Relationship Between Modifiable Health Risks and Short-term Health Care Charges

Abstract

Sedentary lifestyle, obesity, and tobacco use are strongly related to a variety of long-term adverse health outcomes, and over a lifetime, have significant costs to society.^1,2 In formulating clinical policy and making resource allocation decisions, health care delivery organizations need to know the short-term relationship of modifiable health risks to health care charges. Managed care organizations (MCOs) attempt to maximize the value obtained from each health care dollar spent. Because adverse, modifiable health risks are detrimental to health and contribute to higher costs of health care, many MCOs may be interested in devoting resources to initiatives that favorably affect the health-related behaviors of their members. This is particularly true in light of recent reports documenting the efficacy of behavior change intervention strategies,³ lower health care charges with risk reduction,⁴ and a good return on investments in health-related behaviors.⁵ However, little financial data are available to guide resource allocation decisions, or to estimate the potential financial impact of programs that may modify health risks. Moreover, to our knowledge, no report has adequately controlled in the analysis for chronic conditions, which may confound the relationship of health risks to charges.