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Article Title

Factors Associated With Participations and Goals Achievement in an Employee Wellness Program Offering Biometric Screenings and Premium Discounts

Publication Date

8-10-2017

Keywords

health care financing, insurance, premiums, program evaluation, demographics, social determinants of health, complex disease management, multiple chronic conditions, health promotion, prevention, screening, incentives in health care

Abstract

Background: Since 2012, Geisinger Health System (GHS) has redesigned its employee wellness program MyHealth Rewards by requiring biometric screenings and goal achievements for blood pressure, body mass index, glucose and cholesterol levels to be eligible for premium discount in subsequent year. The objective of this study is to determine what baseline employee characteristics were associated with MyHealth Rewards participations and goals achievements.

Methods: Claims data from 2011 to 2015 were obtained from Geisinger Health Plan, restricting to continuously enrolled members. Four mutually exclusive cohorts were identified: GHS employees who met goals in all years (Group 1, n = 2,842); GHS employees who met goals some years (Group 2, n = 3,999); GHS employees who never joined MyHealth Rewards (Group 3, n = 4,398); and non-GHS employees (n = 24,061). A multinominal logit model was used to estimate the probability of being in one of the groups as a function of demographics, chronic conditions and utilization at the baseline (2011).

Results: Compared with non-GHS employees, female employees were less likely to never participate (Group 3; odds ratio [OR]: 0.61, P < 0.01) and more likely to meet goals in all years (Group 1; OR: 2.7, P < 0.001). Employees with more chronic conditions or above 45 at the baseline were less likely to be in Group 1 (OR < 0.08, P < 0.01). Specialist visits at the baseline were associated with higher likelihood of being in Group 1 (OR: 1.28, P < 0.01), but emergency department visits were associated with the opposite (OR: 0.77, P < 0.01).

Conclusion: Employees’ preprogram baseline characteristics predict the employee participation and goal achievement patterns in subsequent years. Specifically, there was a self-selection of employees who were female, younger and healthier prior to the program implementation. This suggests that employees’ baseline characteristics should be taken into account in designing and evaluating similarly designed employee wellness programs.

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