The impact of changes in health practices on medical claims costs between 1985-1987 and 1988-1990 was examined among 796 employees. Employees completed a health risk appraisal in 1985 and 1988 and were categorized into health risk levels. High-cost status and high-risk status were significantly associated at both times. The percentage of employees with high-risk status decreased from 31.8% to 25.3% between 1985 and 1988 (P < 0.01). Changes in average costs and the percentage with high-cost status followed the risk change. The largest increase in average costs occurred in employees who moved from low-risk to high-risk status. The greatest reduction in average costs occurred in employees who moved from high-risk to low-risk status. Median costs were not as sensitive to risk change. The findings provide strong evidence that improving individual health status is associated with financial benefits.

This study assessed the impact of health-promotion program participation on short-term and long-term disability absence days during a 6-year period in a manufacturing company. Male, hourly, active employees (n = 4189) were analyzed from 1995 to 2000. Disability absences were compared for program participants and nonparticipants from baseline (1995) through 5 years of the program. The percentage of nonparticipants absent on any given day was greater than that of participants. Moreover, the average number of disability absence days incurred by nonparticipants significantly increased from baseline to program year 5 compared with participants. The total amount saved each year in disability absence days for the 2596 program participants was $623,040, which resulted in a savings-to-cost ratio of 2.3 per year. Participation in worksite health-promotion programs may lead to reduced disability days in a manufacturing worksite population.

This study provides strong statistical evidence that, regardless of age and sex, employees in this sample with positive behaviors cost less in medical claims from 11 of 18 health-related measures.