Using a Return-On-Investment Estimation Model to Evaluate Outcomes From an Obesity Management Worksite Health Promotion Program

Abstract

Objective: Certain modifiable risk factors lead to higher health care costs and reduced worker productivity. A predictive return-on-investment (ROI) model was applied to an obesity management intervention to ($311,755), 59% were attributed to reduced health care expenditures ($184,582) and 41% resulted from productivity improvements ($127,173) 2008;50:981-990) T he benefits to employers of having a healthy workforce are widely acknowledged as a means of lowering an organization's medical costs and achieving higher levels of worker productivity.1-12 Nevertheless, the decision by employers to invest in health improvement programs often requires an economic justification that includes an estimate of the return-on-investment (ROI) from such programs. 13 In addition, after the programs have been in place for some time, program sponsors may increasingly require evidence that health improvements have produced measurable cost savings, and that these savings outweigh program expenses.14,15 Of particular interest to employers are programs aimed at managing overweight and obesity among workers.16 Employers instituting these programs are requiring health management program managers to demonstrate that these interventions achieve health improvements and a positive ROI. 17Previous examples of the application of ROI forecasting models to estimate program savings associated with risk reduction in employed populations are found in studies conducted at The Dow Chemical Company, Motorola, and Union Pacific Railroad.18 -20 The ROI models applied were based on the research conducted by Goetzel et al 21 for the Health Enhancement Research Organization (HERO). This research found that employees with certain modifiable risk factors were more costly for employers when compared to employees lacking the targeted risk factors. In this article, we apply an adaptation of previously developed ROI models to estimate cost savings and ROI realized from an obesity management program implemented at several employer sites. Results for 890 workers enrolled over a 6-to 12-month period in the program were analyzed and input into the ROI model.

Value of Primordial and Primary Prevention for Cardiovascular Disease

“…Additionally, 59% of the total projected expense reductions were attributed to a 4.3% reduction in healthcare expenditures and 41% were attributed to enhanced productivity. 16 Other investigators have reported findings consistent with these results, supporting the association between health risk reductions, absenteeism, and presenteeism. 86,157,158 Researchers in Switzerland developed a Markov model to evaluate the lifetime effect of a 3-year lifestyle intervention and compared it with standard care among overweight and obese adults.…”

“…Applying a predictive return-on-investment model, another group of investigators tested whether an obesity management program would result in reduced health risks at 119 employer sites. 16 The program included four 30-minute telephone-based coaching sessions each month for a year, plus access to educational materials, exercise planning support, nutrition education, stress management, and Web-based health tracking. Of the 1542 participants enrolled, 890 (57.7%) completed the program.…”

A Systematic Review of the Evidence Concerning the Economic Impact of Employee-Focused Health Promotion and Wellness Programs

“…41 Several programs offered financial incentives to encourage employees to enter the program. 33,35,37,40 Also, three programs provided participants with medications at no cost or with lower copayments. 33,35,42 With regard to study design (Table 4), three were RCTs (one randomizing at the worksite level 40 and two randomizing at the individual employee level).…”

“…[33][34][35][36][37][38][39][40][41][42] The two studies reporting unfavorable results addressed the same disease management program for diabetes but performed different data analyses. 43,44 In both, the study reported that the program improved health but increased some utilization costs and decreased others.…”

Economic Analysis of the Return-on-Investment of a Worksite Wellness Program for a Large Multistate Retail Grocery Organization

“…11 Furthermore, wellness programs often cannot perform rigorous program evaluations utilizing randomization nor are they able to include proprietary information such as claims data in the analysis because of budget, legal, and other resource constraints. 3 The goal of the Price Chopper/Golub Corporation wellness program's ROI study is to compare the expense of providing a wellness program with the savings from lower medical claims costs for a regional retail grocery chain employee population. The evaluation methodology used here is patterned after the study conducted by Highmark as reported by Naydeck and associates, but there are various differences (ie, use of a different morbidity index).…”