Estimating Risk Reduction Required to Break Even in a Health Promotion Program

The well-being valuation model: a method for monetizing the nonmarket good of individual well-being

The objective of this research is to advance the evaluation and monetization of well-being improvement programs, offered by population health management companies, by presenting a novel method that robustly monetizes the entirety of well-being improvement within a population. This was achieved by utilizing two employers' well-being assessments with medical and pharmacy administrative claims (2010-2011) across a large national employer (n = 50,647) and regional employer (n = 6170) data sets. This retrospective study sought to monetize both direct and indirect value of well-being improvement across a population whose medical costs are covered by an employer, insurer, and/or government entity. Logistic regression models were employed to estimate disease incidence rates and input-output modelling was used to measure indirect effects of well-being improvement. These methodological components removed the burden of specifying an exhaustive number of regression models, which would be difficult in small populations. Members who improved their well-being were less likely to become diseased. This reduction saved, per avoided occurrence, US$3060 of total annual health care costs. Of the members who were diseased, improvement in well-being equated to annual savings of US$62 while non-diseased members saved US$26. The method established here demonstrates the linkage between improved well-being and improved outcomes while maintaining applicability in varying populations.

Do work relationships matter? Characteristics of workplace interactions that enhance or detract from employee perceptions of well-being and health behaviors

This qualitative case study adopted the position that health and health behaviors are complex social constructs influenced by multiple factors. Framed by the social ecological model, the study explored how work interactions enhanced or detracted from the perceptions of well-being and health behaviors. Despite the fact that previous studies indicated that the social workplace environment contributed to employee health, there was little information regarding the characteristics. Specifically, little was known about how employees perceived the connections between workplace interactions and health, or how social interactions enhanced or detracted from well-being and health behaviors. The participants included 19 volunteers recruited from four companies, who shared their experiences of workplace interactions through interviews and journaling assignments. The findings indicated that feelings of well-being were enhanced by work interactions, which were trusting, collaborative, and positive, as well as when participants felt valued and respected. The study also found that interactions detracted from well-being and health behaviors when interactions lacked the aforementioned characteristics, and also included lack of justice and empathy. The enhancing and detracting relationships generated physical symptoms, and influenced sleeping and eating patterns, socializing, exercise, personal relations, careers, and energy. Surprisingly, the study found that regardless of how broadly participants defined health, when they were asked to rate their health, participants uniformly rated theirs on physical attributes alone. The exclusive consideration of physical attributes suggests that participants may have unconsciously adopted the typical western medical view of health - an individually determined and physiologic characteristic. Despite research suggesting health is more than biology, and despite defining health broadly, participants uniformly adopted this traditional view. The study also offers human resource development professionals with evidence supporting interventions aimed at minimizing workplace incivility. Interventions designed to improve employee engagement could minimize financial and human costs of negative interactions. The bottom line is that workplaces should be physically, emotionally, and psychologically safe for well-being and healthy behaviors to flourish.

The Novartis health index: a method for valuing the economic impact of risk reduction in a workforce

OBJECTIVES

To develop a calculator that measures the potential cost impact of changes in health risks and presents results graphically.

METHODS

Demographic and health risk data for Novartis employees were input into a calculator that estimated employer medical care, short-term disability, absenteeism, and presenteeism costs associated with risk prevalence, based on a previous cross-sectional analysis of the association between risks and costs. Estimated costs were presented as a relative score, the Novartis Health Index, which is a measure of the overall costs associated with the risk profile of a population of interest.

RESULTS

The population of Novartis employees had an index score of 81.5 (out of 100), indicating a relatively healthy risk profile, and baseline annual costs of $9619 per employee. Risk reduction of 1% and 10% for tobacco, alcohol use, and emotional health risks had the potential to generate annual savings of $91,500 and $915,000, respectively.

CONCLUSIONS

The Novartis Health Index framework allows employers to track performance relative to health risk management using a single, accessible, user-friendly measure.

Worksite Wellness

A 7-month intervention was undertaken to determine the impact of education and coaching on lifestyle choices and lipid values among employees with hyperlipidemia. Four classes over 2 months at the worksite during work time and two telephone interventions were provided with pre, mid, and post data collection. Total cholesterol and low-density lipoprotein values improved during the intervention. Positive lifestyle changes were made involving exercise and diet. Appropriate physician visits and continuous health care increased. Lipid-based interventions at the worksite can elicit positive changes in lifestyle, appropriate health care use, and improved lipid values.

Estimating the Return-on-Investment From Changes in Employee Health Risks on The Dow Chemical Companyʼs Health Care Costs

OBJECTIVE

We sought to estimate the impact of corporate health-management and risk-reduction programs for The Dow Chemical Company by using a prospective return-on-investment (ROI) model.

METHODS

The risk and expenditure estimates were derived from multiple regression analyses showing relationships between worker demographics, health risks, and medical expenditures.

RESULTS

A "break-even" scenario would require Dow to reduce each of 10 population health risks by 0.17% points per year over the course of 10 years. More successful efforts at reducing health risks in the population would produce a more significant ROI for the company.

CONCLUSIONS

Findings from this study were incorporated into other components of a business case for health and productivity management, and these supported continued investments in health improvement programs designed to achieve risk reduction and cost savings.