New Peer-Reviewed Paper Published: Framework for Assessing Wellness …. in Journal of Health and Productivity

Abstract (Link for PDF of entire paper below)


To provide a framework for the evaluation of the financial impact of wellness programs compared to an alternative (standard community care or another wellness program).


Review the components that contribute to measuring the cost of wellness program (the “input”) and their benefits (the “output”) based on the wellness literature and interviews with consumers and producers of wellness programs.


Wellness program costs include those directly related to the wellness organization and its vendors, costs incurred by the purchaser of wellness programs, and costs incurred by the participants.

Outcome metrics used to assess wellness program benefits can based a number of different outcome metrics include direct costs from insurance claims cost;  cost extrapolated from health risk assessments, worker productivity surveys, health activity measures, or clinical measures (e.g., statin use).  The calculation of the wellness benefits themselves, however, must be based on a difference calculation between the expected change in outcomes (i.e. without the wellness program) and the observed change (i.e. with the specific wellness program).    

The benefits measures can be influenced by two different kinds of bias, or error:  random (or non-systematic) bias and non-random (or systematic) bias.  Methods to assess the impact of random bias include the use of statistical tests.  Methods to address non-random bias include the application of rigorous evaluation designs to minimize non-equivalence between populations used to generate the “expected” outcomes compared to the population(s) used to generate “observed” outcomes. The attribution method actually employed to assess program benefit should be judged to determine the “strength of evidence” of the claim that the wellness program was a plausible cause of the outcomes reported.


The basic framework of the financial benefit of a wellness program should include cost, benefit, and the cost-benefit ratio should include
a) The description of the wellness program costs and the components of costs;
b) The description of the attribution method used to calculate benefit,
c) A rating of the strength of the evidence of the claim that the wellness program was a cause of the benefits reported.