Effects of an incentive-based online physical activity intervention on health care costs.

OBJECTIVE: To test whether participation in an incentive-based online physical activity program for employees was associated with a moderation in health care costs. METHODS: Health care claims trends from 2003 to 2005 were analyzed among a matched sample of participants and nonparticipants. Medical and pharmacy costs, hospital inpatient costs, and emergency room costs were examined. RESULTS: The average annual health care costs for participants increased by $291 per year compared with an increase of $360 for nonparticipants (P = 0.09). Higher levels of participation were associated with smaller increases in health care costs. Participants had a significantly smaller increase in inpatient hospital costs (+$20 vs +$119), heart disease costs ($-8 vs $46), and diabetic costs (+$1 vs +$16) compared with nonparticipants. CONCLUSIONS: Participation in an online employee physical activity intervention was associated with smaller increases in health care costs compared to nonparticipants.

Effectiveness of an incentive-based online physical activity intervention on employee health status.

OBJECTIVE: The objective of this study was to test whether a financial incentive integrated with health benefits for an online physical activity program was associated with increased employee participation and improved health status among participants compared with nonparticipants. METHODS: Participation in the Virtual Fitness Center (VFC), an online physical activity program associated with a 150 dollars cash rebate, was assessed. Risk status for 2004 VFC participants and nonparticipants was compared using a health risk appraisal. RESULTS: A total of 53.8% of total eligible employees were VFC participants and reduced their risk for physical inactivity (8.4% points), life dissatisfaction (2.1), low perception of health (1.9), high risk status (1.3), smoking (0.4), and high body weight (0.2). CONCLUSIONS: Providing a cash incentive is one strategy for encouraging VFC participation and eliciting improved health status in an employer-sponsored, web-based physical activity program.

Association of additional health risks on medical charges and prevalence of diabetes within body mass index categories.

PURPOSE: The prevalence of obesity and diabetes continues to increase among employee populations. Although medical costs and the prevalence of diabetes have been studied across increasing body mass index (BMI) categories, little attention has been given to the association of additional health risks within those categories. The purpose of this study was to examine the association of health risk levels on medical charges and prevalence of diabetes across BMI categories within an employee population. METHODS: A cross-sectional study design utilized health risk appraisal data (30% response rate) to measure BMI levels, self-reported diabetes status, and selected additional health risks among 38,841 active employees under age 65 of the General Motors Corporation. Associated average annual medical charges from 1996 to 2000 were calculated for defined health risk levels across five BMI categories (< 18.5; 18.5-24.9, 25-29.9, 30-34.9, and > 35). RESULTS: Higher medical charges were significantly associated with additional health risks (zero risks to four or more risks) across each of the BMI categories: $2689 to $7576 (< 18.5); $2655 to $6555 (18.5-24.9); $3239 to $7118 (25-29.9); $3579 to $7758 (30-34.9); and $4151 to $8075 (> or = 35). Likewise, higher prevalence of diabetes was significantly associated with additional health risks (zero risks to four or more risks) across the BMI categories: 2.6% to 7.0% (< 18.5); 1.3% to 2.7% (18.5-24.9); 2.4% to 5.3% (25-29.9); 5.5% to 8.3% (30-34.9); and 7.7% to 15.8% (> or = 35). DISCUSSION: Medical costs and the prevalence of diabetes were lower when the numbers of additional health risks were lower, regardless of the BMI category. Programs to promote weight management have largely been unsuccessful in maintaining long-term weight control. The current results suggest that a strategy focused on reducing health risks within any weight category could provide an alternative strategy to achieve medical cost savings and a lower prevalence of diabetes. The implied benefits of risk reduction within BMI categories would need to be confirmed with a longitudinal study.

Pattern of medical charges after quitting smoking among those with and without arthritis, allergies, or back pain.

PURPOSE: To examine the time frame of changes in medical charges after smoking cessation among (1) those with arthritis, allergies, or back pain and (2) those with none of these chronic conditions. DESIGN: Cross-sectional study using smoking status determined in 1996 and 4-year average medical charges measured from 1996 to 1999. SETTING: Nationwide manufacturing corporation (General Motors Corporation). SUBJECTS: A total of 20,332 employees and spouses who completed a health risk appraisal in 1996 were younger than 64 years, were enrolled in indemnity or preferred provider organization health insurance plans during 1996 to 1999, and self-reported no preexisting primary diseases. MEASURES: Participants were categorized according to 1996 self-reported smoking status into six subgroups: current smokers, former smokers by years since cessation (0-4, 5-9, 10-14, and > or = 15 years), and never smokers. Average annual medical charges (1996-1999) among those with chronic conditions (arthritis, allergies, or back pain; N = 11,921) or without chronic conditions (N = 8411) were examined independently. Never smokers in each group were compared to respective smoker and former smoker subgroups. RESULTS: Current smokers and former smokers without chronic conditions who quit fewer than 5 years earlier had higher medical charges compared with never smokers ($2613 and $3356 vs. $2203, respectively). Among those with chronic conditions, current smokers, former smokers who quit 0 to 4 years ago, and former smokers who quit 5 to 9 years ago had higher medical charges than never smokers ($4208, $4027, and $4050 vs. $3108, respectively). CONCLUSIONS: It took approximately 5 years for former smokers without chronic conditions and nearly 10 years for former smokers with chronic conditions to reduce their medical charges to levels close to their respective never smokers. Health promotion practitioners and other decision makers should consider the impact of chronic conditions on the course of medical savings when implementing smoking cessation programs at the worksite.

Influence of participation in a worksite health-promotion program on disability days.

This study assessed the impact of health-promotion program participation on short-term and long-term disability absence days during a 6-year period in a manufacturing company. Male, hourly, active employees (n = 4189) were analyzed from 1995 to 2000. Disability absences were compared for program participants and nonparticipants from baseline (1995) through 5 years of the program. The percentage of nonparticipants absent on any given day was greater than that of participants. Moreover, the average number of disability absence days incurred by nonparticipants significantly increased from baseline to program year 5 compared with participants. The total amount saved each year in disability absence days for the 2596 program participants was $623,040, which resulted in a savings-to-cost ratio of 2.3 per year. Participation in worksite health-promotion programs may lead to reduced disability days in a manufacturing worksite population.