A new study in Health Affairs examined an employee wellness program at St. Louis-based BJC HealthCare, finding that it decreased hospitalizations for certain targeted conditions but did not save money for the employer in the short-term.
BJC HealthCare introduced its insurance-based wellness incentive program for employees and their dependents in 2005. It tied employees' eligibility to participate in the system's most generous "Gold" health plan to their participation in a wellness program, which included completing a health assessment, maintaining a healthy diet, exercising regularly and reporting their smoking status or enrolling in a cessation program.
Employees who did not participate in the wellness program were restricted to BJC's less generous Silver and Bronze plans, whereas wellness participants had a choice of Gold, Silver, and Bronze plans. Silver and Bronze were discounted by $180 per year for wellness program participants and BJC also paid $1,647 more toward family coverage for participants in the Gold plan than they paid for Silver members who did not participate in the wellness program. That extra $1,647 employer contribution for wellness program participants made up 13.9 percent of the total cost of $11,828 for Gold family coverage.
From the perspective of enrollment and participation, the wellness program was successful: In 2005 and 2006, 82 percent of the hospital system's beneficiaries chose the Gold plan.
BJC saw a decrease in its hospitalization rates, but not across the board. Rates for conditions that weren't targeted by the wellness program were very similar before and after the intervention. However, for every quarter in 2005 and afterward, the hospitalization rate for targeted conditions at the hospital system was lower than that of every quarter prior to 2005. Targeted conditions included chronic obstructive pulmonary disease, diabetes, hypertensive heart disease, acute pulmonary infection, ischemic heart disease and cerebrovascular disease.
Despite the change in hospitalizations and employees' involvement, study authors researchers said the program did not save BJC money in the short-term, as reductions in inpatient costs were matched with similar increases in non-inpatient costs and incentives.
"We cannot rule out the possibilities that in the long run the financial profile of the incentives may improve or that productivity gains could outweigh increased medical spending and implementation costs," the authors said.
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BJC HealthCare introduced its insurance-based wellness incentive program for employees and their dependents in 2005. It tied employees' eligibility to participate in the system's most generous "Gold" health plan to their participation in a wellness program, which included completing a health assessment, maintaining a healthy diet, exercising regularly and reporting their smoking status or enrolling in a cessation program.
Employees who did not participate in the wellness program were restricted to BJC's less generous Silver and Bronze plans, whereas wellness participants had a choice of Gold, Silver, and Bronze plans. Silver and Bronze were discounted by $180 per year for wellness program participants and BJC also paid $1,647 more toward family coverage for participants in the Gold plan than they paid for Silver members who did not participate in the wellness program. That extra $1,647 employer contribution for wellness program participants made up 13.9 percent of the total cost of $11,828 for Gold family coverage.
From the perspective of enrollment and participation, the wellness program was successful: In 2005 and 2006, 82 percent of the hospital system's beneficiaries chose the Gold plan.
BJC saw a decrease in its hospitalization rates, but not across the board. Rates for conditions that weren't targeted by the wellness program were very similar before and after the intervention. However, for every quarter in 2005 and afterward, the hospitalization rate for targeted conditions at the hospital system was lower than that of every quarter prior to 2005. Targeted conditions included chronic obstructive pulmonary disease, diabetes, hypertensive heart disease, acute pulmonary infection, ischemic heart disease and cerebrovascular disease.
Despite the change in hospitalizations and employees' involvement, study authors researchers said the program did not save BJC money in the short-term, as reductions in inpatient costs were matched with similar increases in non-inpatient costs and incentives.
"We cannot rule out the possibilities that in the long run the financial profile of the incentives may improve or that productivity gains could outweigh increased medical spending and implementation costs," the authors said.
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