E. Dayhoff and Patricia S. Moore, Clinical Solutions, LLC; and
William A. Kent, PK USA
It is challenging, but not impossible, to
find the right metrics for measuring the success or value of a
worksite wellness program.
There are a number of measures that can be
used as indicators of "value." Examples include participation
rates, reduction in claims data associated with chronic
conditions with modifiable risk factors and actuarial analyses
of participant versus non-participant claims.
Another important metric to estimate the
value of a wellness program is measuring risk reduction over
time. In an HR Daily Advisor article, it was
suggested that risk reduction could be measured by health risk
appraisal responses, decreased health costs and
In Clinical Solutions’ Wise Health
Decisions® Wellness Program, registered nurses conduct
worksite wellness clinics on a regular basis throughout the
year. At each clinic appointment, they perform biometric
screening tests and weight metrics. The screening results are
then categorized from very high to low risk using national
Statistical analyses are conducted every six
months to evaluate changes over time in risk categories for
employees who participate in the program two or more times
during the year.
In accordance with national recommendations,
we analyze and report reductions and increases in risk for
each of the screening tests and weight metrics to compute the
changes in overall risk. Differences in risk are then compared
to changes in claims data to estimate the impact of the
wellness program. When we examined changes in risk levels over
12 months for PK USA with over 300 employees, for
example, we found that 34% of those with initial very
high overall risk and 32% with initial high overall risk
decreased to a lower risk level. It is also important to
report increases in risk levels: Seven percent in the
high-risk category increased to very high risk and 5% in the
moderate-risk group increased to high risk.
When integrating these data with claims
data, the medical claims for 2011 as compared to 2010 were
down 10.36%. In addition, medical claims, pharmacy and fixed
costs for our client were over $4,000 less than Midwest
regional norms. This represents an estimated
$1,229,680 savings below the norm.
These numbers reflect the impact of our
wellness program on risk reduction in spite of the fact that
the client is increasing numbers of employees. No changes were
made in the health plan during this time.
By integrating risk reduction data from your
wellness program with claims data, you will have a strong
metric to document the success of your wellness program.
By Nancy E. Dayhoff EdD, RN, and
Patricia S. Moore, MSN, RN, CDE, managing partners, Clinical
Solutions, LLC in Columbus; and William A. Kent, vice
president of corporate relations, PK USA,