Higher 'Culture of Health' Scores Linked to Lower Health Care Cost Trends

Improving Corporate Health Can 'Bend the Curve' on Health Costs

Companies with higher 'culture of health' assessment scores (CHAS) show more progress toward controlling health care costs, reports a study in the June 2018 Journal of Occupational and Environmental Medicine.

"Higher CHAS scores are generally correlated with lower healthcare cost trend," according to the new research by Sharon Glave Frazee, PhD, MPH, of Frazee Research & Consulting, LLC, Beaufort, N.C. "As culture of health scores improve, healthcare cost trends moderate."

Several tools have been evaluated for assessing a culture of health: creating a corporate environment that promotes healthy behaviors while reducing health risks. The researchers analyzed the relationship between CHAS performance and health care cost trend data at 12 companies. The companies, ranging in size from medium to large, included a nearly 87,500 covered lives. The analysis included 21 assessments carried out between 2011 and 2016.

"In general, increasing CHAS scores are linked to lower healthcare cost inflation," the researchers write. The average CHAS result was 459 on a scale from 0 to 1,000, while the average health care cost trend was 4.8%. The results suggest that a 21- to 50-point increase in CHAS score would predict a 1% decrease in health care cost trend.

While more companies are trying to foster a culture of health, it can be difficult to show demonstrate that these efforts slow the trend toward ever-increasing health care costs. The development and availability of CHAS scores — based on factors including health claims and benefit design, worksite visits, and interviews with leadership, management, and employees — provides a new tool for measuring the return on investment of developing an organizational culture of health.

The study adds to previous evidence that increasing CHAS scores are linked to lower healthcare cost inflation. Dr. Frazee and coauthors conclude, "This research clearly shows that companies can bend their medical trend by building cultures of health and safety and adds to our growing literature that demonstrates the true value of creating a healthy and safe workplace."
About the Author — Dr. Frazee may be contacted for interviews at FrazeeResearch@gmail.com.

About ACOEM — The American College of Occupational and Environmental Medicine (www.acoem.org), an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

About JOEM — The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Fabius R, Frazee Glave S, Thayer D, Kirshenbaum D, Reynolds J. The correlation of a corporate culture of health assessment score and health care cost trend. J Occup Environ Med. 2018;60(6):507-14.