Association between Exercise Frequency and Healthcare Costs Within an Employee Population at Duke University

Background: Several analyses indicate that employee populations with a body mass index (BMI) > 25 are associated with higher healthcare expenditures, increased workers' compensation and disability claims, and greater levels of absenteeism compared with normal weight employees. Modifiable risk factors, such as obesity and physical inactivity, are proposed to account for the greatest proportion of these costs. Objective: To determine if increased exercise frequency is associated with decreased healthcare costs among an employee population. Methods: This study used an integrated database linking employee demographics, health risk appraisal (HRA) information, and health insurance claims. Negative binomial regression, with a generalized estimated equations (GEE) approach, was used to analyze the relationship between self-reported exercise frequency and cost, adjusting for important covariates such as age, sex, race/ethnicity, calendar time period and BMI category. In addition, this report is supplemented with a limited review of the literature assessing the effect of workplace wellness programs on healthcare costs (Appendix). Results: This cohort contained 16154 individuals and 32044 person-years of health claims experience over ten years of data. A statistically significant association was found between exercise frequency and reductions in total annual medical and pharmacy costs paid independent of BMI category (p