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National medical journal documents success of King County employees in losing weight through innovative wellness program


King County Executive
Dow Constantine

National medical journal documents success of King County employees in losing weight through innovative wellness program


Employee wellness programs can play an important role in the nation’s health, according to a new study published in a national medical journal that documents sustained weight loss by King County employees


Employee wellness programs can play an important role in the nation's health, according to a new study published in a national medical journal that documents sustained weight loss by King County employees - results that King County Executive Dow Constantine says can provide a model for controlling the spiraling costs of health care.

"At a time when our nation is getting fatter and sicker, this study proves that King County employees are getting thinner and healthier," said Executive Constantine, who called it the most comprehensive study to date of weight loss associated with employee wellness programs.

Employees in the study lost weight while people in a comparable national sample gained steadily over the same period of time. Entitled "Short-term and Long-term Weight Management Results of a Large Employer-Sponsored Wellness Program," the study is published in the November 2011 issue of the Journal of Environmental and Occupational Medicine.

"Compared with other recent studies, King County's results are documented over a longer period of time and include many more participants, providing scientific evidence that workplace wellness programs can be effective in helping people lose weight and keep it off," said study leader John Scoggins, King County's health care economist.

The study examined the Body Mass Index (BMI) of 19,559 participants in the first year of King County's Healthy IncentivesSM program in 2006, and then followed 10,432 participants over five years. The study compares both groups to a national sample.

During their first year in the wellness program, King County employees lost 0.8 percent of their body weight while the national sample gained 0.3 percent - meaning the County employees collectively weighed 19 tons less than the national sample.

Over five years, more than 2,000 overweight or obese King County employees lost at least five percent of their weight, the point at which research shows significant health improvements for the individual.

On average, King County employee weight loss was sustained over time, according to the study. The mean BMI of King County participants fell in the first year, and while it grew very slowly during the four subsequent years, it hit a plateau that was still lower than where it started. The comparable national sample gained steadily throughout that time.

Besides losing weight, employees improved their health in 11 out of 13 areas since the inception of the County's program, with a corresponding decrease in their use of health care services. Most notably, the smoking rate among employees decreased by 40 percent, from 10 percent to 6 percent, leading to fewer medical claims for pneumonia, bronchitis and other respiratory illnesses associated with smoking.

The study found that King County's program was most successful for women, employees older than 60 years, African Americans, and those who did not graduate from college. Nationally, African Americans have the highest mean BMI and fastest BMI growth rate - yet in King County, African American employees who participated lost weight at nearly three times the rate of white participants.

Under King County's Healthy IncentivesSM program, employees take a written wellness assessment and complete an individual action plan in order to qualify for lower levels of health care cost-sharing. The County's program is distinguished from many others in that it rewards for participation instead of outcomes.

"Our approach is to treat our employees like grown-ups - we help them achieve their goals for good health rather than punishing them for poor health," said Executive Constantine.

At a time when governments and businesses everywhere are seeing their cost of employee health care rising, Executive Constantine credited the Healthy IncentivesSM program for dramatically lowering King County's projected costs - a significant efficiency that enabled him to reduce health care budgets by $23 million in 2011 and $38 million in 2012, and redirect the savings to preserve public services that would otherwise have been cut.

"Our Healthy Incentives plan is containing costs even better than we hoped, and the savings demonstrate that our employees' health and the County's fiscal health go hand in hand," said Executive Constantine.

Behind the health care savings was lower use of health care services; greater use of less-expensive generic drugs; and increased enrollment in a more cost-effective health-maintenance organization plan, Group Health, rather than the County's preferred provider plan. As a result:

  • Employees saved the County $3 million since the start of the new plan by choosing generic prescriptions over more expensive name-brand drugs, with the use of generics rising from 71 percent to 76.5 percent. These savings are expected to grow in the future.
  • Enrollment increased by more than one-third in the more cost-effective Group Health Cooperative plan since January, 2010, from 18 percent of all employees to 26 percent. Due in part to its emphasis on preventive care and evidence-based medicine, the Group Health plan costs the County on average $4,300 a year less per employee than the County's preferred-provider KingCareSM plan.
  • The portion of health care costs shared by employees increased, including a tripling of deductibles in the preferred provider plan, and a doubling of co-pays for brand-name drugs.

A link to an abstract of the journal article is available here.

Collaborating with Scoggins on the article were Karleen Sakumoto, Kerry Schaefer, Brooke Bascom, Don Robbins, and Caroline Whalen. Scoggins and the Employee Health and Well-Being Program will be conducting additional research on how much healthier the county's workforce is as a result of the Healthy IncentivesSM program.

More information on realized and anticipated health-related savings can be found at

King County Executive
Dow Constantine
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