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.

Results: Health-care costs were significantly higher for employees at higher risk for blood glucose, obesity, stress, depression, and physical inactivity (all at < .0001) than for those at lower risk. 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.