Medical Claims According to Wellness Program Participation for a Large Insurance Company in the United States.

Abstract

The aim of this study was to identify the number and total cost of medical claims for members of the Municipalities, Colleges, Schools Insurance Group by participation status in a comprehensive incentive-based wellness program. Analyses are based on 6810 members during 2013 to 2016. The wellness program began in 2014. Approximately 32.5% women and 22.9% men (P < 0.0001) participated in the wellness program. In 2013, those who participated in 2014 to 2016 filed a higher number of medical claims (P = 0.0004), but their total cost of claims was similar to those who did not participate in 2014 to 2016. By 2016, participants in the wellness program on average filed 3.6 (P = 0.0102) fewer claims and experienced $1346 (P = 0.0011) lower total cost of claims. Wellness program participation was associated with a lower number and total cost of medical claims.