Critique

Pacific Bell - FitWorks

The following assessment of program strengths and weaknesses has been abstracted from reviews by the Task Force on Program Selection of The Health Project. Where weaknesses are postulated, it must be taken into account that the review Task Force is very critical, that no programs are perfect, that the Award Winning programs have been selected from over 300 candidate programs and represent the very best, that the materials reviewed may have been incomplete, that suggested deficiencies may have resulted from incomplete understanding of the program by the reviewers or that any problems may have been corrected since the time of review.

Evaluation: "FitWorks" at Pacific Bell for 24,000 participants, 30,000 health risk assessments and 500,000 employee medical claims provided the base for measuring savings in 1993 of $5,800,000, a 2.15 ROI. 20 percent of claims come from retirees and a pilot retiree program is underway with evaluation scheduled for first quarter 1996.

High participation rates at 60 percent. Employees and families are involved. There is a low cost per participant. Longitudinal data is available. There is good corporate commitment. This is a comprehensive health promotion program that demonstrated some cost-savings and cost-effectiveness, plus some documented behavior change in the Breast Health Program. It is targeted toward the Healthy People 2000 goals and cost reduction goals. Evaluation was excellent. The approach is multidisciplinary. Offering programs to retirees is commendable. Satisfaction rates are high. Evaluation focus on behavioral efficacy, cost-savings, customer studies and bench marking best practices is impressive as are the results. There is a huge data base. There is a matched control group. The program was begun in 1988 and has been extended, thus has good longevity. Return on investment was 1.84 and 2.15 in 1992 and 1993 respectively. Greatest savings was from absenteeism reduction with three fewer days in members than the matched controls.

Participation should not serve as a proxy for outcomes. There may be self-selection bias in cost evaluations. Some of the research approach is retrospective. There is minimal conclusive health risk change data. They have not published. There may be too much focus on fitness; expansion of the program's scope should be encouraged. There is lack of good pre-implementation data for comparison to post-implementation data. There could be more focus on risk reduction.