ANN ARBOR—In the 1990s, the University of Michigan Health Management Research Center developed a wellness score as a way of measuring individuals’ overall health and providing them incentives to make or maintain positive lifestyle changes.

HMRC senior research analyst Louis Yen, who helped develop the system, now has confirmed a link between the wellness scores for a large employee population and medical claims costs for the employer. His findings are reported in the October issue of the Journal of Occupational and Environmental Medicine.

Wellness scores, ranging from 50 to 100, are calculated from information that individuals report on the HMRC’s Health Risk Appraisal, a health assessment questionnaire. The appraisal measures personal health status based on health behaviors, disease status and preventive services usage.

The study involved 19,861 active employees of General Motors Corp. who completed a Health Risk Appraisal (HRA) during 1996-97 and enrolled in indemnity or preferred provider organizations medical plans for the period of 1996-98, Yen said. The average age of the study group in 1998 was 46, with 46 percent aged 45 to 54, and 10 percent over age 54. Three-quarters of the participants were male.

Controlling for age, gender and disease status, HMRC researchers calculated group averages of medical claims costs, age and wellness scores. The predicted medical claims costs were then compared with the actual claims costs for each of the 19,861 individuals, Yen said. “There were no significant differences between the predicted and actual costs in each of the sub-samples.”

One point in the wellness score was associated with $56 in medical claims costs. An additional year of age adds $88, and an existing major disease adds $3,574 to the total medical claims costs, Yen said.

Although HMRC researchers have extensively documented the validity of the HRA’s wellness score in terms of future disease, this is the first study to show its direct association with medical claims costs.

Three areas determine an individual’s wellness score, HMRC Director Dee W. Edington said. Most important are 10 behavioral health risks: smoking status, physical activity, body weight, blood pressure, total cholesterol, HDL cholesterol, alcohol consumption, seat belt usage, illness days and self-assessment of health. A second area is mortality risks related to conditions such as heart disease, past stroke, cancer, diabetes, emphysema and chronic bronchitis. Prevention practices such as blood pressure and cholesterol measurements contribute the third component of the wellness score.

“The study illustrates the significant toll of an existing disease on medical claims costs,” Yen notes. “However, it also shows that people with an existing condition can nevertheless contain their medical costs through wellness practices. It appears economically beneficial to include preventive services, health promotion, risk reduction and disease management as part of a comprehensive worksite health program.”

For further information Dee W. Edington dwe@umich.edu, (734) 763-2462