saved money,” the study concluded.
BJC president Steven Lipstein said he doesn’t dispute the conclusion, but he remains committed to the program and would invite the researchers to take another look now.