Working Paper: NBER ID: w24229
Authors: Damon Jones; David Molitor; Julian Reif
Abstract: Workplace wellness programs cover over 50 million workers and are intended to reduce medical spending, increase productivity, and improve well-being. Yet, limited evidence exists to support these claims. We designed and implemented a comprehensive workplace wellness program for a large employer with over 12,000 employees, and randomly assigned program eligibility and financial incentives at the individual level. Over 56 percent of eligible (treatment group) employees participated in the program. We find strong patterns of selection: during the year prior to the intervention, program participants had lower medical expenditures and healthier behaviors than non-participants. However, we do not find significant causal effects of treatment on total medical expenditures, health behaviors, employee productivity, or self-reported health status in the first year. Our 95% confidence intervals rule out 83 percent of previous estimates on medical spending and absenteeism. Our selection results suggest these programs may act as a screening mechanism: even in the absence of any direct savings, differential recruitment or retention of lower-cost participants could result in net savings for employers.
Keywords: Workplace wellness programs; Medical spending; Employee productivity; Health behaviors; Randomized controlled trial
JEL Codes: I1; J3; M5
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Financial incentives (M52) | Participation in wellness programs (I19) |
| Participation in wellness programs (I19) | Completion rates of health screenings and HRAs (I11) |
| Advantageous selection (C52) | Participants had lower baseline medical spending (H51) |
| Wellness program participation (I19) | Total medical expenditures (H51) |
| Wellness program participation (I19) | Health behaviors (I12) |
| Wellness program participation (I19) | Employee productivity (J24) |
| Wellness program participation (I19) | Self-reported health status (I14) |
| Wellness programs (I19) | Screening mechanism (C24) |