Objective: To determine the return-on-investment, if any, for the health promotion program adopted by the University of Minnesota in 2006. Methods: Regression analysis was used to determine the cost-savings in annual health care expenditures associated with three components of the prop-am: a risk assessment, a risk management program, and a disease management (DM) program. Differences-in-differences equations with random effects were used to deal with selection bias. Results: The analysis suggests that the DM reduced spending by about $1375 per year for each participant. The risk assessment and risk management components had no effect on spending in this initial year. Conclusions: DM reduced health care spending at the University of Minnesota, but not enough to generate a positive return-on-investment. A number of factors m qualify this conclusion. (J Occup Environ Med. 2009;51:54-65)