Posted 09.26.2016 | by AMRA

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Healthcare costs in the United States rose to over 17% of the Gross Domestic Product in 2015. Employers are increasingly turning to workplace-based lifestyle interventions to control employee healthcare costs. Mindfulness-based interventions (MBIs) are sometimes offered in workplaces to enhance employee self-care and decrease illness-causing stress. How well do workplace-based MBIs succeed in lowering employee healthcare utilization costs?

Using a quasi-experimental design, Klatt et al. [Complementary Therapies in Medicine] retrospectively analyzed 5-year healthcare utilization and the associated costs for participants in a workplace-based MBI and a workplace-based didactic diet-and-exercise program. The researchers then compared these utilization rates and costs with those of matched controls drawn from a health care database.

A sample of 170 faculty and staff members from a large Midwestern university was recruited and randomly assigned to either a MBI or the diet-and-exercise (DE) intervention. The participants were selected, in part, on the basis of their high C-reactive protein levels (3.0-10.0 mg/ml), which are a known risk factor in cardiovascular disease. The MBI was an 8-week program modeled after MBSR, but truncated to fit a lunch hour schedule. The weekly workplace-based group meetings lasted 1 hour, recommended home practice was 20 minutes per day, yoga consisted of standing and chair yoga, and a 2-hour retreat replaced the usual “all day” session. The DE intervention consisted of a series of 8, 1-hour-long, group didactic sessions focusing on nutrition, diet, and exercise along with associated home readings.

After the experiment was concluded, an additional cohort of 258 “controls” was selected from the university health plan database by matching the study participants as closely as possible on age, gender, relative health risk, and prior healthcare utilization. For statistical reasons, the researchers compared the MBI and DE interventions to the matched controls and not to each other.

The researchers analyzed university health plan records for participants and controls for the 5-year period after the interventions were completed. At the end of 5 years, both intervention groups had significantly fewer primary care visits than controls and trended towards fewer hospital visits and lower overall healthcare costs. Total MBI healthcare costs averaged $17,591, compared to $21,487 for DE participants and $25,788 for controls.

On the other hand, MBI and DE participants used significantly more pharmacy prescriptions with significantly higher pharmacy costs. MBI participants spent an average of $7,286 on an average of 100 prescriptions per person compared to $10,398 for 94 prescriptions for DE participants and $4,729 for 3 prescriptions for controls.

The study shows a non-significant trend toward the workplace interventions lowering overall healthcare costs, with MBI participants averaging $8,197 less over 5 years than matched controls. MBI and DE participants were significantly less likely to visit their primary care doctors and trended towards being less likely to be hospitalized, but filled significantly more prescriptions.

The study is limited by the possibility that the control cohort was not completely equivalent to the intervention groups, despite propensity matching. After all, the participants had volunteered for the intervention and made the commitment to attend, while the controls were passively selected from a database. Reference:

Klatt, M. D., Sieck, C., Gascon, G., Malarkey, W., & Huerta, T. (2016). A healthcare utilization cost comparison between employees receiving a worksite mindfulness or a diet/exercise lifestyle intervention to matched controls 5 years post intervention. Complementary Therapies in Medicine.

[Link to abstract]