Abstract P154: Short-Term Health Care Expenditures Increase After Workplace Wellness Program

Abstract

Introduction: A major goal of workplace wellness programs is to improve employee health and lower health care costs. Research on wellness program effectiveness is often limited by either a lack of a control comparison groups or confounding when the intervention and control groups differ on baseline health. Our study objective was to assess the effect on health expenditures of an employee wellness program (BeFit), already shown to improve diet, physical activity, cholesterol, and BP. We compared participants to a matched non-participant control group. Hypothesis: We hypothesized that health care costs would be lower for participants than for non-participants. Methods: BeFit is a 10 week nutrition/exercise program that includes measurement of cardiovascular risk factors, weekly meetings with a nutritionist and personal trainer, gym membership, and team competition to achieve weight and exercise goals. For this study, participants were matched by age, sex, period of employment, and pre-participation Diagnostic Cost Group (DCG) risk score (a predictor of future health care use based on past-year use), to two non-participant control employees. Health expenditures were gathered from claims data obtained by the employer’s human resource department. Subjects in the analysis had at least 12 months pre- and post-program claims data. Within-subject quarterly health care cost trends were compared after subjects’ BeFit start dates using multivariable generalized least squares regression controlling for age, sex, and baseline health. Control subjects were assigned the start date of the subject to whom they were matched. Expenditures were capped at the 99 th percentile ($42,393) so results were not unduly influenced by extreme events unlikely to be affected by a wellness program. We analyzed overall, domain-specific (outpatient, inpatient, pharmaceutical), and diagnosis-specific costs. Results: From 2010-2014, 412 BeFit participants and 824 controls met the inclusion criteria (77% female, mean age 41 [range 23,78], mean baseline DCG risk score of 92.3 [range 3, 2315]). After participation in BeFit, the regression-adjusted health expenditures decreased by $15/quarter among BeFit participants compared to $85/quarter among control subjects (95% CI for difference $27, $113). Trends were significantly more negative in the control group for outpatient, inpatient, and pharmaceutical costs, as well. There were no differences in trends for cardiovascular or diabetes-related costs. Conclusions: Contrary to our hypothesis, trends in health expenditures decreased more for the matched control group than for participants in the employee wellness program. This result may be due to increased attention to health and higher health care use spurred by participation in the program. Further work is necessary to understand the long-term impact of wellness programs on health and health expenditures.