Abstract
Assess whether an insurer-provided Web-based wellness program results in cost and utilization improvements. Quasi-experimental, pre-post, treatment-comparison design. Variables of interest were participation rates; medical, professional, and pharmacy expenditures; inpatient admissions; emergency room visits; and preventive service utilization. Six hundred forty-three employer-based wellness programs in Pennsylvania. Forty-seven employers engaged in the Web-based wellness program and 596 employers who were not engaged. The engaged employer group included 10,463 wellness participants; an equal number of matched nonparticipant employees were identified from employers who were not engaged. Web-based wellness program features were added to an on-site program in 2004. The program was followed through 2007. Outcomes were calculated using health insurance enrollment and claims history. Participating employees were compared to nonparticipants using generalized linear mixed models to study changes in costs and utilization. During the 2003 baseline year, engaged employers had greater costs, greater chronic disease prevalence, and greater hospitalization. Costs of program participants showed a lower rate of increase in 2004, and then dropped below those of the nonparticipants for the duration of the study. Between 2003 and 2007, the increase in medical expenditures of the participant group was significantly less than that of the nonparticipant group (31% vs. 46%, p < .01). In addition, the participant group showed a lower increase in professional service expenditures (p = .02) and greater utilization of preventive services (p < .01). Web-based insurer-provided wellness programs may decrease health care costs and encourage preventive service utilization.
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