Study finds no quick savings from wellness programs

Your bosses want you to eat your broccoli, hit the treadmill and pledge you'll never puff on a cigarette. But a new study raises doubts that workplace wellness programs save the company money.

In what's being called the most rigorous look yet inside the wellness trend, independent researchers tracked the program at a major St. Louis hospital system for two years. Hospitalizations for employees and family members dropped dramatically, by 41 percent overall for six major conditions. But increased outpatient costs erased those savings.

The study in the current issue of the journal Health Affairs has implications for a debate now taking place at companies around the country: How much pressure can you put on workers to quit smoking, lose weight and get exercise before it turns into unwelcome meddling, or worse, a slippery slope toward a new kind of health discrimination?

Wellness programs started out offering gym memberships and modest cash rewards for participating in a health assessment focused on changing bad habits. But employers have been upping the ante, linking the programs to insurance discounts or penalties that can add up to hundreds of dollars.

Most major companies now have wellness programs, and smaller firms are signing up. President Barack Obama's health overhaul law allows employers to expand rewards and penalties, provided workers are also given a path to address lifestyle issues that could undermine their health.

"The immediate payback in terms of cost is probably not going to be there," said economist Gautam Gowrisankaran of the University of Arizona at Tucson, lead author of the study. But he noted there could be other benefits not directly measured in the study, such as reduced absenteeism and higher productivity.

And there's also a risk, Gowrisankaran said. "You are going to be charging people different rates based on their wellness behavior, and that could limit their ability to buy health insurance."

Some previous studies have shown savings from wellness programs, while others found little change or even higher spending. Steven Noeldner, an expert with the Mercer benefits consulting firm, says well-designed programs generally show a positive return of about 2 percent by the third year.

The new study looked at the experience of BJC HealthCare, a hospital system that in 2005 started a comprehensive program linked to insurance discounts. BJC employs 28,000 people and provides health insurance for about 40,000, including family members. The overwhelming majority participated in the wellness program.

The program focused on six lifestyle-influenced conditions: high blood pressure, diabetes, heart disease, chronic lung problems, serious respiratory infections, and stroke.

Employees in the wellness program signed a pledge to maintain a healthy diet and exercise regularly. Smokers had to get help to quit.

The results were surprising: a large drop in hospitalizations for the six conditions targeted, but increased costs for medications and outpatient visits. When those were added to the cost of the wellness initiative itself, "it is unlikely that the program saved money," the study concluded.