title: Comparative Effectiveness of Wellness Programs: Impact of Incentives on Healthcare Costs for Obese Enrollees.
abstract: BACKGROUND
  Employee wellness programs show mixed effectiveness results. This study examined the impact of an insurer's lifestyle modification program on healthcare costs of obese individuals.
  
  
  METHODS
  This nonrandomized comparative effectiveness study evaluated changes in healthcare costs for participants in two incentivized programs, an Internet-mediated pedometer-based walking program (WalkingSpree, n=7,594) and an in-person weight-loss program (Weight Watchers, n=5,764). The primary outcome was the change in total healthcare costs from the baseline year to the year after program participation. Data were collected from 2009 to 2011 and the analysis was done in 2014-2015.
  
  
  RESULTS
  After 1 year, unadjusted mean costs decreased in both programs, with larger decreases for Weight Watchers participants than WalkingSpree participants (-$1,055.39 vs -$577.10, p=0.019). This difference was driven by higher rates of women in Weight Watchers, higher baseline total costs among women, and a greater decrease in costs for women in Weight Watchers (-$1,037.60 vs -$388.50, p=0.014). After adjustment for baseline costs, there were no differences by program or gender.
  
  
  CONCLUSIONS
  Comparable cost reductions in both programs suggest that employers may want to offer more than one choice of incentivized wellness program with monitoring to meet the diverse needs of employees.
authors.affiliation: Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan; Institute for Social Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
authors.affiliation: Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Ananda
authors.initials: A
authors.lastname: Sen
authors.affiliation: Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Plegue
authors.affiliation: Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina; Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Maciejewski
authors.affiliation: Sport, Health, Activity Research and Policy (SHARP) Center, University of Michigan, Ann Arbor, Michigan; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Segar
authors.affiliation: Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan.
authors.forename: Mona
authors.initials: M
authors.lastname: AuYoung
authors.affiliation: Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Miller
authors.affiliation: Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan; Michigan State University College of Human Medicine, Midland, Michigan.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Janney
authors.affiliation: Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California; Division of General Medical Disciplines, Stanford University, Stanford, California.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Zulman
authors.affiliation: Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, Michigan; Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan. Electronic address: caroli@umich.edu.
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005081:Exercise Therapy / Q000191:economics / Q000379:methods; D005260:Female; D015438:Health Behavior; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics / Q000379:methods*; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000191:economics / Q000628:therapy*; D016272:Occupational Health / Q000191:economics; D012189:Retrospective Studies; D016138:Walking; D061217:Weight Reduction Programs / Q000191:economics / Q000379:methods*