UPMC MyHealth

Managing the Health and Costs of U.S. Healthcare Workers


      Workplace wellness programs hold promise for managing the health and costs of the U.S. workforce. These programs have not been rigorously tested in healthcare worksites.


      To evaluate the impact of MyHealth on the health and costs of UPMC healthcare workers.


      Five-year observational study conducted in 2013 with subgroup analyses and propensity-matched pair comparisons to more accurately interpret program effects.


      UPMC, an integrated health care delivery and financing system headquartered in Pittsburgh, Pennsylvania. Participants included 13,627 UPMC employees who were continuously enrolled in UPMC-sponsored health insurance during the study period and demonstrated participation in MyHealth by completing a Health Risk Assessment in both 2007 and 2011, as well as 4,448 other healthcare workers employed outside of UPMC who did not participate in the program.


      A comprehensive wellness, prevention, and chronic disease management program that ties achievement of health and wellness requirements to receipt of an annual credit on participants’ health insurance deductible.

      Main outcome measures

      Health-risk levels, medical, pharmacy, and total healthcare costs, and Healthcare Effectiveness Data and Information Set performance rates for prevention and chronic disease management.


      Significant improvements in health-risk status and increases in use of preventive and chronic disease management services were observed in the intervention group. Although total healthcare costs increased significantly, reductions in costs were significant for those who moved from higher- to the lowest-risk levels. The contrast differences in costs between reduced- and maintained-risk groups was also significant. Matched pair comparisons provided further evidence of program effects on observed reductions in costs and improvements in prevention, but not improvements in chronic disease management.


      Incorporating incentivized health management strategies in employer-sponsored health insurance benefit designs can serve as a useful, though not sufficient, tool for managing the health and costs of the U.S. healthcare workforce.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Kochanek K, Xu J, Murphy S, Miniño A, Kung H. Deaths: preliminary data for 2009. Hyattsville MD: National Center for Health Statistics, 2011. National Vital Statistics Report No. 59.

      2. CDC. Chronic diseases and health promotion: chronic diseases are the leading causes of death and disability in the U.S.

        • Hoffman C.
        • Schwartz K.
        Eroding access among nonelderly U.S. adults with chronic conditions: ten years of change.
        Health Aff (Millwood). 2008; 27: w340-w348
        • National Business Group on Health
        The employee mindset: views, behaviors and solutions.
        Hewitt Associates, Lincolnshire IL2010
        • Goetzel R.Z.
        • Pei X.
        • Tabrizi M.J.
        • et al.
        Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending.
        Health Aff (Millwood). 2012; 31: 2474-2484
        • Burton W.N.
        • Chen C.Y.
        • Conti D.J.
        • Schultz A.B.
        • Pransky G.
        • Edington D.W.
        The association of health risks with on-the-job productivity.
        J Occup Environ Med. 2005; 47: 769-777
        • Burton W.N.
        • Chen C.-Y.
        • Conti D.J.
        • Schultz A.B.
        • Edington D.W.
        The association between health risk change and presenteeism change.
        J Occup Environ Med. 2006; 48: 252-263
        • Yen L.
        • Schultz A.
        • Schnueringer E.
        • Edington D.W.
        Financial costs due to excess health risks among active employees of a utility company.
        J Occup Environ Med. 2006; 48: 896-905
        • Pronk N.P.
        • Goodman M.J.
        • O’Connor P.J.
        • Martinson B.C.
        Relationship between modifiable health risks and short-term health care charges.
        JAMA. 1999; 282: 2235-2239
        • Goetzel R.Z.
        • Carls G.S.
        • Wang S.
        • et al.
        The relationship between modifiable health risk factors and medical expenditures, absenteeism, short-term disability, and presenteeism among employees at Novartis.
        J Occup Environ Med. 2009; 51: 487-499
        • Goetzel R.Z.
        • Anderson D.R.
        • Whitmer R.W.
        • et al.
        The relationship between modifiable health risks and health care expenditures—an analysis of the multi-employer HERO health risk and cost database.
        J Occup Environ Med. 1998; 40: 843-854
        • Pronk N.P.
        • Lowry M.
        • Maciosek M.
        • Gallagher J.
        The association between health assessment-derived summary health scores and health care costs.
        J Occup Environ Med. 2011; 53: 872-878
        • Mattke S.
        • Liu H.
        • Caloyeras J.P.
        • et al.
        Workplace wellness programs study: final report.
        RAND Corporation, Santa Monica CA2013
      3. Robert Wood Johnson Foundation. Commission to Build a Healthier America. Beyond health care: new directions for a healthier America. Princeton NJ, Robert Wood Johnson Foundation, 2009.

      4. Patient Protection and Affordable Care Act, S. 2705, 111th Cong., 2010.

        • Loeppke R.
        • Hymel P.
        Good health is good business.
        J Occup Environ Med. 2006; 48: 533-537
        • Loeppke R.
        • Taitel M.
        • Haufle V.
        • Parry T.
        • Kessler R.C.
        • Jinnett K.
        Health and productivity as a business strategy: a multiemployer study.
        J Occup Environ Med. 2009; 51: 411-428
        • Edington D.W.
        Zero trends: health as a serious economic strategy.
        Health Management Research Center, University of Michigan, Ann Arbor MI2009
        • Caloyeras J.P.
        • Liu H.
        • Exum E.
        • Broderick M.
        • Mattke S.
        Managing manifest diseases, but not health risks, saved PepsiCo money over seven years.
        Health Aff (Millwood). 2014; 33: 124-131
      5. Bureau of Labor Statistics. National employment data: databases, tables & calculators by subject.

        • Altarum Institute CSHS
        Health sector economic indicators.
        Altarum Institute, Ann Arbor MI2011
        • Towers Watson
        2012 health care 360 performance study for hospitals.
        Towers Watson, New York NY2012
        • HighRoads
        2011 hospital employer benefit survey.
        HighRoads, Burlington MA2011
        • Naydeck B.L.
        • Pearson J.A.
        • Ozminkowski R.J.
        • Day B.T.
        • Goetzel R.Z.
        The impact of the Highmark employee wellness programs on 4-year healthcare costs.
        J Occup Environ Med. 2008; 50: 146-156
        • Long D.A.
        • Sheehan P.
        A case study of population health improvement at a Midwest regional hospital employer.
        PHM. 2010; 13: 163-173
        • Gowrisankaran G.
        • Norberg K.
        • Kymes S.
        • et al.
        A hospital system’s wellness program linked to health plan enrollment cut hospitalizations but not overall costs.
        Health Aff (Millwood). 2013; 32: 477-485
        • UPMC Health Plan
        UPMC Health Plan wins Platinum Award from National Business Group on Health.
        UPMC Health Plan, Pittsburgh PA2012
        • National Business Group on Health
        National Business Group on Health honors 66 U.S. employers with Best Employers for Healthy Lifestyles awards.
        National Business Group on Health, Washington DC2012
        • Peirce P.
        UPMC wellness program applauded.
        Tribune-Review. 2013; 23
        • Edington D.W.
        Emerging research: a view from one research center.
        Am J Health Promot. 2001; 15: 341-349
      6. National Committee for Quality Assurance. HEDIS and Performance Measurement.

        • Loeppke R.
        Guidance for a reasonably designed, employer-sponsored wellness program using outcomes-based incentives.
        J Occup Environ Med. 2012; 54: 889-896