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Medical Claims According to Wellness Program Participation for a Large Insurance Company in the United States

Merrill, Ray M., PhD, MPH

Journal of Occupational and Environmental Medicine: November 2018 - Volume 60 - Issue 11 - p 985–989
doi: 10.1097/JOM.0000000000001417
ORIGINAL ARTICLES

Objective: The aim of this study was to identify the number and total cost of medical claims for members of the Municipalities, Colleges, Schools Insurance Group by participation status in a comprehensive incentive-based wellness program.

Methods: Analyses are based on 6810 members during 2013 to 2016. The wellness program began in 2014.

Results: Approximately 32.5% women and 22.9% men (P < 0.0001) participated in the wellness program. In 2013, those who participated in 2014 to 2016 filed a higher number of medical claims (P = 0.0004), but their total cost of claims was similar to those who did not participate in 2014 to 2016. By 2016, participants in the wellness program on average filed 3.6 (P = 0.0102) fewer claims and experienced $1346 (P = 0.0011) lower total cost of claims.

Conclusion: Wellness program participation was associated with a lower number and total cost of medical claims.

Department of Public Health, College of Life Sciences, Brigham Young University, Provo, Utah (Dr Merrill).

Address correspondence to: Ray M. Merrill, PhD, MPH, Department of Public Health, 2063 Life Sciences Building, Provo, UT 84602 (Ray_Merrill@byu.edu).

The author received a payment from the Municipalities, Colleges, Schools Insurance Group (MCSIG) to analyze the data presented in this manuscript. He has no stock option agreement or long-term business connections with MCSIG, but conducted the current study as an independent research.

Merrill has no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2018 by the American College of Occupational and Environmental Medicine