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International Journal of Health Economics and Management

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01-03-2018 | Research Article

Taking the hassle out of wellness: Do peers and health matter?

Author: Shooshan Danagoulian

Published in: International Journal of Health Economics and Management | Issue 1/2018

Abstract

Despite substantial financial incentives provided by the Affordable Care Act and employers, employee enrollment in wellness programs is low. This paper studies enrollment in a wellness program offered along an employer-provided health insurance plan. Two factors are considered in the choice of health plan with wellness: the effect of peer choices and family health on plan choice. Using exclusively obtained data of health insurance plan choice and utilization, this paper compares similar plans and focuses on a subsample of new employees. Result show that peers affect own choice of health insurance: a 10 percentage point rise in the share of colleagues enrolled in Aetna Wellness increases the probability of own enrollment in the plan by up to 3.9 percentage points. This result suggests that lack of experience with a wellness program are key to employee reluctance to enroll. Health effect on probability of enrollment in Aetna Wellness ranges from a 3 percentage point decline to a 3 percentage point rise depending on the measure, suggesting that while wellness programs appeal to low- to medium-intensity users of medical services, they do not appeal to individuals with more severe medical conditions which might benefit most from better coordinated medical care.

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The Charlson Comorbidity Index tracks 22 comorbid conditions each assigned a score 1, 2, 3 or 6 depending on the risk of dying associated with each one (a higher score indicating a higher probability of mortality). For example, a score of 1 is assigned to myocardial infarction, congestive heart failure, peripheral vascular disease, dementia, cerebrovascular disease, chronic lung disease, chronic liver disease. A score of 2 is assigned to hemiplegia, kidney disease, diabetes, tumor, leukemia, lymphoma.

Developed at the Johns Hopkins Bloomberg School of Public Health ACG^® System (Version 10.0.1) uses diagnostic codes from claims and case-mix methodology to describe and predict population health care utilization and costs. The Adjusted Clinical Groups (ACG) are a series of mutually exclusive health status categories defined by morbidity, age, and sex. They are based on the premise that the level of resources necessary for delivering appropriate healthcare to a population is correlated with the illness burden of that population. Thus, individual diseases or conditions are placed into diagnostic groups based on five clinical dimensions: duration of condition, severity of condition, diagnostic certainty, etiology of the condition (infectious, injury, other), and specialty care involvement.

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Title: Taking the hassle out of wellness: Do peers and health matter?
Author: Shooshan Danagoulian
Publication date: 01-03-2018
Publisher: Springer US
Published in: International Journal of Health Economics and Management / Issue 1/2018
Print ISSN: 2199-9023
Electronic ISSN: 2199-9031
DOI: https://doi.org/10.1007/s10754-017-9221-0

At a glance: The STEP trials

Springer Medicine

Taking the hassle out of wellness: Do peers and health matter?

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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