Effects of Periodic Health Assessments among Enrollees in a Managed Healthcare Plan: A Four-Year Assessment

This retrospective study examined the impact of taking a periodic health assessment (PHA) on costs, service utilization, and health outcomes among members of an employer-sponsored managed healthcare plan. The PHA was offered as part of a larger employee wellness program that included chronic disease management and behavior change programs. A random sample of 500 enrollees completing a PHA between January and July 2007 was compared to a matched sample of 500 enrollees who did not take a PHA. Assessments include a baseline period (6 and 12 months prior to PHA completion) and follow-up (6, 12, 18, 24, 30 and 36 months after PHA completion). Healthcare costs and service utilization were examined over the 4-year period. Changes over time in biometric measures (glucose, cholesterol, triglyceride, blood pressure, and weight) were assessed. Mixed effects analyses found significantly lower overall costs among the PHA group by the end of the study, but higher costs and service utilization for primary care and preventive care services (compared to the non-PHA group). Significant improvements in health risk indicators were observed at the mid-point (18 months) and final assessment (36 months), indicating that health risk changes can be sustained over time for individuals taking a PHA. For example, average cholesterol decreased by 9.32 points at 18 months and by 17.49 points at 36 months. Continuing engagement with the program was demonstrated through multiple annual assessments (62% completed a PHA each year) and a greater level of utilization of wellness and lifestyle programs compared to the non-PHA group.