Health Promotion International, Vol. 15, No. 1, 5-15,
March 2000
© Oxford University Press 2000
Effectiveness of health promotion programs in moderating medical costs in the USA
Health Management Research Center, University of Michigan, 1027 E. Huron Street, Ann Arbor, MI 48104-1688, USA and 1 Wellness/Fitness Programs, The Progressive Corporation, 6300 Wilson Mills Rd, Mayfield Village, OH 44143, USA
Address for correspondence: D. W. Edington, Health Management Research Center, University of Michigan, 1027 E. Huron Street, Ann Arbor, MI 48104-1688, USA
Although evidence from scientific evaluations of health promotion programs has demonstrated improvements in selected health outcomes, the relationship between participation in health programs and definitive economic returns in medical cost savings has been more difficult to establish. The purpose of this study is to evaluate the effect of employee participation in health promotion programs with selected medical cost outcomes. Program participation was operationalized as a summed participation score based on employee program participation data. Increasing levels of program participation were associated with increasingly higher medical costs but not with higher numbers of health risks. A Cost Change Model was developed to investigate the relationship between program participation and changes in cost status (high cost/low cost) over a 6-year time period. Program participation was highest among the high-cost employees. Participation patterns may have reflected the appeal of most health promotion programming to high-risk/high-cost employees. Over time those employees who participated in a comprehensive health promotion program, including intervention programs, experienced moderation in medical costs. In contrast, for those employees with participation primarily concentrated in health risk awareness and identification programs, medical costs continued to increase. These findings provide evidence for the effectiveness of a comprehensive health promotion program in moderating medical care costs.
Key words: health promotion; medical costs; participation
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