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Medical Claims According to Wellness Program Participation for a Large Insurance Company in the United States

Objective: The aim of this study was to identify the number and total cost of medical claims for members of the Municipalities, Colleges, Schools Insurance Group by participation status in a comprehensive incentive-based wellness program. Methods: Analyses are based on 6810 members during 2013 to 2016. The wellness program began in 2014. Results: Approximately 32.5% women and 22.9% men (P < 0.0001) participated in the wellness program. In 2013, those who participated in 2014 to 2016 filed a higher number of medical claims (P = 0.0004), but their total cost of claims was similar to those who did not participate in 2014 to 2016. By 2016, participants in the wellness program on average filed 3.6 (P = 0.0102) fewer claims and experienced $1346 (P = 0.0011) lower total cost of claims. Conclusion: Wellness program participation was associated with a lower number and total cost of medical claims.