As summer approaches, many people are trying to get in shape for beach getaways and tennis events. Fitness programs may have a long-term benefit to personal finances as well.
The Center for Studying Health System Change (HSC) notes that both employers and health plans are increasingly engaging workers and members in wellness activities, such as exercise, weight-loss and smoking cessation programs. Some are even “turning to financial incentives to secure greater participation,” according to an HSC issue brief summarizing site visits in 12 metropolitan areas.
Health plans and employers view the cost of these programs as investments, hoping to cut health care expenditures and boost productivity among participants. Employers seek to reduce absenteeism and hold the line on insurance costs, regardless of whether they maintain fully insured or self-funded plans, such as health savings accounts (HSAs). Health plan sponsors are interested not only in reducing expenditures but also in branding and reinforcing the value proposition they offer employers and individual customers.
But ultimately, as noted in the issue brief, “the credibility of health and wellness activities as mechanisms to improve health and contain costs is dependent on evidence demonstrating their clinical and financial effectiveness, as well as consumers’ acceptance and validation of their legitimacy.”
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The problem is, there’s little hard evidence on either score.
“Despite growing enthusiasm for health and wellness activities, the investment payoff has been difficult to demonstrate,” according to HSC.
“There is recognition that a healthier workforce leads to less spending and more productivity, but it’s hard to prove….There is no way to prove what health spending would have been in the absence of change,” a benefits consultant said in the issue brief.
One reason there’s so little evidence is that so many health and wellness programs have only been around for a year or two, and it generally takes three to five years to evaluate them. Health plans and employers are left with their “belief that investment in health and wellness activities is the right thing to do and is particularly important as employees assume more responsibility for health care decisions and costs,” according to HSC.
One recent study bears out the premise that fitness programs lead to better health outcomes and lower health care expenditures, at least in older adults. This study, published by the Centers for Disease Control and Prevention in January, looked at hospital admissions and total health care costs over two years for participants in the Silver Sneakers health club benefit included in some Medicare plans. While it found little difference between Silver Sneakers participants and controls in year one, those who visited the health club on average twice a week over the two years had at least $1,252 less in health care expenditures in year two than those who visited on average less than once a week.
Despite the lack of more concrete evidence that investments in fitness pay off in the long run, HSC said it sees employers increasingly looking to health and wellness programs to engage their workers in taking more responsibility for health care decisions and costs. “In the short term, it is likely that interest in health and wellness initiatives will gain momentum as employers continue to confront the pressure of rising health care costs,” according to the issue brief.
In the long run, however, it’s the same story as for any wise investor: Credible evidence is needed for the investment to continue.