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Functional Medicine Care was Associated with Lower Pharmacy Claims Costs Among Ashland School District Employee
Background:
Musculoskeletal disorders are a leading cause of healthcare utilization and disability among the millions of school employees in the United States. While school-based workplace wellness programs have demonstrated improvements in health behaviors, the long-term financial impact of these programs remains unclear.
Objective:
Identify factors associated with health insurance claims costs within a school district featuring a workplace wellness program emphasizing health behaviors aligned with the functional medicine model of care.
Setting:
Ashland School District in Oregon, USA.
Participants:
Ashland School District employee health plan participants.
Methods:
Medical and pharmacy claims from 2010 to 2021 were included for analysis. Multivariate linear regression models of medical and pharmacy claims costs were constructed including year of claim, age, sex, baseline comorbidities, and whether the participant received functional medicine care.
Results:
The sample included 1,178 participants with musculoskeletal disorders and a total of 92,922 claims. Older age ($46.28 per year, P < .0001) and comorbidities ($258.24 per comorbidity, P = .03) were associated with higher yearly per member medical claims. Older age ($21.84 per year, P < .0001) and comorbidities ($335.62 per comorbidity, P < .0001) were also associated with higher yearly per member pharmacy claims. Receiving functional medicine care (-$534.81, P = .0002) was associated with lower yearly per member pharmacy claims. There were no meaningful changes in total medical or pharmacy claims costs over time after adjustment for covariates (P > .4).
Conclusion:
Medical and pharmacy claims remained stable over the study period among employee health plan participants with musculoskeletal disorders, and functional medicine care was associated with significantly lower pharmacy claims costs.
