An evaluation of the Well at Dell health management program: health risk change and financial return on investment

Abstract

Purpose: To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment).

Design: A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks.

Setting: Ongoing worksite health management program implemented across multiple U.S. locations.

Subjects: Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming.

Intervention: Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs.

Measures: Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment.

Results: The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement.

Conclusion: An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

Keywords: Health Management Program; Health focus: health management program; Manuscript format: research; Outcome measure: health care expenditures, productivity; Prevention Research; Research purpose: program evaluation; Return on Investment; Setting: workplace; Strategy: incentives, education, behavior change; Study design: quasi-experimental; Target population age: adults; Target population circumstances: workplace, employees; Wellness Evaluation.