Monday, June 23, 2014

Data Show More Support Warranted for Worksite Wellness Programs

Photo: Flickr/abraj
This week I had the privilege of addressing the American Cancer Society CEOs Against Cancer at their annual meeting that this year was held at Washington University in St. Louis. As a member of the panel addressing worksite wellness, I was able to briefly summarize the strong evidence that worksite wellness programs can generate substantial savings. For example, in a critical meta-analysis of the literature on costs and savings associated with workplace disease prevention and wellness programs, Baicker, Cutler and Song (2009), show that medical costs fall by about $3.27 for every dollar spent on wellness programs. In addition, absenteeism costs fall by about $2.73 for every dollar spent.

Others have summarized the evidence on worksite physical activity and nutrition programs. A systematic review and meta-analysis of 18 programs shows that physical activity and nutrition programs are effective in reducing body weight when compared to usual care (van Dongen et al., 2012).

Even more impressive are the benefits of smoking cessation. Halpern and colleagues (2007) show savings in terms of reduced healthcare costs. The savings per smoker range from $350-$582 at 10 years, with internal rate of return ranging from 39% to 60% at 10 years. In addition, as noted in the 50th anniversary Surgeon General’s Report on Smoking and Health (2014) after stopping smoking, former smokers experience an increase in their quality of life. Never smokers have the lowest health care costs in the age range of 45 to 64. Smokers have a loss of productivity in the workplace through absenteeism and also incur more hospitalization and medical charges as a result of outpatient visits. It is the sum of these benefits of quitting smoking, over several years, that drives the benefits of worksite wellness.

A rigorous evaluation by investigators at RAND evaluating a worksite wellness program that included prevention services as well as navigation and support for those with chronic conditions also shows substantial savings (Liu et al 2013). Disease management interventions reduce costs per employee per month significantly. The prevention interventions also substantially reduced costs. While such a program has expenses in the first year, savings are visible in 3 to 5 years after implementing a worksite wellness program.

In sum, worksite wellness programs save employers in terms of health care costs and increase productivity of the workforce. It is hard to see why we don’t have even more support for these programs across all workplaces.

References
Baicker K, Cutler D, Song Z. Workplace Wellness Programs Can Generate Savings. Health Aff. 2010;29:304-311.

DeVol R, Bedroussian A. An Unhealthy America: The Economic Burden of Chronic Disease. Santa Monica, CA: Milken Institute. 2007. 

Halpern, MT, Dirani, R, and Schmier, JK. Impacts of a Smoking Cessation Benefit Among Employed Populations. J Occup Environ Med. 2007;49:11–21. 

Liu, H, et al. Effect of an Employer-Sponsored Health and Wellness Program on Medical Cost and Utilization. Population Health Management. 2013;16:1–6.

U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Printed with corrections, January 2014. 

van Dongen, JM, et al. A systematic review of the cost-effectiveness of worksite physical activity and/or nutrition programs. Scand J Work Environ Health, 2012. 38:393-408.

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