Investing in Wellness: How a Cleveland Clinic Program Rewards Healthy Living

At Cleveland Clinic, supporting the wellness of caregivers and their families goes beyond providing excellent medical benefits. The organization is also incentivizing good health by discounting the insurance premiums of employees who take meaningful steps to improve and prevent chronic disease.

Launched in 2010, the institution’s Healthy Choice program highlights how healthcare systems can support their workforce by investing in employee wellness, says Bruce Rogen, MD, Chief Medical Officer of Cleveland Clinic’s Employee Health Plan.

“As an internal medicine physician, I’ve seen the physical and financial toll that diseases like diabetes, high blood pressure and heart disease can take on patients and their families,” he explains. “Fortunately, patients can improve their longevity and reduce the risk of long-term medical issues by investing in their own well-being. In turn, this self-care can help healthcare organizations reduce operational costs by minimizing the need for expensive emergency treatments and hospitalizations.”

Inside the program

Soon after arriving at Cleveland Clinic 16 years ago, Dr. Rogen and his dedicated team began devising a plan to offer health insurance premium discounts to employees who were willing to set and work toward personalized wellness goals. Encouraged by the idea of incentivizing healthy habits, the institution’s leaders also saw the approach as a smart way to support caregiver well-being while reducing overall organizational costs.

Participants follow one of two tracks based on their individual needs:

• Care coordination: Designed for those managing six chronic conditions: asthma, high cholesterol, diabetes, high blood pressure, weight management or tobacco use. This track provides personalized support tailored to each employee’s personal health goals.
• Preventive care: For individuals without one of the six chronic conditions, this path encourages physical activity and overall wellness by setting monthly step goals and promoting healthy habits.

In 2025, nearly 37,000 caregivers and their spouses – representing 47% of eligible health plan members – participated in the Healthy Choice program across both tracks.

Rapid success

When Healthy Choice first launched, not everyone was on board with the idea of tying health insurance discounts to the management of chronic disease. Dr. Rogen says some caregivers were skeptical, questioning why their weight mattered or why an insurance plan should be involved in their personal health choices. But as the program unfolded, perspectives began to change.

“Within a few short months, participants were losing weight, saving money on their premiums and feeling better overall,” he explains.

Dr. Rogen notes the initiative’s success reinforces what the team set out to prove: Effectively managing chronic conditions leads to better health and helps prevent serious, expensive complications down the line.

“For example, when diabetic patients received coordinated care and their blood sugar was better controlled, we see a sharp reduction in emergency room visits and hospitalizations,” he explains. “The longer-term benefits, including fewer amputations, infections and complications involving the heart or kidneys, take more time. But the immediate impact on acute care use has been clear.”

He notes that the organization has achieved a documented return on investment of 2:1 to 3:1 in cases involving asthma, diabetes and hypertension.

Another major success has been the program’s ability to improve medication compliance. The team states that caregivers who participate in the Healthy Choice program have some of the highest rates of staying on track with their medications for chronic conditions. Not only are employees taking their medications as prescribed, but they’re also being reimbursed for the cost, Dr. Rogen explains. As a result, participants are experiencing fewer complications and requiring fewer doctor visits – a win for employees and the healthcare system at large.

Incentivizing healthy habits

Dr. Rogen says building an outcomes-based employee wellness program takes more than just good intentions – it takes the right strategy. Based on their years of collective experience, he and his team offer several suggestions to other institutions interested in implementing a similar program:

1. Integrate your programs. Bring together all employee health efforts to build a unified strategy that makes a greater impact.
2. Leverage data. Use a combination of claims (medical and pharmacy), clinical and fitness data to identify health risks and build tools to actively manage populations.
3. Focus on care coordination. Make care coordination robust by including coaching, behavioral health resources, and access to risk-stratified registries for both high-risk and rising-risk individuals.
4. Recognize obesity as a chronic condition. Treat it with the same long-term, structured approach as other chronic diseases.
5. Eliminate financial barriers. Ensure that cost is not a barrier to care. This encourages people to take action that benefits their health.
6. Offer meaningful incentives. Offer strong, patient-centered financial incentives to motivate participation and improve outcomes.
7. Communicate effectively. Focus on positive messaging to promote engagement and trust.
8. Take it step by step. Roll out changes gradually to allow time for adjustment and long-term success.