Ten Modifiable Health Risk Factors and Employees’ Medical Costs—An Update

PURPOSE: To estimate the relationship between employees' health risks and health-care costs to inform health promotion program design. DESIGN: An observational study of person-level health-care claims and health risk assessment (HRA) data that used regression models to estimate the relationship between 10 modifiable risk factors and subsequent year 1 health-care costs. SETTING: United States. PARTICIPANTS: The sample included active, full-time, adult employees continuously enrolled in employer-sponsored health insurance plans contributing to IBM MarketScan Research Databases who completed an HRA. Study criteria were met by 135 219 employees from 11 employers. MEASURES: Ten modifiable risk factors and individual sociodemographic and health characteristics were included in the models as independent variables. Five settings of health-care costs were outcomes in addition to total expenditures. ANALYSIS: After building the analytic file, we estimated generalized linear models and conducted postestimation bootstrapping. Similar cost differentials were found when specific health-care services were examined. CONCLUSION: Employers may achieve cost savings in the short run by implementing comprehensive health promotion programs that focus on decreasing multiple health risks.