Louis Yen

The financial impact of changes in personal health practices

The impact of changes in health practices on medical claims costs between 1985-1987 and 1988-1990 was examined among 796 employees. Employees completed a health risk appraisal in 1985 and 1988 and were categorized into health risk levels. High-cost status and high-risk status were significantly associated at both times. The percentage of employees with high-risk status decreased from 31.8% to 25.3% between 1985 and 1988 (P < 0.01). Changes in average costs and the percentage with high-cost status followed the risk change. The largest increase in average costs occurred in employees who moved from low-risk to high-risk status. The greatest reduction in average costs occurred in employees who moved from high-risk to low-risk status. Median costs were not as sensitive to risk change. The findings provide strong evidence that improving individual health status is associated with financial benefits.

Associations between Health Risk Appraisal Scores and Employee Medical Claims Costs in a Manufacturing Company

Background. The bivariate relationships between 18 health-related measures on a health appraisal and prospective medical claims costs were examined among 1,838 employees for three consecutive years. Methods. Employees were classified into high- or low-risk categories for each of the 18 health-related measures, and divided into high- or low-cost categories according to their averaged three-year medical costs respective to the mean of their sex/age subgroup. Results. Average annual medical costs for the 18 health-related measures were

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

67 to

Financial costs due to excess health risks among active employees of a utility company.

778 higher for the employees classified at high risk. The high-cost category was statistically associated with high-risk status in 11 of 18 health-related measures with a high-cost/high-risk to high-cost/low-risk ratio of 1.26 to 2.50. The average annual medical claims costs were also significantly related to number of high-risk classifications. Discussion. This study provides strong statistical evidence that, regardless of age and sex, employees in this sample with positive behaviors cost less in medical claims from 11 of 18 health-related measures.

Comparing the predictive accuracy of health risk appraisal: the Centers for Disease Control versus Carter Center program.

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

Association between wellness score from a health risk appraisal and prospective medical claims costs.

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.

Changes in health risks among the participants in the United Auto Workers--General Motors LifeSteps Health Promotion Program.

Objective: The objective of this study was to examine the health risk-related excess costs of time away from work, medical claims, pharmacy claims, and total costs with and without considering the prevalence of health risks. Methods: A total of 2082 of 4266 employees of a Midwest utility participated in a health risk appraisal (HRA). Individuals were classified by their HRA participation status and also by 15 health risks. Total and excess costs were analyzed for all employees. Results: There were significant excess costs due to individual risks and overall excess health risks in all cost measures. Both excess cost per risk and prevalence of the risk were important factors in determining the excess costs in the population. As compared with low-risk participants, HRA nonparticipants and the medium- and high-risk participants were 1.99, 2.22, and 3.97 times more likely to be high cost status. Conclusions: Approximately one third of corporate costs in medical claims, pharmacy claims, and time away from work could be defined as excess costs associated with excess health risks.

Long-term return on investment of an employee health enhancement program at a Midwest utility company from 1999 to 2007

BACKGROUND From 1986 to 1987 the Carter Center of Emory University joined with the Centers for Disease Control (CDC) to develop a new, probability-based, adult health risk appraisal (HRA) instrument for the public domain. This new instrument is compared with the CDC HRA version to determine which is a more accurate predictor of mortality. METHODS We compared predicted mortality risks from the CDC HRA and the Carter Center HRA with the observed mortality among 3135 smokers and never-smoking persons, aged 25 to 60, followed from 1959 to 1979 as part of the Tecumseh Community Health Study. RESULTS When individuals were classified according to the difference between their actual age and risk age, for the CDC HRA, there was a progressively increasing risk of 10-year mortality as the difference increased. The Carter Center HRA did not show this trend. An analysis using relative operating characteristic curves showed that the mortality risk predictions for both programs were very similar for men and women. However, differences between actual age and risk age for the two programs were not similar for men or women, particularly older men. Therefore, actual age minus risk age for the CDC program was a more accurate predictor of 10-year mortality than was this difference for the Carter Center program. CONCLUSIONS The results from both types of analyses suggest that the validity of risk ages obtained from the Carter Center version may not be sufficient to justify updating programs for those currently using the CDC instrument.

Is it possible to simultaneously reduce risk factors and excess health care costs

Learning ObjectivesExplain how the updated health risk appraisal used in this study differs from previous versions, and recall the components of the wellness score.Point out the predictive factors included in the multivariate regression model and note how successfully they explained the variance in medical claims costs.Recall the potential predictive factors that did - and those that did not - correlate significantly with actual medical claims costs, and those that were most predictive. 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 −

Participation in employer-sponsored wellness programs before and after retirement

56,