Work-site health promotion. Five-year trend in employee health care costs.

Participants in work-site health promotion programs are compared with other employees at the same work-site in terms of health care utilization as measured by insurance claims. Participants tended to incur higher health care costs than nonparticipants for the six-month period after the program began. However, a cohort analysis of one of the groups shows that participants' costs declined in relation to nonparticipants' for subsequent periods. Overall, for 4.75 years after the program, participants averaged 24% lower health care costs than nonparticipants. The imputed savings in health care costs exceeds program costs for this cohort by a factor of 1.45. The findings substantially strengthen the conclusions of other controlled studies that work-site health promotion reduces health care costs.