Benefits of Wellness Programs, On-Site Care Services

Las Vegas—Research presented during a session at the Fall Managed Care Forum showed that employers, employees, and health plans can benefit from implementing wellness programs, managing chronic conditions such as diabetes, and having on-site pharmacies, chiropractic services, and health centers.

Ross M. Miller, MD, MPH, medical director at Cerner Corp, discussed research the healthcare company conducted to determine ways to reduce costs and have a healthier population.

To demonstrate the importance of wellness programs, Dr. Miller discussed a retrospective cohort study of 1095 members of Cerner’s health plan who were continuously enrolled from 2008 through 2010. Of the total study population, 396 had risk factors for chronic disease and 699 did not have risk factors.

After 3 years, the percentage of members who had reduced their risk score was significantly higher than the percentage whose risk scores increased (P<.0001). Among members whose risk scores decreased, glucose level, total cholesterol, tobacco use, blood pressure, and body mass index (BMI) declined.

At the 3-year follow up, members who had decreased risk cost $91 per member per month less than those who had increased risk. They also filled more prescriptions but at a lower cost per prescription and cost approximately $700 million less than the increased risk group during the 3 years.

The company also conducted a comprehensive database review of employer-sponsored wellness programs, according to Dr. Miller. It found that companies saved between $1.60 and $3.90 for every dollar spent on their programs. In addition, employee absences decreased and productivity increased. There were decreases in tobacco use, BMI, blood pressure, and lipid levels and an increase in exercise and better nutrition among employers implementing the wellness programs.

To study medication adherence, Cerner followed employees and their dependents for 1 year after they filled a prescription for asthma, depression, diabetes, hypertension, or hyperlipidemia between January 1, 2009, and December 31, 2009. Those who used on-site health centers had a significantly higher medication possession ratio across all of the conditions compared with those who used off-site centers (P≤.005).

Dr. Miller suggested on-site health centers can improve medication adherence by giving patients reminders via written notices, telephone calls, and text messages, implementing a system that automatically refills prescriptions, providing pill boxes to help patients remember to take their medications, and offering personalized medication therapy management counseling.

Dr. Miller also mentioned another Cerner study, a retrospective claims analysis and survey that found on-site chiropractic services were associated with lower healthcare utilization and improved the functional status of musculoskeletal conditions. Members who had on-site chiropractic services were significantly less likely to visit a physical therapist and have an outpatient visit compared with those who did not have on-site services (P<.0001). The on-site group had fewer physician visits, radiology procedures, musculoskeletal medication use, and physical therapy visits (P<.0001).