There is a group in Michigan doing some incredible research related to wellness and costs. The “Health Management Research Center” took quite a long view perspective in the are of wellness with 25 year longitudinal studies on some Fortune 500 companies (and some of the HERO studies- a related group have samples in the thousands or tens of thousands), and has the ability to get healthcare, morbidity and mortality data. While there are still access issues and a host of “other” things beyond the info below I figured it may help add to the dialog until I can get through this work project and jump in full tilt. (There is also some info on changing nutrition and community fitness if you guys are interested- and you wonder where I have been J Dee The savings gained from participation in health promotion programs for Medicare beneficiaries. _J Occup Environ Med._ (javascript:AL_get(this,%20'jour',%20'J%20Occup%20Environ%20Med.');) 2006 Nov;48(11):1125-32. _Ozminkowski RJ_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Ozminkowski+RJ"[Author]) , _Goetzel RZ_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Goetzel+RZ"[Author]) , _Wang F_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="W ang+F"[Author]) , _Gibson TB_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Gibson+TB"[Author]) , _Shechter D_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Shechter+D"[Author]) , _Musich S_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPl us&term="Musich+S"[Author]) , _Bender J_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Bender+J"[Autho r]) , _Edington DW_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Edington+DW"[Author]) . OBJECTIVE: The objective of this study was to estimate savings to Medicare associated with participation in one or more health promotion programs offered to 59,324 retirees from a large employer and their aged dependents. METHODS: Propensity score and multiple regression techniques were used to estimate savings adjusted for demographic and health status differences between elderly retirees and dependents who used one or more health promotion services and nonparticipants. RESULTS: Participants who completed a health risk assessment saved from $101 to $648 per person per year. Savings were generally higher as more programs were used, but differences were not always statistically significant. CONCLUSION: Using the health risk assessment as a guide for health promotion programs can yield substantial savings for the elderly and the Medicare program. The federal government should test health promotion programs in randomized trials and pay for such programs if the results suggest cost savings and better health for Medicare beneficiaries. Association between wellness score from a health risk appraisal and prospective medical claims costs. _J Occup Environ Med._ (javascript:AL_get(this,%20'jour',%20'J%20Occup%20Environ%20Med.');) 2003 Oct;45(10):1049-57. _Yen L_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Yen+L"[Author]) , _McDonald T_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&t erm="McDonald+T"[Author]) , _Hirschland D_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Hirschland+D"; [Author]) , _Edington DW_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Edington+DW"[Author]) . This study examines how wellness scores generated from the Health Risk Appraisal are associated with prospective medical claims costs, controlling for age, gender, and disease status. The study was conducted among 19,861 active employees who participated in the Health Risk Appraisal and selected indemnity or PPO medical plans from 1996 to 1998. A multiple regression model based on group averages of age, gender, disease status, and wellness score levels was developed among a randomly selected screening subsample (n=10,172) from the study sample. Total medical claim costs of -$56, $88, and $3574 were estimated for one additional point on the wellness score, 1 year of additional age, and an existing major disease, respectively. No significant differences were found between the model predicted and actual medical claims costs for the individuals in both screening and calibration (n=9689) subsamples. The association between health risk status and health care costs among the membership of an Australian health plan. _Health Promot Int._ (javascript:AL_get(this,%20'jour',%20'Health%20Promot%20Int.');) 2003 Mar;18(1):57-65. _Musich S_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Musich+S"[Author]) , _Hook D_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus &term="Hook+D"[Author]) , _Barnett T_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Barnett+T"[Author] ) , _Edington DW_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Edington+DW"[Author]) . Health promotion in Australia has developed into an accepted strategy for solving public health problems and promoting the health of its citizens. However, there are few evidence-based research studies in Australia that measure health risk status or track health changes over time with defined cost outcome measures. Those individuals with more high-risk lifestyle behaviors have been associated with higher costs compared with those with low-risk behaviors. Although intuitively it was believed that the health promotion programs had a positive impact on health behaviors and consequently on health care costs, the relationship between health risk status and health care costs had yet to be tested in the Australian population. Consequently, a verification study was initiated by the Australian Health Management Group (AHMG) to confirm that those relationships between health risks and medical costs that had been published would also hold in the Australian population using Australian private health care costs as the outcome measure. Eight health risks were defined using a Health Risk Appraisal (HRA) to determine the health risk status of participants. Consistent with previous studies, low-risk participants were associated with the lowest health care costs (377 Australian dollars) compared with medium- (484 Australian dollars) or high-risk (661 Australian dollars) participants and non-participants (438 Australian dollars). If the health care costs of those at low risk were considered as the baseline costs, excess health care costs associated with excess health risks in this population were calculated at 13.5% of total expenditures. Health risk reduction and low-risk maintenance can provide important strategies for improving/maintaining the health and well-being of the membership and for potential savings in health care costs. The UAW-GM health promotion program. Successful outcomes. _AAOHN J._ (javascript:AL_get(this,%20'jour',%20'AAOHN%20J.');) 2002 Jan;50(1):26-31. _Edington M_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Edington+M"[Author]) , _Karjalainen T_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_A bstractPlus&term="Karjalainen+T"[Author]) , _Hirschland D_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&ter m="Hirschland+D"[Author]) , _Edington DW_ (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Search&itool=pubmed_AbstractPlus&term="Edington+DW"[A uthor]) . 1. The success of the LifeSteps program may rest in the UAW and GM leadership's vision to use a high level joint steering committee, a day to day working committee, third party program providers, support of confidentiality throughout the entire program, and a comprehensive data driven decision making system. 2. The program design is a multiplatform method of program delivery to a diverse and nationwide population of the active and retired employees and dependents (more than 1 million individuals older than age 18). They receive an annual health risk appraisal, telephone access to a registered nurse 24 hours a day. LifeSteps website, a quarterly health information newsletter and a health care book sent to each of the households, and access to a telephonic audiotape library. 3. A pilot program has a more intense design of low risk maintenance and high risk reduction programs specifically for all active employees who work in the pilot locations. A telephonic program for behavior change is available only to high risk individuals in the total pilot population of active and retired employees and dependents. 4. The major success criterion for the LifeSteps program is helping workers, former employees, and their families maintain or achieve low risk status. The increased number of employees at low risk status (4% gain the second year and a 2% gain from the second to the third year) documents the improved health status of the population. Moreover, of surveyed participants and nonparticipants, 85% supported program continuation and 74% said they had an improved opinion of the UAW and GM due to the program.
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