Published in Population Health Management

Author(s): Patricia L. Harrison, MPH; James E. Pope, MD; Carter R. Coberley, PhD; and Elizabeth Y. Rula, PhD

Escalating health care expenditures highlight the need to identify modifiable predictors of short-term utilization and cost. Thus, the predictive value of individual well-being scores was explored with respect to 1-year health care expenditures and hospital utilization among 2245 employees and members of a health plan who completed the Well-Being Assessment (WBA). The relationship between well-being scores and hospital admissions, emergency room (ER) visits, and medical and prescription expenditures 12-months post WBA was evaluated using multivariate statistical models controlling for participant characteristics and prior cost and utilization. An inverse relationship existed between well-being scores and all measured outcomes (P≤0.01). For every point increase in well-being on a 100-point scale, respondents were 2.2% less likely to have an admission, 1.7% less likely to have an ER visit, and 1.0% less likely to incur any health care costs. Among those who did incur cost, each point increase in well-being was associated with 1% less cost, and individuals with low well-being scores (≤50) had 2.7 times the median annual expenditure of individuals with high well-being (>75) ($5172 and $1885, respectively). Also, well-being proved lowest among respondents who incurred more than $20,000, and was highest among those who incurred ≤$5000, with median scores of 71.1 and 80.3, respectively. These results indicate that individual well-being is a strong predictor of important near-term health care outcomes. Thus, well-being improvement efforts represent a promising approach to decrease future health care utilization and expenditures.

Key Takeaways:

  • Individual well-being is a strong predictor of near-term health care outcomes.
  • An inverse relationship was seen between well-being scores and utilization outcomes.
    • Each point increase in the well-being score was associated with 2.2% less likelihood in having a hospital admission, 1.7% less likelihood to have an ER visit, and 1.0% less likely to incur any health costs.
    • Among members incurring health care costs, each point increase in well-being score was associated with 1% less cost.
    • Well-being scores were lowest for members who had more than $20,000 in yearly health care costs, and highest for members who incurred $5,000 or less in yearly costs.
  • Programs working to improve well-being represent a new and promising approach to help decrease future health care utilization and costs.