title: Self-reported health risks linked to health plan cost and age group.
abstract: BACKGROUND
  Studies of private sector employee populations have shown an association between health-risk factors and healthcare costs. Few studies have been conducted on large, public sector employee populations. The objective of the current study was to quantify health plan costs associated with individual tobacco, obesity, and physical inactivity risks in Arkansas's state employee plan.
  
  
  METHODS
  De-identified medical and pharmacy claim costs incurred October 1, 2004-February 28, 2006 were linked with results from self-reported health-risk assessments (HRA) completed August 1, 2006-October 31, 2006. High- and no-risk groups were defined on the basis of cigarette use, BMI, and days/week of moderate physical activity. Annualized costs were compared between groups and across ages. Data were analyzed in September 2007.
  
  
  RESULTS
  Of the eligible adults (n=77,774), 56% (n=43,461) voluntarily accessed and completed an Internet-based HRA and had claims data-linked for analyses. Average annual costs across the eligible population totaled $3205. Respondents with high risks incurred greater annual costs ($4432) than those with no risks ($2382). Costs were greater among those with one or more risks, compared with no risks, and increased with age. The greatest average annual cost was for people aged 55-64 years in the high-risk group, who had a 2.2-fold higher cost than those aged 55-64 years in the no-risk group ($7233 versus $3266).
  
  
  CONCLUSIONS
  Healthcare costs increased with age and were differentially higher for those who used tobacco, were obese, or were physically inactive. The financial viability of the healthcare system is at risk, particularly in plans with a high proportion of adults with health-risk factors.
authors.affiliation: Arkansas Center for Health Improvement, Little Rock, Arkansas 72201, USA. rkhill@uams.edu
authors.forename: Rhonda K
authors.initials: RK
authors.lastname: Hill
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Thompson
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Shaw
authors.forename: Sathiska D
authors.initials: SD
authors.lastname: Pinidiya
authors.forename: Paula
authors.initials: P
authors.lastname: Card-Higginson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001131:Arkansas; D017049:Employer Health Costs / Q000706:statistics & numerical data*; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000191:economics; D017150:Public Sector; D012307:Risk Factors; D012907:Smoking / Q000191:economics; D013219:State Government; D055815:Young Adult